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

2. 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?

3. 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

4. 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 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

5. 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 – 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.

6. 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.

7. 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

8. 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.

9. 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

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

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

12. 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

13. 5 Most Common Indoor Environmental Triggers
Secondhand Smoke
Dust Mites
Mold
Pets
Cockroaches

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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%

20. 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

21. 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

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

23. 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

24. 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

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

26. 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

27. 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

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

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