ASTHMA

Asthma Identify asthma population in Ohio Define asthma Identify causes of asthma Explain control of asthma symptoms Control asthma triggers Medical management

Asthma in Ohio

Ohio Population with Asthma 2012 data Ohio adults with less educational attainment and lower household income had a higher prevalence of current asthma than their peers with more education and higher household income.

Ohio Population with Asthma 2012 data The prevalence of asthma decreases with increasing household income. Ohioans with a household income less than $15,000 per year were three times more likely to currently have asthma compared with those earning $75,000 or more per year. Ohioans who had not completed high school were 2.4 times more likely to report having asthma compared with those who earned a college degree. Ohio Department of Health, 2013

Children with Asthma In Ohio 417,000 children have been told they have asthma African American children Living at or below the federal poverty level The prevalence of asthma decreases with increasing household income. Ohioans with a household income less than $15,000 per year were three times more likely to currently have asthma compared with those earning $75,000 or more per year. Ohioans who had not completed high school were 2.4 times more likely to report having asthma compared with those who earned a college degree.

Ohio Asthma Morbidity 1,200,825 Ohio adults have been told they have asthma 847,000 Ohio adults report they currently have asthma Relevant: 1,200,825 adults have been told they have asthma, 847, 641 report currently having asthma, 417,567 children have asthma in Ohio. Ohio Stadium has an official capacity of 104, 851 people. You fill the stadium 11.5 times for people who have been told they have asthma, 8 times for people who currently have asthma and 4 times for children.

Ohio Asthma Mortality Ohio experiences in one year: 155 asthma deaths 1 child a month Little has changed since 1990 Very few people die from asthma 155 deaths a year in Ohio 1 death every 2-3 days. Approx. one child a month

What is Asthma? Asthma is a chronic, treatable disease of the lungs where there is inflammation (or swelling) of the airways making the airways sensitive. GINA, 2015

What is Asthma? A history of respiratory symptoms AND Asthma is a disease with many variations (heterogeneous). It is characterized by chronic airway inflammation and has two key defining features: A history of respiratory symptoms AND variable expiratory airflow limitation. Asthma is a chronic, treatable disease of the lungs where there is inflammation (or swelling) of the airways making the airways sensitive. GINA, 2015

Asthma Symptoms Symptoms range from mild to severe. They are: Frequent Cough – more common at night, waking you up. Wheezing – a whistling sound when you breathe Short of Breath – the feeling of not being able to get enough air Tight Chest – the feeling like something heavy on your chest These symptoms vary over time and in intensity.

Asthma Airway Asthma Airway: Muscles tighten Airway lining swells Mucus increases

Asthma Airway A closer look

What causes asthma? Asthma Triggers The first and most important step in controlling allergen-induced asthma is to advise patients to reduce exposure to indoor and outdoor allergens to which they are sensitive Asthma Triggers

And How To Control Symptoms Environmental Control Cover it Clean it Clear it Treat it Environment Cover it Clear it Clean it Educate and treat smoking cessation Environmental Control

Healthy Homes & Asthma https://portal.hud.gov/hudportal/documents/huddoc?id=DOC_11882.pdf U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control http://www.hud.gov/healthyhomes

Asthma and the Environment Animal Allergens - Pets Clear the pet out of the bedroom Keep the bedroom door closed Clear upholstered furniture from the bedroom Clear carpets from the home or bedroom when possible Animal allergens – If removal of the animal is not acceptable: — Keep the pet out of the patient’s bedroom. — Keep the patient’s bedroom door closed. — Remove upholstered furniture and carpets from the home, or isolate the pet from these items to the extent possible. — In children’s beds, minimize the number of stuffed toys, and wash them weekly.

Asthma and the Environment House-dust mite allergen Cover mattress and pillow in an allergen-impermeable cover Wash (clean) sheets weekly in hot water Treat indoor humidity by Reducing it to 30 – 50% Clear stuffed animals & clutter House-dust mite allergen. Encase the mattress in an allergen-impermeable cover. — Encase the pillow in an allergen-impermeable cover or wash it weekly. — Wash the sheets and blankets on the patient’s bed weekly in hot water. Reduce indoor humidity to or below 60 percent, ideally between 30 and 50 percent. — Remove carpets from the bedroom.

Asthma and the Environment Mouse allergen exposure can be reduced by: Cover or block entry Treat with low-toxicity pesticides, traps Clean or vacuum regularly All warm-blooded animals, including pets and rodents, produce dander, urine, feces, and saliva that can cause allergic reactions Rodents — Mouse allergen exposure can be reduced by a combination of blocking access, traps, and vacuuming and cleaning. low-toxicity pesticides should be used sparingly, as they can be an allergen, themselves.

Asthma and the Environment Cockroach allergen Clear food or garbage from home Cover food in containers with lids Treat with poison baits, boric acid, & traps Cockroach allergen. Patients should not leave food or garbage exposed. Poison baits, boric acid, and traps are preferred to other chemical agents, because the latter can be irritating when inhaled by persons who have asthma. If volatile chemical agents are used, the home should be well ventilated, and the person who has asthma should not return to the home until the odor has dissipated.

