air epair indoor - aap.org · so thick with them they would hide your hand. so where did they go...

at Home, Schoo l and Play

5th Edition aanma.org

AIRepair™INDOOR

2 • AANMA Indoor AIRepair aanma.org

8229 Boone Blvd., Suite 260Vienna, VA 22182Phone: 800.878.4403www.aanma.org

Indoor AIRepairTM at Home, School and Play is published by Allergy & Asthma Network Mothers of Asthmatics (AANMA), Copyright 2003. Revised 2014. All rights reserved.

AANMA Mission: Founded in 1985, AANMA is the leading nonprofit patient-centered organization dedicated to eliminating needless death and suffering due to asthma, allergies and related conditions through education, advocacy, outreach and research.

Funded by the U.S. Environmental Protection Agency (EPA) under cooperative agreement XA-83466701. The contents of this document do not necessarily reflect the views and policies of EPA, nor does mention of trade names or commercial products constitute endorsement or recommendation for use.

800.878.4403 AANMA Indoor AIRepair • 3

Every breath we take contains millions ofparticles of dust, allergens, chemicals, pol-

lutants and other tiny molecules. Andwhile pollen and outdoor air pollution get

most of the attention, EnvironmentalProtection Agency (EPA) studies show thatpollutant levels inside homes and buildingsare two to five times higher than outside!

When you have asthma and allergies, thatputs clean indoor air at the top of your

must-have list.

Welcome to Indoor AIRepair at Home,School and Play, a family-friendly maga-

zine developed by Allergy & AsthmaNetwork Mothers of Asthmatics.

IndoorAIRepair™at Home, School and Play

4 Asthma – What’s It All About?

5 Indoor AIRepair at Home7 Room-by-Room

11 Recipes for Success: Nontoxic cleaningrecipes

14 The Importance of a Smoke-Free Home

15 Asthma At A Glance

16 AIRepair Friends and Neighbors:Organizations, government agencies andwebsites that can help you repair your air

18 Indoor AIRepair Checklist

19 Indoor AIRepair at School: HelpingParents, Students and Teachers Breathe Easier

20 Indoor Air Pollutants -- Finding the source:Mold, Pests, Animals, Secondhand Smoke,Dust Mites

25Managing Medications at School

26 Common Medication Myths

27 Advice for Parents

28 Advice for Teachers

31 Indoor AIRepair at Play: The Businessof Being a Kid

32 Asthma and Allergy Fun Busters: Keep play-time safe for little airways by watching outfor these symptom-starters

33 AIRepair Tips: Play dates and birthday parties; slumber parties and overnights;community center classes; travel

35 Fun-tastic Activities for Kids

PLAY

SCHOOL

HOME

Inside:

4 • AANMA Indoor AIRepair at School aanma.org

Signs that an asthma episode is underway and needs treatment:

l coughing – with or without throat clearing, sniffling. The cough may comeevery few minutes or within seconds.

l wheezing – this whistling sound can sometimes be heard as the personbreathes out. Wheezing is a sign the asthma episode is becoming danger-ous. However, not all people with asthma wheeze during an asthmaepisode. Others may always sound wheezy – not a good thing.

l breathing – becomes rapid and difficult.l talking – may be difficult, but the person with asthma will usually use fullsentences when symptoms first show up. As the episode gets worse, he orshe will use fewer and fewer words.

l energy level – may decrease slowly or suddenly. If the person has been running, he may stop, lean forward and place his hands on his knees while trying to catch his breath.

Each person responds to asthma differently and may display any or all of these symptoms during an asthma episode.

Steps to take if a person shows the above symptoms:

l take the person away from any obvious irritants that are making it difficult to breathe (such as animals, smoke or chemical smells).

l use the prescribed inhaled bronchodilator immediately. This medicationrelaxes twitchy airways so the patient can breathe more easily.

l help the patient drink water to keep airways hydrated.l allow him or her to rest long enough to recover.

