Asthma Awareness Month

Students Lead the Way on Climate Change

In recognition of Asthma Awareness month, we recently had the pleasure of visiting Dr. Phillips High School in Orlando where we were greeted by a group of incredibly knowledgeable and passionate students enthusiastic about environmental issues. Our discussion ranged from upcoming legislation and the role of EPA in improving air and water quality to pollution and how we can live healthier, cleaner lives, especially with growing threats from climate change.

The juniors and seniors at Dr. Phillips high school explained to us how they were learning to reduce pollution and environmental health concerns such as asthma.  These kids are doing great work, but Orlando, is not the only place where these students can be found. College Board Statistics showed that at least 118,000 students were enrolled in AP Environmental Science (APES) classes across the country in 2013, which is 10,000 more students than the year before. Interest in the environment is growing among this demographic at an amazing rate. More

Editor's Note: The views expressed here are intended to explain EPA policy. They do not change anyone's rights or obligations.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

EPA Working to Help Children in Puerto Rico Breathe Free

May is Asthma Awareness Month and I took the opportunity to spend part of the month traveling to several cities where asthma is a problem to raise awareness about this serious childhood illness and the importance of asthma intervention and education.

In San Juan, Puerto Rico, I visited the St. Jorge Children’s Hospital and met asthmatic children, their parents and doctors and health professionals who are working to better understand the illness and ways to reduce its incidence. They spoke from experience about the often devastating effects of the illness on people’s lives – family concern and disruption, increased medical expenses and lost days of school and work. More

Editor's Note: The views expressed here are intended to explain EPA policy. They do not change anyone's rights or obligations.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Ashlynn’s Plan

By Heather Duncan, Region 7 Water, Waste & Pesticides

asthma

My daughter Ashlynn is seven years old. She loves the color pink. She enjoys reading but she would rather play outside. She is a daddy’s girl. Her favorite school subject is math. She dreams of being a spy someday.

And, my daughter has asthma.

Ashlynn’s asthma is triggered by sudden changes in the weather (otherwise known as spring and fall in the Midwest), respiratory viruses, acid reflux, poor air quality, and by dry ice at high school theatrical productions. (You can imagine how “fun” it was to discover that last one…)

No matter how well controlled it is, asthma redefines a family’s version of normal routine. Our family has had five years to adjust to our version of normal. It currently includes:

  • An asthma action plan involving a full rainbow of colored inhalers and nebulizer treatments with names like Dulera®, Flovent®, albuterol, and DuoNeb®;
  • A calendar on the kitchen counter, where we track Ashlynn’s asthma symptoms and her yellow and red zone medication doses;
  • Family budget line items for co-pays, annual family flu shots, monthly prescription refills, and caffeine (that last one is for me, not for Ashlynn);
  • A roll of quarters in the glove box of my vehicle, for the vending machines during an unexpected journey to the emergency room; and
  • A thankfulness for our employers who understand when our family’s schedule changes suddenly – and for the medical insurance they provide.

In other words, our routine involves accepting that from August to April, normal is just a setting on the dryer. The goal of Ashlynn’s asthma action plan is to prevent asthma from being her limiting factor. That goal is a family goal, and most days, we accept whatever version of normal comes with it.

And, we hope for a better day tomorrow.

Implementing The Plan

3:07 p.m.        Just as the meeting conversation picks up, my cell phone buzzes. Caller ID says “Pathfinder Elementary”. I duck into the hallway to answer the call before it goes to voicemail.

3:11 p.m.        I thank Nurse Brooke and hang up the phone, sighing with relief. Thank goodness for amazing school nurses, I think. I step back into the room and reengage with the meeting.

5:35 p.m.        Ashlynn tells me about her day as we walk out of after school club. “I was squeezy after recess. Nurse Brooke gave me my rescue inhaler,” she relays. “How are you feeling now?” I ask. “A little better,” she says hesitantly. Probably time for the yellow zone of her asthma action plan, I remind myself.

5:40 p.m.        I set out the yellow zone inhaler when we get home. Ashlynn takes a daily controller medication in her green zone, and she adds a second controller medication during her yellow zone. There is also a red zone. The red zone is not fun. We hope it doesn’t come to that this time.

6:45 p.m.        Was that a cough I heard? I glance at the clock. It’s been less than four hours since her last asthma treatment. After my not-so-subtle Mom stare, Ashlynn gives in. “Four puffs of your red albuterol inhaler…,” I remind her. Dulera®, Flovent®, albuterol, prednisone… Asthma is a language all its own!

