Greenversations

By Carmen Torrent

Recently, I had a respiratory problem and had to use an inhaler to breathe better. It’s very difficult to describe the sensation of helplessness that I felt because I never experienced something like that before. I was very lucky because I was with two of my colleagues who knew what to do due to their training. That experience has increased my passion to continue my outreach efforts at EPA educating the Latino community about Indoor Air Quality (IAQ) and asthma management.

I am the EPA project officer working with a Turabo University in Puerto Rico project led by Dr. Teresa Lipsett. This project, Indoor Air Quality Champions in Puerto Rico, is funded by EPA. Dr. Lipsett and her team of students, teachers, and volunteers are known for their enthusiasm for increasing the knowledge about indoor air quality (IAQ) and asthma management in public schools in Puerto Rico. Puerto Rico has one of the highest rates of asthma in the world; about 30% of Puerto Rican children have asthma.

Among the main objectives of this project are: increase the number of public schools with effective indoor air quality management practices and plans based on the EPA IAQ Tools for Schools program; create an asthma friendly environment; transforming school teachers into IAQ champions thru IAQ education and support; and build local capacity to create and sustain and IAQ programs in participating schools.

The University of Turabo team translated the IAQ Tools for Schools guidance and adapted it to the Puerto Rican culture to be used at participating schools. As part of this project, team members conduct IAQ trainings, host educational panel and conferences, created ecological clubs (EKOLOG), maintain a Facebook page, and have recorded plays available on You Tube.

During the first year of this project Dr. Lipsett and her team were able to educate more than 6,000 students, teachers and parents. By the end of the four year agreement UT expects to reach more than 38,000 students, teachers and parents.

The passion and devotion of the University of Turabo team are amazing. Their dedication overflows in abundance and even excites the children. Watch this video of students singing about improving their school’s indoor air quality to the tune of Puerto Rican style Christmas carols.  I’m proud to be part of this effort.

You can find more information about this project online at Asthma Community Network.

About the author: Carmen Torrent a public affairs specialist in EPA’s Office of Indoor Air.

Editor’s Note: The opinions expressed in Greenversations 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.

By Brandy Angell

Ready for school? It’s that time of the year and we all can relate to the end of summer and the beginning of back-to-school preparations. As a new mom, this time of year has given me a new perspective. Ethan is just 8-months-old but these past months have taught me a lot about the values of preparation and that it’s possible to overanalyze everything in your child’s surrounding environment. Eventually, I would like to think the neurosis fades away but my mom serves as a reminder that you never stop worrying about your children. As kids head back to school, I wonder if school staff and parents consider whether children are returning to a healthy learning environment?

Between last minute preparations and summer vacations, the school’s environment and its impact on occupant health can be easily overlooked. However, levels of pollutants indoors can be higher than in outdoor air and poor Indoor Air Quality (IAQ) is associated with fatigue, nausea, allergies and asthma and can also have an effect on concentration, attendance, and student performance.

With the help of the Indoor Air Quality Tools for Schools you can learn how to identify, correct, and prevent indoor air problems that can trigger asthma attacks and other health problems in order to create a healthier learning environment. Here are some tips:

• Learn more about IAQ issues, related health effects, and how student performance is affected. EPA’s free resources can help you use your voice to promote a healthier learning environment and discuss indoor air with parents, community organizers, and your school community. The  Action Kit shows schools how to carry out a practical plan to improve indoor air.

• Help manage asthma in the schools. Many of the same asthma triggers found in homes can also be found in schools. Learn how to reduce exposure to asthma triggers in your school. Work with your healthcare provider to create an asthma action plan and give a copy to the school nurse, coach and other caregivers.

• Build momentum for a school environmental health project. With the help of curricula, students can learn about the indoor air environment and how it directly affects them!

Ethan may be five years away from his first day of school, but at least I know there are steps we can take to help keep him healthy. What actions will you take to create a healthier school environment?

About the author: Brandy Angell is a public affairs specialist with the Office of Radiation and Indoor Air’s Indoor Environments Division. She joined EPA in 2009 to focus on improving children’s health in the school environment and reducing the burden of asthma.

Editor’s Note: The opinions expressed in Greenversations 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.

By Molly Hooven

Summer heat is here, the air quality is diminishing and the asthma triggers are beginning to strike my family and possibly yours as well. Asthma can play a big role in your life but it’s important to remember that it should never slow you down.

I remember, as a young girl, when the ambulance came to my house and my uncle had to be given oxygen because he had a severe asthma attack. My uncle is my role model and he has asthma. What many people may not realize is that many of their role models have asthma too!
Did you know that Redskins player Chris Draft, first daughter Malia Obama and nearly 7 million children across the U.S. have asthma? You can still accomplish great things while managing asthma!

