![Page 1: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/1.jpg)
Asthma and IAQ
Lani Wheeler, MD, Medical Officer
Sarah Merkle, MPH, Program Analyst
Division of Adolescent and School Health
Centers for Disease Control and Prevention
![Page 2: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/2.jpg)
Asthma is a Major Public Health Problem
Nearly 5 million children have asthma (6.9% of children under 18)
It is one of the most common chronic childhood illnesses
It is a leading cause of school absences
![Page 3: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/3.jpg)
2 or more children are likely to have asthma
In a classroom of 30 children,
![Page 4: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/4.jpg)
What is Asthma?
A disease that:Is chronicProduces recurring episodes of breathing problems Coughing Wheezing Chest tightness Shortness of breath
Cannot be cured, but can be controlled
![Page 5: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/5.jpg)
What are the Symptoms of Asthma?
Shortness of breath
Wheezing
Tightness in the chest
Coughing at night or after physical activity; cough that lasts more than a week
Waking at night with asthma symptoms (a key marker of uncontrolled asthma)
![Page 6: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/6.jpg)
What Happens During an Episode of Asthma?
The lining of the airways becomes swollen (inflamed)
The airways produce a thick mucus
The muscles around the airways tighten and make airways narrower
![Page 7: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/7.jpg)
What Makes Asthma Worse?
AllergensWarm-blooded pets (including dogs, cats,
birds, and small rodents)House dust mitesCockroachesPollens from grass and treesMolds (indoors and outdoors)
![Page 8: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/8.jpg)
What Makes Asthma Worse? (cont.)
Irritants Cigarette smoke and wood smoke Scented products such as hair spray, cosmetics,
and cleaning products Strong odors from fresh paint or cooking Automobile fumes and air pollution Chemicals such as pesticides and lawn treatments
![Page 9: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/9.jpg)
What Makes Asthma Worse? (cont.)
Infections in the upper airways, such as colds (a common trigger for both children and adults)
Exercise
Strong expressions of feelings (crying, laughing)
Changes in weather and temperature
![Page 10: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/10.jpg)
Is There A Cure For Asthma?
Asthma cannot be cured,but it can be controlled.
You should expect nothing less.
![Page 11: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/11.jpg)
How Is Asthma Controlled?
Follow an individualized asthma management plan
Avoid or control exposure to things that make asthma worse
Use medication appropriately Long-term-control medicine Quick-relief medicine
![Page 12: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/12.jpg)
How Is Asthma Controlled? (cont.)
Monitor response to treatment Symptoms Peak flow
Get regular follow-up care
![Page 13: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/13.jpg)
How are Asthma Episodes Controlled?
Know the signs that asthma is worsening
Treat symptoms or drop in peak flow at first signs of worsening
Monitor response to therapy
Seek a doctor’s help when it is needed
![Page 14: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/14.jpg)
What Should People with Asthma Be Able To Do?
Be active without having asthma symptoms; this includes participating in exercise and sportsSleep through the night without having asthma symptomsPrevent asthma episodes (attacks)Have the best possible lung function (e.g., good peak flow number)Avoid side effects from asthma medicines
![Page 15: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/15.jpg)
Asthma Goals For SchoolHealth
Healthy school environment
Health services in school
Asthma education
Supportive policies
Sound communication
![Page 16: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/16.jpg)
Goal: Healthy School Environment
Enforce no-smoking policies
Reduce exposures to triggers: tobacco smoke, chemical vapors, furry or feathered animals, mites, cockroaches, chalk dust, mold
Keep temperature and humidity at appropriate settings
Maintain HVAC systems
Dry up damp and wet areas within 1-2 days
![Page 17: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/17.jpg)
Goal: Health Services in School
Provide full-time nursing services
Include nursing assessments, care plans in student records
Teach and monitor correct inhaler techniques, peak flow meter use
Train, supervise and delegate to health assistants and education staff, as appropriate
![Page 18: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/18.jpg)
Goal: Asthma Education
Provide asthma awareness for all students
Teach asthma management to students with asthma
Provide asthma education for faculty and staff
Teach parents how to manage asthma
![Page 19: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/19.jpg)
Goal: Supportive Policies
Identify students with asthmaProvide quick, reliable access to medicationsEstablish individualized student asthma management planEstablish individualized student emergency plan for asthma episodesPromote safe and full participation in all school activitiesMonitor students’ asthma
![Page 20: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/20.jpg)
Supportive Policies
Identify StudentsReview student health records
Interview parents
Interview school health staff
![Page 21: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/21.jpg)
Supportive Policies
Provide Access to MedicationEnsure reliable access to medication for all school activities
Allow self-administration as appropriate
Provide for nebulizer treatment as needed
![Page 22: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/22.jpg)
Supportive Policies
Establish Student Asthma Management PlanAddress triggersRecord personal best peak flowSpecify routine medicationsOutline signs and symptoms of worsening asthmaSpecify medications required for emergencies and how to monitor response to them.Indicate emergency contactsPlace plan in student’s health record Make copies for off-campus activities
![Page 23: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/23.jpg)
Supportive Polices
Establish Plan for Asthma EpisodesDevelop school wide emergency plans/procedures Include respiratory distress treatment protocols Include plan for someone without an individualized
plan
Include an emergency plan for asthma episodes in the individualized student asthma management plan.
![Page 24: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/24.jpg)
Supportive Policies
Promote Participation in All Activities, including Physical ActivitiesEncourage student participation
Allow pretreatment and or warm-up before physical activity
Allow access to quick relief medication
Modify activity or substitute with less strenuous option
![Page 25: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/25.jpg)
Supportive Policies
Monitor Students’ AsthmaWatch for symptoms of uncontrolled asthma
Monitor absenteeism due to asthma
Refer for home teaching as needed
![Page 26: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/26.jpg)
Goal: Sound Communication
Form linkages among school, home and health care providersObserve and report symptoms, medication useReview difficulties student may have with daily school management planResolve problems with school performance related to asthmaEncourage active student participation in school activities
![Page 27: Asthma and IAQ Lani Wheeler, MD, Medical Officer Sarah Merkle, MPH, Program Analyst Division of Adolescent and School Health Centers for Disease Control](https://reader036.vdocuments.us/reader036/viewer/2022081519/56649f065503460f94c1c44c/html5/thumbnails/27.jpg)
Asthma Resources For School Health
National Asthma Education and Prevention Program (NAEPP) Website and Materials Start at www.nhlbi.nih.gov Check out health information for lung diseases
NAEPP Partner Organization Website and Materials Start at www.nhlbi.nih.gov Go to NAEPP homepage; click on “roster” to link
with partners