asthma

Beauty of the Aroma (in the nose of the beholder)

By Amy Miller

You either hate it or you love it. That’s what people say about cilantro (I love it). And root beer (I also love it). And apparently patchouli. (I’ll have to get back to you on that one.)

Even though I came of age in the 60s and 70s, and even though all the other 50-something women were in the know and even though I consider myself well-versed on fashion trends – well, okay, that’s not true – I had no idea of what patchouli was.

Clearly it was a perfume of sorts, a scent. And I got the idea that it was not of the Chanel variety, but rather something for earthier types. But other than that I was in the dark.

Turns out that patchouli oil, which is often used in perfumes, comes from a plant native to southeast Asia. Descriptions range from “musky” or “spicy” to “wet soil.” One friend who is firmly in the “hate it” camp said it “smells like dirt.” All this from an upright, bushy, evergreen with fragrant leaves and violet-dabbed white flowers.

Turns out patchouli isn’t the only scent that can bother people. EPA notes that the perfumes in scented products are complex chemical formulations that may adversely affect the health and/or comfort of others, especially those susceptible to asthma.

The agency has some Ms. Manners advice on avoiding the offending scents without offending the carrier: “Explain that you have adverse reaction to ‘something in the perfume’ rather than saying it’s the perfume that affects you.”

Also turns out the factories that make these complex chemical formulations that become our perfumes are subject to numerous environmental laws. Like any other factory using chemicals, they are regulated by the Clean Air Act; Safe Drinking Water Act, Resource Conservation and Recovery Act, Emergency Planning and Community Right to Know act, and Clean Water Act.

Patchouli actually became known as the hippie scent even before the US EPA was created. But hippies weren’t the first to take it out of the jungle. King Tut was buried with 10 gallons of patchouli oil. The Chinese, Japanese and Arabs thought it had aphrodisiac properties. And clothing sent from Asia was scented with patchouli because the smell supposedly kept away moths. The plant’s been used to treat skin inflammation and scars, headaches, colic, even depression. Today it’s in paper towels, detergents, and air fresheners, as well as perfume.

And after I have whiffed patchouli-infused perfume I will let you know on which side of the fence I sit.

More info: Why EPA doesn’t regulate use of fragrances indoors

About the author: Amy Miller is a writer who works in the public affairs office of EPA New England in Boston. She lives in Maine with her husband, two children, eight chickens, dusky conure, chicken-eating dog and a great community.

 

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.

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It’s Not Getting Any Easier for People with Ragweed Pollen Allergies

By Erin Birgfeld

“Close the windows!” my father’s voice boomed through the house. “Are you trying to kill me? I have hay fever, you know!”

Back from college for the summer, I had opened all the windows to enjoy a mild summer day, so rare in the Washington, DC, area. What I had forgotten was that my father has allergies to all types of pollen. So while I enjoyed the fresh breeze, the open windows also let in those tiny pollen grains that tortured him every year. Sure, my dad could be a little overdramatic— hay fever (the common term for allergies to ragweed and other types of pollen) wasn’t going to kill him. But it does cause his seasonal sneezing, watery eyes, and aggravates his asthma.

My father isn’t the only one avoiding the sweet spring and summer breezes. More than half of Americans have at least one allergy, with hay fever accounting for more than 13 million visits to physicians’ offices and other medical facilities every year. One of the most common environmental allergens is ragweed, which can cause hay fever and trigger asthma attacks, especially in children and the elderly.

And unfortunately, the news for those suffering from ragweed allergies isn’t good. It turns out that climate change can have an effect on pollen and allergy season. Warmer spring temperatures cause some plants to produce pollen earlier and to keep producing later into the fall season. Plus, increased carbon dioxide (CO2) concentrations allow ragweed and other plants to produce more pollen overall. That means more pollen for longer periods of the year! Yikes!

EPA’s Indicators of Climate Change Report features data from the National Allergy Bureau that shows that the length of ragweed pollen season has already expanded by 12-26 days in 8 of the 10 cities where data was collected between 1995 and 2011. Interestingly, ragweed pollen season length increased the most in northern latitudes and less in the south. If this trend continues, people allergic to ragweed pollen will have to deal with bothersome symptoms for longer. That’s nothing to sneeze at.