7:15 p.m.        “Mommy, I’m still squeezy,” Ashlynn says, wearily. Her hands jitter from the side effects of the albuterol. I begin to think through our asthma action plan options. Do we try an albuterol stack? “Let’s get your nebulizer and the iPad. You can watch a movie while you take your next treatment.” Ever the daddy’s girl, Ashlynn climbs on her father’s lap to finish her treatment.

8:30 p.m.        Ashlynn’s bedtime. As I tuck her in, I wonder how long the medicine will hold her. Asthma is usually worse at night than during the day, and well, today wasn’t that great. Best get to bed early yourself, Heather. Get some sleep while you can. Meanwhile, I ponder what may have triggered this attack. Was there a big weather change? Is she coming down with a cold? How was Kansas City’s air quality today? Most times, we can point to something.

9:22 p.m.        “I’ll take the first shift,” Jason says. My husband and I have learned to subdivide the night during asthma flares. First shift means asthma duty from bedtime until 1am; second shift involves from 1am to wakeup. This way, we’re both guaranteed a few hours of sleep and someone is fresh enough to help the rest of the family get ready in the morning.

5:15am           I turn off my alarm clock and wander to the kitchen. Ashlynn’s asthma calendar – the calendar where we track her asthma symptoms and her yellow and red zone medication doses – sits on the kitchen table. Only one treatment after bedtime... Not too bad!

6:35am           Ashlynn is not a morning person.

6:40am           Ashlynn begrudgingly gets out of bed, and trudges to her closet to pick and accessorize her outfit. Odds are, she’s wearing something pink.

6:52am           Cough.

6:54am           Cough. Coughcoughcough.  Sometimes, getting out of bed is too much activity for an already irritated airway. I instinctively load another DuoNeb® treatment in the nebulizer.

7:15am           After the treatment, the coughs have subsided, and Ashlynn’s takes her daily and yellow zone medications. I leave a voicemail for Ashlynn’s asthma coordinator at the pediatrician’s office – they will want to know we’ve used four treatments in the past 24 hours.

7:25am           Jason and I agree Ashlynn should go to school today. I shoot a quick email to Nurse Brooke and Mrs. McCall, letting them know how the overnight went and when Ashlynn’s last treatment was. The goal of Ashlynn’s asthma action plan is to prevent asthma from being her limiting factor. Most days, we succeed. Today, even as her asthma flares, Ashlynn will get to be a first grader who loves math class. We hope for an uneventful day today, a restful night tonight, and a better day tomorrow.

Heather Duncan has been with EPA Region 7 since 2006. Since 2006, Heather has also married her husband, purchased a house, gave birth to three children (one with special medical needs), and unsuccessfully attempted to give up caffeine three times.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Getting the Right Asthma Care to People Who Need it Most: Recognizing Community Asthma Leaders

By Gina McCarthy

We’ve done quite a bit this May to raise awareness on asthma. As this Asthma awareness month comes to a close, I want to remind folks about the important work that’s going on in communities across the country to help families manage asthma.

Nearly 26 million Americans, including seven million children, are affected by asthma, and according to the Centers for Disease Control and Prevention (CDC), minority children living in poor socioeconomic conditions are at greatest risk.  Poor and minority children are more likely to have asthma and their health outcomes are worse. For example, black children are twice as likely to be hospitalized and four times as likely to die from asthma as white children. The annual economic cost of asthma, including direct medical costs from hospital stays and indirect costs such as lost school and work days, amounts to approximately $56 billion.

This year’s National Environmental Leadership Award in Asthma Management winners  are all taking steps to address these issues, including finding innovative ways to meet the needs of disproportionately impacted populations. This award is the highest recognition a program and its leaders can receive for delivering excellent environmental asthma management as part of their comprehensive asthma care services.

The 2013 award-winning programs are working in communities to get the right care to some of the people that need it the most, and EPA applauds their innovative approaches and dedication:

Greenville Health System, Greenville, South Carolina: a multidisciplinary, multilingual, family-centered program providing asthma care and management support for over 4,000 children and adolescents with asthma, especially those who have limited access to health care. Their program includes a partnership that provides home visits through a parent-to-parent support network which has led to a 71 percent decrease in urgent health care utilization.

North East Independent School District, San Antonio, Texas: an urban, diversified school district whose Asthma Awareness Education Program targets more than 8,000 students in the district with asthma. This district implements interventions that have resulted in a 70 percent reduction in annual emergency transports to hospitals during the school day.

