1. Asthma And The School Environment Developed and Prepared by the Minnesota Department of Health June 2004

2. Minnesota Department of Health www.health.state.mn.us/divs/hpcd/cdee/asthma

3. Common Asthma Triggers Allergens Allergens Mold, dust mites, cockroaches, animal dander, pollens, foods Mold, dust mites, cockroaches, animal dander, pollens, foods Irritants Irritants Secondhand smoke, strong odors, volatile organic compounds, ozone, particulate matter, aerosols Secondhand smoke, strong odors, volatile organic compounds, ozone, particulate matter, aerosols Other Viral respiratory infections Changes in weather (cold air, wind, humidity) Exercise Medication

4. Indoor School Environment All of the common allergen and irritant triggers are found indoors All of the common allergen and irritant triggers are found indoors Americans spend about 90% time indoors Americans spend about 90% time indoors Reducing exposure to indoor allergens & irritants can reduce asthma symptoms Reducing exposure to indoor allergens & irritants can reduce asthma symptoms Prevention is an important asthma management tool Prevention is an important asthma management tool

5. Most Common Indoor Environmental Triggers Animals in the classroom Animals in the classroom Dust Mites Dust Mites Mold Mold Pests such as cockroaches & rodents Pests such as cockroaches & rodents Secondhand smoke Secondhand smoke

6. Animals In The Classroom Skin flakes, urine and saliva of warm blooded animals can be asthma triggers Skin flakes, urine and saliva of warm blooded animals can be asthma triggers Triggers can remain for several months after the animal is removed Triggers can remain for several months after the animal is removed

7. Avoiding Animal Triggers Remove animals from school, if possible Remove animals from school, if possible If removing animals is not possible: If removing animals is not possible: Keep animals in cages or localized areas Keep animals in cages or localized areas Clean cages regularly Clean cages regularly Locate animals away from ventilation system Locate animals away from ventilation system Locate sensitive students away from animals Locate sensitive students away from animals Keep animals away from upholstered furniture and carpets Keep animals away from upholstered furniture and carpets

8. Dust Mites Found in most schools Found in most schools Live in soft bedding such as pillows, carpet, stuffed toys, fabric-covered furniture Live in soft bedding such as pillows, carpet, stuffed toys, fabric-covered furniture Feed on skin flakes Feed on skin flakes Mites and mite droppings can cause asthma and trigger existing asthma Mites and mite droppings can cause asthma and trigger existing asthma

9. Avoiding Dust Mite Triggers Select washable stuffed toys and wash them often in HOT water Select washable stuffed toys and wash them often in HOT water Cover pillows and mattresses in dust-proof zipped covers Cover pillows and mattresses in dust-proof zipped covers Vacuum often when people who are allergic arent around Vacuum often when people who are allergic arent around

10. Mold Found almost everywhere and can grow on almost any damp substance Found almost everywhere and can grow on almost any damp substance Key to mold control is moisture control Key to mold control is moisture control Eliminate excess moisture and clean up mold Eliminate excess moisture and clean up mold Reducing moisture also reduces other triggers such as dust mites and cockroaches Reducing moisture also reduces other triggers such as dust mites and cockroaches

11. Avoiding Mold Triggers Wash mold off hard surfaces Wash mold off hard surfaces Absorbent materials such as ceiling tiles and carpet may need to be replaced Absorbent materials such as ceiling tiles and carpet may need to be replaced Fix leaky plumbing and roofs Fix leaky plumbing and roofs Reduce condensation on cold surfaces such as exterior walls by adding insulation Reduce condensation on cold surfaces such as exterior walls by adding insulation Dont install carpet in areas with regular moisture problems such as drinking fountains and classroom sinks Dont install carpet in areas with regular moisture problems such as drinking fountains and classroom sinks

12. Pests Cockroaches and other pests such as rats and mice can be found in schools Cockroaches and other pests such as rats and mice can be found in schools Droppings or body parts of pests can trigger asthma Droppings or body parts of pests can trigger asthma

13. Avoiding Pest Triggers Integrated pest management (IPM) is used to avoid exposure Integrated pest management (IPM) is used to avoid exposure Key IPM methods Key IPM methods Look for signs of pests Look for signs of pests Do not leave food, water or garbage exposed Do not leave food, water or garbage exposed Remove pest pathways and shelters Remove pest pathways and shelters Use pest control products, such as poison baits, traps and pesticide sprays only as needed Use pest control products, such as poison baits, traps and pesticide sprays only as needed Avoid eating or drinking in classrooms Avoid eating or drinking in classrooms