Dad, what does this mean for you? Since climate change could prolong allergy season for millions of Americans, it’s probably a good thing you moved to Florida…at least for the sake of your hay fever. The climate change impacts on sea level rise and hurricanes is another story, though.

About the author: Erin Birgfeld is the Communications Director for the Climate Change Division within the Office of Air and Radiation. When she’s not working to protect the environment, Erin enjoys hanging out with her two young children, and doing a bit of swimming and biking when she can find the time.

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.

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Staying Active with Asthma

runner

In celebration of Asthma Awareness Month, I thought it would be fun to talk with a student who has asthma herself.  I interviewed Shannyn, an energetic 10 year-old who taught me all about what it is like to have asthma.  Shannyn let me know that she doesn’t let asthma get in the way of her active lifestyle and love of playing outdoors with her sisters and friends. At around age 3, Shannyn experienced her first asthma attack.  She explained to me that an asthma attack is an episode, accompanied by wheezing and coughing, which makes it very difficult to breathe.  Triggers, such as dust, chemicals and seasonal allergies, are things that can provoke the event of an asthma attack.  Lucky enough for this smart girl, she knows to avoid these triggers by staying away from heavy bathroom cleaners and helping her mom to clean the house of dust.  

Asthma doesn’t get in the way of Shannyn’s busy lifestyle.  Her love of running club, tumbling, soccer, kickball and playing in the pool are what keep Shannyn going.  By taking a daily preventative inhaler, she is able to participate in these sports and after school activities.  Shannyn is careful to also carry her rescue inhaler with her when going for runs, in case this physical activity makes her asthma worse.  She let me know that although her asthma can sometimes make it hard to keep up with others when running, that she has a few good friends that will run at a steady pace with her.  I am impressed with all the fun, physical activities this girl does!  When telling me about how she is teaching one of her friends how to do a kart wheel, I asked if she could teach me.  At age 22, I still haven’t picked up how to do a kart-wheel. 

It’s no secret that Shannyn doesn’t let her asthma define how she spends her time and what kinds of activities she does.  By knowing which triggers to avoid, taking the proper medication, and doing routine activities like running club to control her asthma, Shannyn is able to live a very spirited life.  She is looking forward to the summer, where she is planning to spend lots of time swimming in the pool with her two sisters.  She has even started to plan her next birthday party, where she and friends will have a spa day.  Shannyn let me know that asthma doesn’t get in the way of staying active and having fun with friends and family.  She is a role model to people of all ages who have asthma.

Shelby Egan was an extern in the EPA’s Air and Radiation Division in Region 5. She is currently obtaining her Master’s degree in Urban Planning and Policy at the University of Illinois at Chicago.  She has a passion for protecting natural resources, cities she’s never been to and cooking any recipe by The Pioneer Woman. 

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.

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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.

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Equipping Students To Monitor and Improve Their Local Air Quality

By Joni Nofchissey

I live and work in Shiprock, New Mexico, on the Navajo Reservation. It’s a rural place, far away from any big city, and yet, despite the community’s rural setting, the rates of asthma and pulmonary diseases are comparable to those found in highly populated urban areas. In fact, Shiprock Indian Health Service Center sees five times the number of children with upper respiratory health problems than other centers on the Navajo Nation.

Surrounding Shiprock are two large coal-fired power plants and thousands of natural gas wells, each with a diesel engine. During the winter, air pollution is highly visible because thermal inversions trap particulate matter and smog near the ground. You can see this smog, and it’s only made worse by the use of wood and coal stoves in residential homes, which many students at Diné College and families in Navajo Nation depend on for warmth and cooking.

Last year, I co-led an EPA Tribal ecoAmbassadors project with some Diné College professors, staff, and several groups of students to collect and analyze air quality samples collected by M-PODs part of the Mobile Air Quality Sensing System (MAQS)—devices you can wear that collect data on five gases, one of which is nitrogen dioxide (NO2). NO2 is produced when natural gas or other fuels undergo incomplete combustion. One of the very useful and fun applications of the MAQS was the Android application and website interactive user-faces developed by University of Colorado Boulder.