Parkview Health System, Fort Wayne, Indiana: a nonprofit health care provider addressing the growing incidence of asthma-related illnesses in the urban, suburban and rural populations they serve. An important program component includes their Emergency Department (ED) Asthma Call Back Program that reduced repeat ED visits for asthma from almost 22 percent at baseline to 15 percent in the intervention year.

I want to thank these and the thousands of other organizations that are working to make life better for families and communities across the United States and I look forward to continuing our work together.

I also want to thank the team in our Office of Radiation and Indoor Air for their great work in making Asthma Awareness Month a success. Their efforts are helping to raise public awareness, strengthen partnerships and advance comprehensive asthma management.

Please read more about Asthma Awareness.

About the author: Gina McCarthy is the Assistant Administrator for EPA’s Office of Air and Radiation.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Asthma: Public Health Issue for Hispanics

Several links below exit EPA Exit EPA Disclaimer

By Fedora Cagnoli Braverman

Haga clic en la imagen para unirse a la conversación en nuestro blog en español… ¡No olvide de suscribirse!

May is not only the month when April flowers bloom, it’s also Asthma Awareness Month.

According to MedlinePlus en español, asthma is a disease that affects your airways. It causes repeated episodes of wheezing, coughing, chest tightness and shortness of breath. It is a condition that could go from being a nuisance to extremely serious. If you don’t suffer from it, you probably know somebody who does.

But, why is asthma a public health concern? There are several reasons. Among them, it’s a chronic disease that can worsen the quality of life for the sufferer. Unfortunately, more and more people are being diagnosed with this condition.

For Latinos, though, asthma is a problem that requires attention because statistics show Hispanics are more vulnerable to it. According to the Office of Minority Health, HHS, we are more likely to visit a hospital because of asthma than non-Hispanics. Asthma is also a big problem for our children. Hispanic children are nearly twice as likely to die from asthma than non-Hispanic children. Asthma is such an important public health issue that the National Library of Medicine published several pages on its bilingual magazine (where you can see the statistics stated before) about this condition.

As a mom of two, these numbers really caught my attention. Is it possible that genetics makes us such a high risk group? There could be other problems besides genes including access (or often, lack thereof) to health information.

But thanks to years of research, there is a growing awareness about detection and management of asthma. According to EPA, it’s important to know what could trigger asthma (allergies, tobacco smoke, pollution, chemicals, upper respiratory infections, etc.) and to avoid these triggers to prevent symptoms from flaring or worsening.

If you have a small child with asthma, it’s important that you learn how to recognize the symptoms and talk to your health care provider. Otherwise, you could experience what happened to me when my son came running to me saying that his chest hurt and he couldn’t breathe. We rushed to the emergency room only to discover that he gulped too many cheese crackers at once.

Be smart: Know the symptoms, know when to get medical attention in case of an attack and, above all, leave cheese crackers out of children’s reach.

About the author: Fedora Cagnoli Braverman is responsible for developing and maintaining MedlinePlus and  MedlinePlus en español, the government web site for consumer health information in Spanish from the National Library of Medicine – NIH.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Putting Together the Pieces for Award-Winning Research


imageBy Dustin Renwick

People often invoke the Rubik’s cube as a metaphor for deep, multifaceted ideas. Although math supports the premise, the cube is still a toy with colored squares.

Human diseases, on the other hand, represent more intricate puzzles.

Take asthma, for example. May is asthma awareness month, and the disease affects an estimated seven million U.S. children.

“It’s a complex disease,” said Jane Gallagher, an EPA health research scientist. “We’re trying to understand the interplay between the genetic and environmental factors that we know are important to the underlying the pathology.”

To match the puzzle that is asthma, Gallagher worked with a diverse set of individuals from across the country that included experts from other organizations within EPA as well as academic researchers and post-docs – a team filled with “doers and problem solvers.”

Team members specialize in a range of aspects that contribute to childhood asthma, from genetics and behavior to indoor and outdoor air quality. With its collective expertise, the team examined relationships between environmental exposure, physiological markers, genetic susceptibility and asthma-related health outcomes.

Such a variety of knowledge meant the team could begin connecting the threads that run through the entire process of how asthma affects a child, a process called the “exposure-to-health-outcome paradigm.”

“We’re trying to integrate all those factors so the study is not so siloed or focused on only a few of the many factors that play a role in asthma,” Gallagher said.

Her team collected fingernail, blood, and urine samples to explore how genetic markers could relate to clinical indicators – for example, sensitivity to allergens or impaired lung function.

Peers in EPA’s Office of Research and Development voted Gallagher and her team one of a dozen Top Innovators during PeerOvation, an internal effort to recognize creative solutions and innovative ideas.