One of my greatest accomplishments is being able to manage my asthma and still play volleyball. On one hot July day I competed in an outdoor match when there was barely enough good air to breathe just standing on the sidelines. My competitive nature led me to overlook the Air Quality Index and soon the surrounding area started to blur.

Panic rose upon my face and tears began to spill as my throat was quickly closing and it felt like trying to breathe through a straw.
While I didn’t avoid the unhealthy air, which is a known asthma trigger, I did have a plan. Quickly I used my inhaler, sat in the shade, and rehydrated. People are going to have asthma attacks; the key is to have a plan!

Part of your plan should be to understand and recognize what your triggers are. Particulates (soot) and ozone (smog) are outdoor asthma triggers I faced in my game but there are also indoor triggers such as dust mites, molds, cockroaches and second hand smoke.

The main asthma trigger at my house is actually part of our family — our yellow lab. Since we can’t get rid of her pet dander, which is another asthma trigger, we take alternative actions such as not allowing her in bedrooms and brushing excess hair outside.

Those with and without an asthma condition need to understand potential triggers during the summer, develop a plan if faced with an attack, and realize that you’re not alone. If James Monk, Jerome Bettis, my uncle and I can succeed with an inhaler by our side—so can you!

About the author: Molly Hooven joined the EPA in November 2010 as a SCEP intern. She recently earned her M.B.A. from Mount St. Mary’s University and has an undergraduate degree in Communications.

Editor’s Note: The opinions expressed in Greenversations 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.

By Steve Conti

In our asthma management work at the Seton Asthma Center, in Austin, Texas, we strive for three goals every day: to keep children from having to enter our hospital doors; to reduce the number of children readmitted to our facilities; and to keep children out of the emergency room (ER). These are the reasons that I work in asthma care and prevention, and why I am proud to tell our program’s story.

We started off almost 10 years ago with alarming numbers of ER visits and readmission rates for pediatric asthma patients in our community; so we began to question our methods: Where were our gaps? What could we enhance? And more importantly, how could we better serve our community? In short, we wanted to understand how to better provide comprehensive asthma management to the children we treated to improve their quality of life.

We took this opportunity to evaluate our programmatic goals and activities to determine how we could achieve the results that would align with our goals of improving asthma health outcomes. After implementing new strategies, including how we conducted asthma education outreach to families, we started to see fewer children returning to the ER. However, in order to determine if we achieved success, we really needed to measure our results. To do so, we tracked patients’ doctor and ER visits for one year, as well as had patients’ complete quality of life assessments. Coupling this information with their previous year’s medical history allowed us to do a comparative evaluation of each child’s condition.

The results were amazing. We saw an almost 50 percent decline in ER visits, a 90 percent decrease in patient visits and a positive return on investment – for every dollar we spent on program expenses, we were able to demonstrate a $5 return.

It is because of our evaluation efforts that I am able to articulate Seton’s story and describe the positive impact our program has had on managing asthma in our community. I would highly encourage any asthma management program that is interested in learning more about evaluation and how to articulate their program’s story to attend the upcoming EPA’s Communities in Action National Asthma Forum, June 9-10, 2011, in Washington, D.C. It’s an inspiring event that helps programs promote healthier, happier lives for their patients, and provides an opportunity to meet national experts in asthma care.

About the author: Steve Conti has been with the Seton Family of Hospitals for 15 years and currently serves as the Director of Disease Management. Seton Asthma Center is the recipient of the 2009 EPA National Environmental Leadership Award in Asthma Management.

Editor’s Note: The opinions expressed in Greenversations 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.

By Kathy Sykes

One of the indelible memories I have of my grandfather, Lars Svensson, was the trouble he had breathing. For as long as I can remember he struggled to breathe, even when we went for a short walk or just a few feet to the mail box in the front yard. My grandfather was a smoker and suffered from a serious lung disease called emphysema, also known as chronic bronchitis, chronic obstructive pulmonary disease, or COPD.
COPD is now the fourth leading cause of death in the United States and also causes long-term disability. Both asthma and COPD are common chronic respiratory diseases that take a toll on the quality of life for persons of all ages. More than 12 million Americans suffer from COPD and another 12 million may have it and not know it.

I was a teenager when my grandfather died, at a time when very little was known about treating the disease. We fortunately know a lot more now about living with COPD and asthma including how to avoid the environmental triggers that can cause an attack. By reducing exposure to environmental triggers one can control and reduce the frequency of symptoms and make it easier to breathe.

Triggers in the environment include outdoor particle pollution and ozone. Indoors, where we spend 90 percent of our time, common indoor hazards may trigger an asthma or COPD attack including tobacco smoke, direct and second-hand smoke, animal dander, dust mites and cockroaches, mold, and pollen. It is also important to check furnace and heating units each year and fix water leaks quickly help to reduce the occurrence of these triggers in your home. Pesticides, household cleaning products and substances with irritating odors may also exacerbate COPD and asthma. And don’t forget to check the air quality index where you live to see if the air quality is a problem. If it is, reduce outdoor activity as much as possible on poor air quality days.