At the end of the project, three classes of students were able to use advanced air quality sampling technology to collect and assess the air quality in the Shiprock area, as well as in their homes and schools. What they found was that each of the residences tested exceeded the recommended healthy levels of 0.05 parts per million of NO2 for the sampling period. Further testing showed high levels of carbon dioxide (CO2) in homes. According to the department of health guidelines for indoor air quality, the recommended range of CO2 concentration indoors is 600–1000 parts per million. In one of the homes tested, the readings were more than five times the maximum recommended healthy range.

While these findings were troubling, I wouldn’t say they were necessarily surprising. Going into the project, we knew there were concerns—we just needed a “from the ground up” way to assess the degree of indoor and outdoor air pollution Shiprock residents faced. Now that a group of Diné students and professors have the ability to do this, we’re placing the emphasis on continued monitoring, awareness, and low-tech solutions like proper ventilation and safe wood-burning practices. To create a greater awareness of the issue, each student shared the results of the data with their families and communities through poster sessions and presentations. Diné College also strengthened partnerships with University of Colorado-Boulder, the National Center for Atmospheric Research, and surrounding air quality labs, where students now have access to all kinds of data.

My students even provided insight to the developers of the M-POD and MAQS technology on how to improve the air quality monitors—and stressed the importance of exploring alternative heating sources (such as solar, wind, and biomass) to improve residential air quality in the northern regions of the Navajo reservation in and around Shiprock.

This year, I’m delighted to co-lead a second-year Tribal ecoAmbassador project that will result in a curriculum using these air quality monitoring tools to relate carbon emissions to climate change. DEI Spring interns have been able to use particulate counters “Dust Tracs” to measure levels of 2.5 μ particulate matter (PM2.5) in their families home to create discussion on occupant behavior and PM2.5 levels. In addition to looking at indoor heating behaviors effects on PM2.5 levels, interns also assisted in assessing ambient CO2 levels with readings collected by the Autonomous Inexpensive Robust CO2 Analyzer (AIRCOA) developed and maintained by the National Center for Atmospheric Research (NCAR). We’re sharing the results through college classroom presentations, college science labs, K-12 hands-on workshops, professional conferences, and community hands-on workshops/seminars/presentations. Something I’ve learned over the last two years is that you can collect all the data in the world, but you’ll never get anywhere on a problem like air quality without the involvement and support of your local community.

I am very excited to start our summer internship which includes two weeks of intensive air quality studies in July with six DEI interns and DEI staff as well. The eight week internship pertaining to environmental science will end with a series of workshops and presentations to community members and K-12 students. The interns will also be very instrumental in providing insight to a meeting regarding another DEI project, the Indoor Stove Coal Use Project.

 About the author: Joni Nofchissey serves as the Environmental Technician of Diné College – Shiprock Campus, Diné Environmental Institute (DEI).  As the co-lead of the Diné College Tribal ecoAmbassador project, she helps interns design studies and analyze data collected with a stationary carbon dioxide monitor developed and maintained by the National Center for Atmospheric Research.

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.

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Asthma: Public Health Issue for Hispanics

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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.

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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.

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Addressing Asthma Disparities: Helping Children Breathe Easier

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Blog-Authorby Brenda Doroski, Director, Center for Asthma and Schools

As we approach the one-year anniversary of the release of The Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities, I am excited to be part of this effort to improve the lives of children with asthma

The Action Plan was released on May 31, 2012 by CEQ Chair Nancy Sutley, HUD Secretary Shaun Donovan, HHS Secretary Kathleen Sebelius and former EPA Administrator Lisa Jackson.  They were joined by other federal representatives and national leaders who helped to unveil the Action Plan to the 100 participants at the event and the 400 participants joining by live broadcast.