About the author: Dustin Renwick works as part of the innovation team in the EPA Office of Research and Development.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Asthma Awareness Month: Tackling Prevention

By Sally Darney 

SoccerplayerwithballWhen my daughter decided to join a soccer team, I was delighted.  Sports would provide healthy exercise, along with a host of other physical and mental benefits.  So we were dismayed when she complained of tightness in her throat and difficulty breathing during the games.

A trip to the doctor revealed “exercise-induced asthma,” but thankfully she was able to manage her symptoms with an inhaler and stay on the team.  I had little awareness of this disease at the time, but now know that childhood asthma is common, affecting nearly one in ten American children.

This month we celebrate Asthma Awareness Month learning about asthma triggers and the latest advances in medical treatment and comprehensive care for our children.

But what causes asthma to begin with?  Asthma is a curious disease that can first appear in toddlers, school-aged children like my daughter, or even in adults. Furthermore, studies have shown ethnic and economic-related disparities of who is most at risk. African American children, children of certain Hispanic groups, and children living in poor communities are more likely to get asthma, and to suffer more severe attacks, than Caucasian children and those in the higher social-economic groups. (For more information, download America’s Children and the Environment.)

This disparity suggests that the causes of asthma involve a complex interplay of environmental and social-economic factors, which in turn interact with a genetic-based predisposition. These factors can  play a role in both causing the disease itself, and in exacerbating the symptoms.

EPA researchers and partners from across the federal government are banding together to address asthma causes and disparities.  I was fortunate to be on the taskforce behind the landmark report: The Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities.

Working with scientists from the Centers for Disease Control and Prevention, the U.S. Department of Housing and Urban Development, and other agencies, EPA is helping implement the Plan, which emphasizes how research into the causes of asthma can help inform ways to tackle this burdensome disease.

We can’t change our genetics, but we can change the “environmental stressors” that contribute to, and cause, asthma.  To advance that work, researchers in ORD and from across the network of Centers for Children’s Environmental Health and Disease Prevention, co-sponsored by EPA and the National Institutes of Environmental Health Sciences, are exploring causes of asthma that can be prevented even before a baby is born. For instance, recent research has revealed that women who smoke during pregnancy, or are exposed to high levels of air pollution and/or certain environmental chemicals, are at increased risk of having a baby who develops asthma as a child.

Armed with more knowledge about the causes of asthma, pregnant women, mothers of young children, health care providers and decision makers can take actions to avoid risky exposures and provide healthy, asthma-free environments for women and children—preventing asthma from the start.

I’ll never know why my daughter got asthma, but I am happy to work at a place that is looking to prevent it. I have faith that together our research will do that, and eliminate racial and ethnic asthma disparities. Whether you play soccer or not, it’s a goal we can all shoot for.

About the Author: Sally Perreault Darney, Ph.D. is a senior health scientist at EPA working on  coordinating Agency research on children’s environmental health.      

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Tackling Asthma: On and Off the Field

Several links below exit EPA Exit EPA Disclaimer

By Chris Draft

While playing linebacker in the NFL for 12 years, I am proud to say I achieved much success during my career. But maybe my greatest accomplishment is just being on the field with asthma. There was a time when asthma would have been considered too great an obstacle to overcome to achieve pro football status. By being proactive and working with my physician to identify my asthma triggers, I was able to show that asthma does not have to be a setback in life.

I am one of approximately 25 million people across the U.S. who has asthma. People often ask me what it was like to play in the NFL with asthma, and my response is I don’t know what it was like to play in the NFL WITHOUT asthma. Asthma is a part of me and I’m pleased to be able to use my voice to show that asthma can be overcome.

During the last few years, I have been proud to partner with EPA to promote the message that asthma does not have to limit what you can achieve in your life. The Asthma Team at the Chris Draft Family Foundation, works to promote asthma awareness and education across the country.

These days, I am tackling asthma off the field. I continue to charge on in my campaign to raise awareness and help others triumph over asthma. During Asthma Awareness Month, I hope to inspire others by showing them how I achieved my success in controlling asthma. I can summarize it in a very simple statement: “Asthma can’t stop me, so don’t let it stop you.”

About the author: A former NFL linebacker, Chris Draft is also the Founder, President, and CEO of the Chris Draft Family Foundation (CDFF), a non-profit organization dedicated to empowering families to live healthy lifestyles.  Draft is a nationally recognized community leader and health advocate who serves as an NFL Ambassador, National Ambassador for the Parent Teacher Association, and a national spokesperson on many health-related issues, including the care and treatment of asthma, from which he suffers, and lung cancer, the disease that claimed the life of his wife, Keasha, late last year.