Asthma and COPD have a lot in common and affect the health and quality of life of older Americans. The U.S. EPA Aging Initiative has developed a poster in English and Spanish called Age Healthier, Breathe Easier. The fact sheet on the same topic has been translated into 17 languages.

About the author: Kathy Sykes began working for the U.S. EPA in 1998. Since 2002, she has served as the Senior Advisor for the Aging Initiative.

Editor’s Note: The opinions expressed in Greenversations 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.

By Jan Roberts

Chances are you or someone you know has asthma. Whether it’s your child, parent or friend, this person helps make up the nearly 25 million people with asthma living in the U.S. This statistic is staggering, as asthma is one of the most controllable diseases. Our job at Genesee County Asthma Network is to turn around this figure by making healthy, environmental changes within our community. By making small changes in homes and schools, we can significantly improve our patients’ quality of life.

Those affected by asthma often use only 50 percent of their lung function because they don’t – or are unable to – eliminate the asthma triggers around them. To effectively deliver high-quality asthma care, we complete tailored environmental interventions in our patients’ homes and schools. We assess homes for asthma triggers while identifying potential financial or social barriers to fixing them. During these visits, we educate our patients about their medication, demonstrate safe cleaning methods, and help develop a personalized asthma action plan, which is tailored to the patients’ sensitivities, such as secondhand smoke or pet dander. For children in our program, we take it one step further and go into schools to educate their teachers, principals and maintenance staff (among others) on the basics of asthma and how it can affect student productivity and performance.

We know this hands-on approach works and produces dramatic results; among the patients we serve, emergency room visits have dropped by 45 percent and hospitalizations by 25 percent. By tracking medical records and administering questionnaires, we have also seen reductions in medication usage, decreased school absenteeism, and a general improved quality of life in both the children and adults we serve.
With limited resources and staff, our program continues to deliver comprehensive care by building partnerships within our community. We team with our local lead poisoning prevention program, Habitat for Humanity, the American Lung Association and others to share resources and holistically address asthma management.

If your program is interested in learning strategies on developing meaningful partnerships, I recommend attending EPA’s Communities in Action National Asthma Forum, June 9-10, 2011, in Washington, D.C. The Forum helped our program discover the power of collaboration and optimizing our resources, while delivering tailored environmental interventions that make a great impact.

About the author: Jan Roberts, RN, AE-C, has been with the Genesee County Asthma Network for 14 years and currently serves as the Asthma Disease Manager. The Genesee County Asthma Network is the recipient of EPA’s National Environmental Leadership Award in Asthma Management.

Editor’s Note: The opinions expressed in Greenversations 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.

This post is cross-posted from Mom’s Rising.org

By Administrator Lisa P. Jackson

This month is National Asthma Awareness Month, when we address an illness that affects nearly 25 million Americans and one in every ten children in the United States.

Safeguarding the air we breathe and preventing illnesses like asthma attacks is one of my most important jobs as Administrator of the U.S. Environmental Protection Agency. But it is important to me for other reasons as well — before I am Administrator, or an environmentalist, I am a mother of two teenage sons whose health, happiness and future are my and my husband’s top concerns. Over the years, my youngest son has struggled with asthma, giving my work for clean air an added urgency.

In some cases, raising a child with asthma means startling awake at night because of the lightest sound of a cough. In other cases, it means family trips with a nebulizer, breathing masks and asthma medication. But in every case, it means taking special care to monitor the environmental conditions that might trigger an attack.

National Asthma Awareness Month is an important opportunity to raise awareness about those triggers and ensure that everyone has the knowledge they need to help control asthma. The EPA has assembled a number of great resources on our website.  I’ve also recorded a short video about Asthma Awareness Month. I hope you’ll watch it, share it, and help us get the word out about asthma awareness.

This National Asthma Awareness Month, we need your help to make sure everyone knows what they can do to help prevent and protect against asthma.

Editor’s Note: The opinions expressed in Greenversations 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.

Asthma remains a critical public health challenge – nearly 25 million people in the U.S. have asthma, including 7 million children. But what is perhaps even more alarming is how asthma disproportionately affects minority and disadvantaged children. Among children with asthma, black and Hispanic children are twice as likely to be hospitalized and black children over 4 times more likely to die from asthma than white children. In addition, minority children are less likely than white children to have been prescribed asthma medications.

The causes of asthma disparities are not yet fully understood, but are likely a result of a variety of factors including genetics, environmental exposures, access to programs and policies that influence the control of asthma, and socioeconomic factors, such as housing quality and family and community social supports.

EPA is on the front lines of the fight against asthma disparities and I’m excited about the work we’re doing. For example, we’re supporting community-based asthma programs in Puerto Rico that specifically target improving school environments for children in districts throughout the territory.