The Action Plan outlines strategies to reduce barriers to implementation of guidelines-based asthma care; enhance local capacity to deliver integrated, comprehensive asthma care; improve capacity to identify the children most in need; and accelerate efforts to prevent the onset of asthma.  EPA is leading efforts to equip parents to effectively manage environmental asthma triggers as part of their child’s asthma care.

While the Action Plan is focused on coordinated federal action, this alone is not enough to fully address racial and ethnic disparities in asthma. We are actively engaging non-federal stakeholders to take action at the local community level through interactive webinars, meetings and conferences.

We are creating pathways for community programs and non-governmental organizations to engage with us on this important work.  Headlining this effort is www.AsthmaCommunityNetwork.org–an online peer to peer network that provides access to valuable tools and resources.  This Network, supported by EPA in collaboration with the Merck Childhood Asthma Network and the Robert Wood Johnson Foundation Allies Against Asthma at the University of Michigan, serves as the communication hub for stakeholders to explore the Action Plan and share the strategies and best practices they are deploying in the field.  Today, the Network has more than 2,000 members representing and supporting nearly 700 asthma programs across the country.

Asthma Awareness Month provides another excellent opportunity to further engage with our stakeholders to promote and adopt best practices and effective strategies for successfully managing asthma.  To learn more, visit www.epa.gov/asthma/childrenstaskforce.

About the author:  Brenda Doroski serves as the Director of the Center for Asthma and Schools in EPA’s Indoor Environments Division.  She leads efforts to improve indoor air quality in homes and schools.  Brenda has twenty-five years experience developing and leading domestic and international environmental health programs with the EPA and the Peace Corps in Latin America.

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.

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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.

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Asthma Disparities: Making an Impact in Chicago’s Public Housing

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By Melissa Gutierrez Kapheim

It’s Asthma Awareness Month! For hundreds of asthma community programs across the country, raising asthma awareness is a year-round reality as we work to improve the lives of people living with asthma every day.

As a 2010 winner of EPA’s National Environmental Leadership Award in Asthma Management, my organization, Sinai Urban Health Institute (SUHI), is always excited to partner with EPA. We strive to share successful strategies that will help programs across the nation deliver environmental asthma management as part of their asthma care services to underserved communities.

Later this month, on May 16th, I will co-present an EPA webinar with Andy Teitelman from the Chicago Housing Authority (CHA) on our collaboration efforts for a program called Helping Children Breathe and Thrive in Chicago Public Housing (HCBT).

With funding from the U.S. Department of Housing and Urban Development, SUHI partners with the CHA to implement HCBT in a community where asthma affects 25–30 percent of children, a rate twice the national average. Through community engagement and partnerships, we provide asthma education, assistance navigating the healthcare system, and environmental home assessments.

HCBT uses a Community Health Worker (CHW) model to deliver its services. We hire and train people who live in the same building to educate residents about asthma management. This approach is effective in accelerating honest communications in which people with asthma and their families feel comfortable discussing their home environment.

The visits include a home assessment to identify asthma triggers. HCBT refers triggers to CHA’s case management service, which works with property management to resolve the issue. This referral system was developed so participants can report their housing concerns to CHWs, who shepherd them through the process of getting the problem fixed.  As a result, a variety of housing issues that exacerbate asthma, such as mold, roaches, carpet, and mice, are referred to property management. To date, 80 percent of those referrals have been resolved.

Through our partnerships with CHA and residents of the housing developments, we have achieved results indicative of improved asthma symptoms and control. Specifically, preliminary six-month outcomes of the HCBT program indicate a 56 percent reduction in asthma symptoms, significant reductions in health resource utilization, and statistically significant and clinically associated improvements in quality of life. The project is slated to end in the fall of 2013.

Please join us for our webinar on May 16th. For more information and to register, visit

About the author: Melissa Gutierrez Kapheim, MS, is an epidemiologist at the Sinai Urban Health Institute (SUHI) in Chicago, IL. She has worked in the field of health disparities and community-based health interventions for more than eight years. Since joining SUHI in 2006, she has worked on three consecutive asthma interventions that utilize the community health worker model to improve the health and well-being of children and adults with asthma living in Chicago’s most vulnerable communities.

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.

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