A leader both on and off the field, Draft has received a number of awards and honors for his tireless work in the community.  Learn more about his accomplishments.

See Chris’s EPA asthma public service announcement

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Asthma Awareness Month: Part III

By Elias Rodriguez

On a rainy, Friday the 13th the last in a long line of seven children was born to a Puerto Rican immigrant in Manhattan’s Beth Israel Hospital. Yep! The Big Apple welcomed me as a native New Yorker once upon a time, but no one gave me a “heads-up” about New York City’s poor air quality. Sometime around grade school I recall seeing my classmate suffer a wheezing, intense, asthma attack. Thankfully, the teacher knew what to do and she had his inhaler handy. Having an Asthma Action Plan is one of the key tips EPA offers to people who suffer from asthma. Folks can learn to control their symptoms and still maintain active lifestyles.

Here are some simple steps:

Know your Asthma Triggers and Avoid Them: Air pollution, dust mites, mold, secondhand smoke and even cockroaches can trigger asthma attacks. Learn your triggers and avoid them in your home and neighborhood.

Create an Asthma Action Plan: You can help avoid the emergency room by managing your asthma daily. With a doctor’s help, you should create an asthma action plan to help you effectively manage your asthma and reduce exposure to triggers.

Get Active: Even if you have asthma, by taking the appropriate medications and avoiding your triggers, you can still participate in sports and activities.

Be ‘Air Aware': Check local air quality conditions at airnow.gov and make informed decisions about participating in outdoor activities.

Effective execution of clean air laws has improved air quality in New York City significantly, yet it still remains important for people to manage their asthma by knowing the warning signs of attacks, avoiding things that can trigger asthma attacks, and following the advice of their healthcare providers. Children are especially vulnerable, but can learn to manage their asthma at an early age with the help of their doctors, teachers, friends, and families. So, keep up the good fight and learn to breathe easy!

About the Author: Elias serves as EPA Region 2’s bilingual public information officer. Prior to joining EPA, the proud Nuyorican worked at Time Inc. conducting research for TIME, LIFE, FORTUNE and PEOPLE magazines. He is a graduate of Hunter College, Baruch College and the Theological Institute of the Assembly of Christian Churches in NYC.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Asthma Awareness Month: Part II

By Elias Rodriguez

New York City is home to 8,391,881 people, if you go by the latest U.S. Census Bureau estimates. Lately, I’ve blogged about asthma because May is Asthma Awareness Month and this chronic respiratory condition is especially tough when you live in a mega metropolis like New York City.

Living, working and playing in the Big Apple is wonderful, but our combination of people, pollution, cars, trucks and 24/7 activity makes for some poor air quality.

Pollutants in the outdoor air, including particulates (soot) and ozone (smog) are major asthma triggers. When ozone levels increase, most commonly in the summer months, they can affect people’s health, especially children with asthma. Ozone can irritate the respiratory system, causing coughing, throat irritation, and aggravating asthma. When ozone levels are high, more people with asthma have attacks that require a doctor’s attention or medication. Asthma triggers include pets, pesticides, cockroaches, dust mites, mold and secondhand smoke. Ozone makes people more sensitive to allergens, which are common triggers of asthma attacks and lead to increased hospital admissions and emergency room visits.

Asthma hospitalization rates in NYC have been gradually declining since their peak in the mid-1990s. Yet, in some areas of the City, asthma rates can be found in the double digits.  It is insightful to look at asthma hospitalization rates because it is the most common cause of hospitalization for children 14 years and younger. In NYC, the asthma hospitalization rate per 1,000 (ages 0 to 14 years) is 9.2 in Bronx, 4.1 in Brooklyn, 4.0 in Manhattan, 3.9 in Queens, 2.0 in Staten Island and 5.0 for New York City. Hunts Point – Mott Haven in the Bronx has a rate of 11.5 and East Harlem in Manhattan has a rate of 11.2  Asthma is a leading cause of missed school among children and many New Yorkers suffer from poor control of their asthma.

In my next blog, I share how people who suffer from asthma can learn to control their symptoms and still maintain active lifestyles.

About the Author: Elias serves as EPA Region 2’s bilingual public information officer. Prior to joining EPA, the proud Nuyorican worked at Time Inc. conducting research for TIME, LIFE, FORTUNE and PEOPLE magazines. He is a graduate of Hunter College, Baruch College and the Theological Institute of the Assembly of Christian Churches in NYC.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.