It is important for the patient to use the prescribed bronchodilator (albuterolor levalbuterol) at the first sign of symptoms. Most often, people will recoverquickly as the medication takes effect. However, the longer the symptomscontinue without medication, the more dangerous the episode becomes.

Signs the person needs emergency medical assistance:l breathing doesn’t become easier within 5 minutes after inhaling thebronchodilator medication. The skin around the person’s neck, collar-bone and ribs may appear to suck in with each breath or the stomachmay contract.

l skin color – may become pale or dusky. Lips may lose color or fingernailsmay look slightly blue. Dark circles may form around the eyes.

l talking – the person may become very agitated, talking in single words only.l wheezing – is louder and longer. Sometimes, wheezing may disappear altogether, if the airways are so clogged with mucus that airflow is notstrong enough to produce wheezes.

Steps to take if you notice any one of these symptoms:

l call 911 for emergency assistancel call the parents, if the patient is a child

Breathe in. Oxygen just passedthrough your nose, sinuses andthroat. It branched into a system ofsmaller and smaller air tubes in yourlungs, then entered your bloodthrough tiny air sacs – billions ofthem! Circulating red blood cellspicked up the oxygen and carried itto your brain, heart, kidneys, musclesand skin – every organ of your body.

Now breathe out. Used oxygen,which has become carbon dioxide,just left your blood, reenteredthose air sacs and traveled backthrough your airways into theroom where you sit.

That breath contained more thanjust oxygen – mixed in were 25 mil-lion tiny pieces of dust, allergens,irritants and other air pollutants. Ifyou could see these tiny moleculesfloating in the air, the air would beso thick with them they would hideyour hand. So where did they gowhen you inhaled them?

Many stuck to the hairs inside yournose and sinuses. Others got trappedin mucus inside your airways. Eachtime you swallow, cough, sneeze orblow your nose you get rid of a fewmillion. It’s nature’s filter system.

But for people with asthma, someinhaled particles go too far. As theyhit the airways, they signal the bodyto make more mucus and releasefluids. Breathing tubes and nasalpassages swell and clog. Muscles thatusually keep the airways open beginto twitch and squeeze, trying tomake room for the air.

This is what some people call anasthma attack or episode. In the earlystages, aside from a slight cough orsniffle, the person’s breathing maylook normal. But within minutes orhours, the picture changes, as usedair gets trapped inside the air sacsand fresh air can’t get in.

Asthma – What’s it all about?Take a Deep Cleansing Breath

ASTHMA SYMPTOMS

800.878.4403 AANMA Indoor AIRepair at Home • 5

Get ready to roll up your sleevesand pinch the dust mask tight onyour face because we’re going in –into your home, that is – hunting forairborne invaders that can make yousneeze, wheeze, itch and drip!

That’s right – AANMA’s IndoorAIRepairTM guide will help you findand remove allergens and irritantsthat can trigger asthma, allergies andother health conditions. Every homehas them, whether tent, mansion oranything in between, but we don’talways recognize them.

The point is, even if you think the airinside your home is clean, it may notbe as healthy as you’d like. So use thisIndoor AIRepair guide as a startingpoint. Shine your flashlight in everynook and cranny, searching for theclues we list room-by-room, then fill

in your Checklist and use ourAIRepair tips to clean things up. Needoutside help? Consult the Friends andNeighbors resource list and don’tdespair! As intimidating as theprocess can seem, there’s always help.

Visit AANMA’s website, www.aanma.org, to find additional resources andhelp and to join our network of fami-lies, caregivers, consumer advocates,and healthcare professionals.

Share your AIRepair stories and tips --write to [email protected] or AANMA, 8229 Boone Blvd., Suite 260,Vienna, VA 22182.

Join us on Facebook.com/aanma or follow us on twitter.com/aanma

Your opinions are important! Let’s stay in touch!