14. Parents Right To Know Act Applies to public and non-public K-12 schools Applies to public and non-public K-12 schools Must notify parents and employees when plan to apply specific pesticides Must notify parents and employees when plan to apply specific pesticides MDH has model notices available on the environmental website page MDH has model notices available on the environmental website page

15. Secondhand Smoke Also called environmental tobacco smoke Also called environmental tobacco smoke Contains over 4,000 substances Contains over 4,000 substances Can cause asthma in young children Can cause asthma in young children Can trigger asthma attacks Can trigger asthma attacks

16. Avoiding Secondhand Smoke Minnesota law prohibits tobacco use in all K-12 public schools Minnesota law prohibits tobacco use in all K-12 public schools Enforce smoking bans Enforce smoking bans

17. Outdoor Environment Can trigger asthma Can trigger asthma Outdoor air quality Outdoor air quality Ozone Ozone Particulate matter Particulate matter School buses School buses Diesel emissions Diesel emissions State law State law

18. Outdoor Air Quality School staff have little control over most pollutants School staff have little control over most pollutants Sign up for Air Quality Index alert Sign up for Air Quality Index alert Pollution Control Agency sends electronic alerts when poor outdoor air is expected Pollution Control Agency sends electronic alerts when poor outdoor air is expected

19. School Buses State law requires schools to: State law requires schools to: Reduce unnecessary bus idling in front of schools Reduce unnecessary bus idling in front of schools Reroute bus parking zones away from air intake vents, if possible Reroute bus parking zones away from air intake vents, if possible Actions include: Actions include: Post no idling signs Post no idling signs Maintain bus fleet Maintain bus fleet Invest in cleaner fuels Invest in cleaner fuels Purchase newer, cleaner buses over the long-term Purchase newer, cleaner buses over the long-term

20. Other Environmental Issues Indoor Air Quality Management Plan Indoor Air Quality Management Plan Cleaning and cleaning products Cleaning and cleaning products Flooring Flooring Air cleaners Air cleaners

21. Indoor Air Quality Management Plan State law requires school districts to develop an Indoor Air Quality (IAQ) Management Plan State law requires school districts to develop an Indoor Air Quality (IAQ) Management Plan Health and Safety funds are tied to an approved plan Health and Safety funds are tied to an approved plan

22. IAQ Management Plan IAQ Management Plan must include: IAQ Management Plan must include: Certified (trained) IAQ Coordinator Certified (trained) IAQ Coordinator Walkthrough of all school buildings Walkthrough of all school buildings Evaluate specific building systems Evaluate specific building systems Written policies Written policies »Correct existing problems »Prevent future problems »Respond to emergencies and concerns School board approval School board approval

23. Cleaning And Cleaning Products Remove spots and stains immediately using manufacturers recommendations Remove spots and stains immediately using manufacturers recommendations Keep the dirt out by using walk-off mats at ALL entrances Keep the dirt out by using walk-off mats at ALL entrances Use recommended amounts of products Use recommended amounts of products Avoid products with irritants, chemicals or strong odors that may affect students and staff Avoid products with irritants, chemicals or strong odors that may affect students and staff Dont mix cleaning products Dont mix cleaning products

24. Flooring No one floor covering works for all situations No one floor covering works for all situations Maintenance is key Maintenance is key Keep out dirt, use walk-off mats Keep out dirt, use walk-off mats Regular vacuuming helps reduce allergens Regular vacuuming helps reduce allergens Carpet and Rug Institute Green Label program for vacuum cleaners Carpet and Rug Institute Green Label program for vacuum cleaners Consider carpet with high density, short pile & short level loop Consider carpet with high density, short pile & short level loop

25. Air Cleaners Consider other control methods first Consider other control methods first Need to consider type and size for best results Need to consider type and size for best results Avoid ozone air cleaners Avoid ozone air cleaners

26. Acknowledgements & Resources Resources and materials used Resources and materials used US Environmental Protection Agency http://www.epa.gov/iaq/schools/asthma/index.html Minnesota Pollution Control Agency http://aqi.pca.state.mn.us/hourly/ http://aqi.pca.state.mn.us/hourly/ Minnesota Office of Environmental Assistance Minnesota Office of Environmental Assistancehttp://www.moea.state.mn.us/ee/noidle.cfm

27. Acknowledgements & Resources Resources and materials used Resources and materials used MDH Environmental Health Division http://www.health.state.mn.us/divs/eh/indoorair/schools/index.html Minnesota Department of Agriculture http://www.mda.state.mn.us/ipm/ipminschools.html Institute of Medicine Clearing the Air: Asthma and Indoor Air Exposures http://www.nap.edu/books/0309064961/html/