Asthma and the Environment Non-pharmacological strategies for people with asthma Remediation of dampness or mold in homes reduces asthma symptoms and medication use in adults (Sauni et al, Cochrane 2015) Dampness and Mold For children at risk of asthma, dampness, visible mold and mold odor in the home are associated with increased risk of developing asthma (Quansah et al, PLoS ONE 2012)

Asthma and the Environment Indoor Mold Fix or treat leaks Repair water problems Clean all mold with warm soapy water

Asthma and the Environment Indoor Irritants Formaldehyde and Volatile Organic Compounds Gas Stove Sprays or strong scents body sprays plug-ins essential oils Formaldehyde and VOCs—can arise from sources such as new linoleum flooring, synthetic carpeting, particleboard, wall coverings, furniture, and recent painting—have been implicated as potential risk factors for the onset of asthma and wheezing. We saw an increase in calls at ODH after the 60 Minutes“ reported Lumber Liquidators was selling laminate flooring made in China with levels of formaldehyde higher than those allowed under California law. The news program sent an undercover team to a factory in China to speak with factory managers who acknowledged that inventory being produced for Lumber Liquidators was labeled incorrectly being compliant. Gas Stoves Use of unvented gas stoves and appliances results in increased indoor levels of NO2. Sprays or strong scents are a source of irritation and can be difficult to diagnose. The girl’s body wash, sitting in the next seat during math, or the body spray after gym.

Asthma and Smoking Clear The Home and Car of Smoke Eliminate smoking in home Eliminate smoking in car Other Sources of Smoke Fireplace Campfire Trash fire Tobacco smoke is the most common irritant Heavy smokers are less likely to realize the impact of secondhand smoke. Smoking out of doors to avoid exposing others may not adequately reduce exposure for children. Exposure to maternal smoking has been shown to be a risk factor for the development of asthma in infancy and childhood. Effects of ETS on a child’s asthma are greater when the mother smokes than when others in the household smoke. Other Sources of Smoke Fireplace wood-burning appliances or fireplaces, Campfire Trash fire which aren’t as common anymore, but are occasionally experienced out in the country. Avoiding is the best line of defense, of sitting as far way and down wind as possible.

Asthma and Smoking

Asthma and Smoking

Asthma and Smoking Nearly 9 out of 10 cigarette smokers first tried smoking by age 18. ***** If smoking continues at the current rate among youth, 5.6 million of those younger than 18 today will die early from a smoking-related illness. That is 1 of every 13 youth 17 years or younger alive today. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm

Medical Control Of Asthma Asthma is a chronic, lifelong disease of the lungs. It must be routinely managed Asthma has no cure. Asthma is a chronic, lifelong disease of the lungs. Asthma has no cure. It is possible to live an active, normal life with asthma. Asthma must be routinely managed It is possible to live an active, normal life with asthma.

Medical Control Of Asthma Evaluating asthma control Do you have an asthma action plan? Do You take asthma medicine? Do you have a Primary Care Provider (PCP) who manages your asthma? Do you have health insurance? Evaluating asthma control

Medical Control Of Asthma Asthma Action Plan Explain taking medicine Identify triggers Recognize worsening symptoms Define actions at each level Green Yellow Red Everyone with asthma should have an asthma action plan, but only about 20% actually have one. Asthma emergency happen at home, school, work or away from medical help. This help people with asthma and their families know what to do. If someone has asthma ask if they have an asthma action plan? Do you have an asthma action plan?

Medical Control Of Asthma Is the medicine expired? Is it a metered dose inhaler (MDI)? Do you use a spacer with it? Have them locate their medication and check the expiration date. Medicine comes in different packaging but Do you have asthma medicine?

Medical Control Of Asthma Do you have a Primary Care Provider who manages your asthma? Do you have health insurance?

Get Covered Connector

Asthma Medical Management Do you have an asthma action plan? Review People with asthma Symptoms of asthma Medical management Environmental Triggers Asthma is a chronic disease of the lungs Once you have asthma you always have asthma There is no cure but it can be controlled You can life a normal healthy life with asthma when if is controlled Although anyone can have asthma, it is most common along adults with less education and lower income Medical Management Do you have an asthma action plan? Do You take asthma medicine? Do you have a Primary Care Provider (PCP) who manages your asthma? Do you have health insurance? Frequent Cough – more common at night, waking you up. Wheezing – a whistling sound when you breathe Short of Breath – the feeling of not being able to get enough air Tight Chest – the feeling like something heavy on your chest Environmental Triggers Identify it Clean it Clear it Cover it Treat it

References U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control Center for Disease Control. (2016). Database and statistics. Smoking and tobacco use. Retrieved from: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm Environment Cover it Clear it Clean it Educate and treat smoking cessation

Questions Environment Cover it Clear it Clean it Educate and treat smoking cessation