EPA is also working with other agencies to develop a Federal Action Plan to Reduce Asthma Disparities. This includes identifying immediate actions that we can take in order to better leverage our collective assets across agencies to reduce asthma disparities.

EPA’s Communities in Action National Asthma Forum brings national, state and community level asthma experts and professionals together from across the country to share their experiences, knowledge and best practices about providing successful asthma programming in the community. This event offers an opportunity like no other to openly discuss barriers and challenges impacting underserved populations, as well as to get advice from others in the field who have found success. This year’s National Asthma Forum is taking place in Washington, DC, June 9-10. It’s really a can’t-miss opportunity. Also, AsthmaCommunityNetwork.org is another great place to exchange ideas and knowledge about health disparities with asthma professionals.

There is still much to understand about how to prevent asthma and tailor interventions to serve disproportionately impacted populations, but every day we get a little closer to finding the solutions.

About the Author: Alisa Smith is a biologist with the Indoor Environments Division’s Asthma Education and Outreach Program EPA’s Office Air and Radiation.

Editor’s Note: The opinions expressed in Greenversations 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.

Healthy buildings provide a safe and secure physical structure that helps occupants maintain their health and well-being through improved indoor air quality. Creating a healthy indoor environment can have a particularly significant impact on people who have asthma. Allergens, such as dust mites, other pests, including cockroaches and rodents, and mold are all related to asthma symptoms and unfortunately we know these triggers are ubiquitous in urban housing.

At the Boston Public Health Commission, we work collaboratively within the community to address these triggers, teach residents how to better manage their asthma and their environment, and support residents when their indoor environment is making them sick and it is out of their control. We conduct over 100 direct service home visits for families with asthma each year to help people create healthier indoor environments within their homes.

In addition, with EPA support, we established the Breathe Easy At Home program, a collaborative effort among city agencies and health care institutions. This program enables clinicians to make online referrals for housing code enforcement inspections, for their patients with asthma. A patient tells their doctor about a health concern related to their home environment, the clinician reports it, an inspection is performed, and the clinician receives continued information about the resolution of the complaint. The city of Boston is reaping the benefits of this powerful collaboration. The hospitalization rate for Boston’s children with asthma has decreased 39 percent and emergency department visits are 16 percent lower.

Attending EPA’s Communities in Action National Asthma Forum was an amazing learning opportunity for us and really helped us to solidify our vision for the future. It brings together both clinical and community-based programs and affirms that we are a continuum of care. It also allowed us to reevaluate and reprioritize our efforts and to learn from other leaders working in asthma management. It also pushed us to think about how to address asthma management from a nation-wide perspective.  I would highly encourage both new and established asthma management programs to attend the upcoming National Asthma Forum, June 9-10 in Washington, D.C. It’s an inspiring event that yields a huge return on investment.

About the author: Margaret Reid has been with the Boston Public Health Commission for twelve years and currently serves as the Director of the Division of Healthy Homes and Community Support.

Editor’s Note: The opinions expressed in Greenversations 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.

Last week, I joined security officer William Jones when he visited a group of students at the First Environments Day Care Center located on EPA’s Research Triangle Park campus. The purpose of our trip was to raise a yellow flag on the pole in front of the school.

When Officer Jones asked if the kids wanted to help him, they cheered in unison, “YES.”  They eagerly held the flag while Officer Jones hooked it to the chain, watched as he raised it – and promptly asked why the flag was yellow. Officer Jones explained that the yellow flag meant that the kids could play outside, “because the air quality was pretty good today– not the best like what a green flag means.”

Schools in a number of areas across the country are raising the colored flags to help their teachers and parents track EPA’s daily Air Quality Index (AQI). These flags help students and teachers know what the air quality forecast is for the day, and help them track whether students’ asthma symptoms get worse when the air is polluted and whether they need to take extra steps to protect their health.

Later this week, the Bethesda Elementary School in Durham, N.C. will launch its school flag program as part of Air Quality Awareness Week, marked every May to remind Americans to check the AQI forecast in planning outdoor activities. The school will fly an air quality flag along with the American flag each day.

When you see a green or yellow flag at school, it means that teachers and coaches will encourage students to get outside and get moving!  When the flag is orange or red, it is still OK to play outside, but kids are encouraged to cut back on activities that involve lots of running.  On those days, teachers and coaches will also make indoor exercise space available for children who need it.

The flags also help parents by reminding them of the day’s air quality forecast when they drop their children off at school, and assuring them that teachers will reduce their children’s exposure to air pollution, while ensuring they get important play and exercise time.

Don’t have a flag program at your school? It’s easy to start one.

About the author: Amy J. Gaskill, APR, works in the Innovative Programs and Outreach Group in EPA’s Office of Air Quality Planning & Standards