Controlling Asthma and Allergy Triggers in Your Home Let’s Clear the Air Controlling Asthma and Allergy Triggers in Your Home

Topics Covered What is asthma? Who is most at risk to get asthma? The presentation will include general information on asthma, as well as more specific information about how our indoor environments relate to asthma. The audience will come away with easy, effective ways for people to avoid asthma triggers indoors. What is asthma? Who is most at risk to get asthma? What does the indoor environment have to do with asthma? How can you reduce exposure to indoor asthma triggers?

What is Asthma? A chronic inflammatory disorder of the airways It is treatable, but not yet curable It is not the same as allergies, but allergies MAY cause asthma Not contagious Can be life-threatening! Asthma is a lung disease. It may cause people to wheeze, cough, become short of breath, and can cause death. It is treatable, but not curable. Allergies can cause asthma. It is not contagious but it can run in families. Chronic means long-term or having many episodes It is manageable

Asthma Facts About 17 million Americans have asthma, including about 7 Million children It is the most common chronic childhood disease. 1 out of every 10 North Carolina children has asthma Asthma causes more hospital stays than any other childhood disease Cost of lost workdays of parents with asthmatic children is near $1 billion It is a leading cause of school absences Estimates actually are anywhere between 17-23 million people, including 7 million children have asthma 1 out of every 10 NC children have asthma It causes more hospital stays than any other childhood disease 13 million school days are missed each year in US due to asthma -- nearly 17 million physician office and hospital visits (in US) and nearly 2 million emergency room visits (in US) Cost of lost work days is near 1 billion – add the cost of expenditures for health and that number is closer to $20 billion each year

Who is most at risk to suffer from asthma? Children Low-income, urban residents Some minorities Allergic individuals People with hereditary disposition for asthma (genetics) Children Low-income and urban residents Minorities – African Americans have higher rates of asthma emergency department visits, hospitalizations and deaths than do Caucasians; approximately 2 million Hispanics in US have asthma and Puerto Ricans are disproportionately impacted Allergic Individuals – 40-50 million people have allergies. Allergies can also make it hard for people to breathe by causing an asthma attack. An allergy is an unusual reaction to something (food or plant) that is normally harmless.

What happens during an asthma episode? Airways narrow, caused by: tightening of the muscles that surround the airways swelling of the inner lining increase in mucous production Airways are the passages that carry air to the lungs These airways become smaller and smaller as they progress into the lungs An asthma episode is caused by the narrowing of airways During an asthma episode the breathing tubes/airways in your lungs swell, the muscles around these tubes then tighten. The tubes make large amounts of a thick fluid called mucus.

Warning Signs of Asthma Coughing (especially when it is not a cold) Wheezing (a squeaking sound when breathing) Fast breathing Poor skin color Shortness of breath Hunched over posture Restless during sleep Fatigue Space between the ribs may sink in when breathing Anxiety Vomiting Warning sings of an asthma episode may include tightness in the chest, shortness of breath, wheezing and coughing. People with asthma who learn to spot the early signs of an episode can take their needed medicine right away – hopefully lessening the severity of the attack. Even when a person is not coughing or wheezing, the lining of the airways can become inflamed and this also requires medical treatment

Warning Signs of Asthma Strained breathing Prominent neck muscles Out of breath after physical activity IMPORTANT: These symptoms don’t necessarily mean it is asthma Additional signs of an asthma episode.

Asthma can be controlled! There are excellent medicines available now that can control asthma--some must be taken on a daily basis Environmental “triggers” of asthma--which are different for everyone--can be controlled to reduce asthma symptoms There are other triggers, including exercise, respiratory issues, cold weather Our focus today is on Environmental Triggers

Common Asthma Triggers Allergens Molds Dust Animals Pollen Food Pests (cockroaches) Irritants Secondhand smoke Strong odors Ozone Chemicals/cleaning compounds

Other asthma triggers Viral respiratory infections Exercise colds flu often worse at night after lying down Exercise Changes in weather cold air wind humidity

Indoor Air Pollution: A Major Health Concern Most people spend 90% of their time indoors Toxin levels indoors may be higher than outdoors because of energy tight buildings Most of the common asthma triggers are found indoors

5 Most Common Indoor Environmental Triggers Secondhand Smoke Dust Mites Mold Pets Cockroaches

Other Indoor Triggers: Household Products Vapors from cleaning solvents (non-water based), paint, liquid bleach, mothballs, glue Spray deodorants, perfume bleach, pesticides, oven cleaners, drain openers, aerosol spray products

Recognize asthma triggers to control indoor air Not all triggers affect every person 3 Basic Strategies to improve indoor air quality: identify the problem control the source mitigation--get rid of the pollutant or triggering substance

Pollen Transported by wind Grass, ragweed, pine, birch, oak trees Can get indoors during pollen season Close windows during pollen season Caulk and weather-strip doors and windows

Secondhand Smoke Contains more than 4,000 substances (over 40 are carcinogenic) Is particularly harmful to young children Can trigger asthma attacks Causes coughing, excess phlegm, reduced lung capacity and other lung irritation Particles such as nitrogen dioxide and sulfur dioxide may cause decreased lung function Increased risk of respiratory tract infections (bronchitis, pneumonia) Not only tobacco smoke--also caused by burning wood, candles, coal, kerosene, natural gas Avoid Second Hand Smoke by: Do not allow smoking indoors or in vehicles Limit use of fireplaces and candles Exhaust fan over gas stoves Smoke particles stick to clothing--can affect young child when held in arms

Dust Mites Too small to be seen Found almost everywhere! Live in soft bedding Feed on dead skin cells Mites and mite droppings can be asthma triggers Live in warm, humid places

Avoiding Dust Mite Triggers Wash sheets and blankets once a week in very HOT water (130 F) Use air conditioner in summer to lower humidity levels Remove carpets if possible Damp clean hard surfaces Vacuum often with HEPA vacuum or microfiltration bags Low indoor humidity-between 30-50%

Avoiding Dust Mite Triggers Cover mattresses and pillows in dust-proof (allergen- impermeable) zippered covers Vacuum mattress, chairs and carpeting Replace pillows every 5 years

Pets/Animals Skin flakes, urine, and saliva of warm blooded animals can be asthma triggers Triggers can remain inside for several months after an animal is removed, even with cleaning

Molds A type of fungus Grow on damp surfaces Molds grow by releasing spores Grow on organic materials: wood, drywall, wallpaper, carpet, foods

Avoiding Mold Triggers Mold problems are caused by excess moisture Correct the moisture problem first! Maintain low indoor humidity (between 30-50%) Warm air holds more water than cold air Fix leaky plumbing Empty and regularly clean refrigerator drip pans

Avoiding Mold Triggers Run a bathroom fan during bathing Exhaust the dryer to the outdoors Control moisture in the crawlspace Replace carpet with hard- surface floors in basement Use air conditioner to lower humidity Don’t need to test for mold-- if you see it or smell it—then you have mold Clean up small areas with a bleach solution-- 1/2 cup of bleach to 1 gallon of water Limit houseplants--since soil/leaves contain mold--at least in bedrooms Clean when children are not present

Pests (especially Cockroaches) Many people are allergic to the body parts and droppings of cockroaches People who have dust allergies frequently have cockroach allergies

Avoiding Pests 3 steps to avoid pests indoors: Prevention Identification Control Get rid of places for pests to hide and sources of food and water reduce clutter (boxes, stacks of newspapers, grocery bags) do not leave food or garbage out clean up food spills and crumbs caulk cracks and crevices Make sure you identify the pest before using pesticides Use less toxic baits, boric acid or traps first--before using toxic pesticides If you use sprays: Limit spray to infested area Ventilate room--sprays may be a trigger for asthma or cause lung irritation

Air Cleaners and Filters Use Air Cleaners only as a last resort HEPA filters (High Efficiency Particle Air) Do not use air cleaning devices that produce ozone Know the size of the room to be treated before purchasing the unit Keep filters changed or cleaned frequently Some gases and very small particles are difficult to remove Ozone exposure Potential risk of experiencing: Decreases in lung function Aggravation of asthma Throat irritation and cough Chest pain and shortness of breath Inflammation of lung tissue Higher susceptibility to respiratory infection

Actions to Control Asthma in the Home Control the environment to prevent triggers: dust, pests, mold, secondhand smoke, strong odors and cleaning solvents

For More Information and Credits The U.S. Environmental Protection Agency (EPA) www.epa.gov/asthma The American Lung Association 1-800-LUNG-USA Thanks to the Healthy Indoor Air for America’s Homes project for photos and background information: www.healthyindoorair.org This presentation is adapted from one developed by Laura Booth, Auburn University