Helping OthersBreathe Easier

AIRepair™INDOOR

A T H O M E

6 • AANMA Indoor AIRepair at Home aanma.org

Your home is your castle, be it anapartment, mobile home, single-family dwelling or townhouse in thebustling city, suburbs or rural country-side. And whether you consideryourself a neat freak or a creativelycluttered person, if you or someonein your family has asthma or allergies,the air inside your home may bemaking you sick.

Americans spend nearly 90 per-cent of our time inside – and oftentake indoor air quality for granted.But Environmental ProtectionAgency (EPA) studies show air pollutant levels may be two to five times higher indoors than outdoors!

If we could color the tiny air specksand chemicals we breathe eachday, we’d be amazed at all the par-ticles that constantly bombard ourairways. Allergens such as animal

dander, dust mites, cockroachesand mold; irritants such as smoke,chemical odors and dust; and bio-logical pollutants such as virusesand bacteria swirl in, often causingheadaches, stuffy nose, ticklythroat, nagging cough, wheezing,shortness of breath, itchy eyes andmore. And while medications cansometimes relieve these symptoms,

Calling All Neat FreaksandMessies

Find it Fix itHow good is your home’s indoor air quality?

Even the cleanest homes have room for improvement. Take this quick quiz – the answers may surprise you!

Tell AANMA

how your

self-tour went, what you did

and the results you expect.

[email protected]

the best way to prevent them is toremove the offending elementsfrom our home, school and playenvironments.

Asthma and allergies are the mostcommon health conditions linkedwith indoor pollutants. Othersinclude rhinitis, chronic sinusitis,eczema, skin rashes, fungal infec-tions, headaches and eye irritations.

How healthy is the air inside yourhome? Let’s find out. Grab a dustmask, a pair of gloves, a flashlight,a pencil and this Indoor AIRepair atHome guide. Start at the kitchensink (or any other convenient pointin your home) and take the Room-by-Room tour to look for indoorallergens, irritants and pollutants.Record your findings on the handyChecklist on page 18.

My family and I have takenthe EPA Smoke-Free HomePledge.

I’ve marked the calendarto check the filters oncea month.

We use only unscentedor nontoxic cleaningproducts.

I’ve reminded my familymembers to run theexhaust fan during andafter their showers, andI’m now using a mildew-free shower curtain.

I’ve put dust-mite-proofcovers on my mattress,box springs and pillows.

Friends and/or family uselighted tobacco products inmy home.

It has been more than onemonth since I cleaned orreplaced the air filter onour heating/cooling unit.

We use bleach indoors andother scented cleaners inour home.

My shower enclosureseems impossible to keepfree from mold.

I often wake up with anitchy nose and eyes.

FIND IT? FIX IT!

Yes Non n

Yes Non n

Yes Non n

Yes Non n

Yes Non n

Yes Non n

Yes Non n

Yes Non n

Yes Non n

Yes Non n


A T H O M E

Getting StartedLike a detective, you will be lookingand sniffing for clues pointing toindoor allergens, irritants and pollutants. Some things to look for:

l Petsl Tobacco smokel Odorsl Accumulated house dustl Cockroachesl Rodent droppingsl Mold l Pollenl Leaky pipesl Cleaning products

Indoor AIRepair Room-by-Room

AIRepair:

l Repair leaking faucets (a simple “o” ring or washermay do the trick) and pipes to discourage moldgrowth, rodents and other pests.

l Wash dishes immediately after use; dry and replace incupboard.

l Place thin lemon slices in the garbage disposal andturn it on while running cold water into the sink tokeep it smelling fresh and clean.

l Limit clutter under the sink; wipe the area cleanmonthly to discourage pests and mold growth.

l Never store wet sponges or dishrags under the sink.l Stuff steel wool in gaps left around plumbing pipes toprevent rodents from entering the kitchen from behindthe wall.

l Use nontoxic, childproof insect and rodent traps orbaits to reduce pests.

l Use a lid on your trash bin. Empty trash daily. Cleanthe inside and outside of trash bin weekly.

l Store pet food and bird seed in airtight containers.Wash and put away pet food dishes each night.

l Replace odor-masking, fragranced and expensivecleaners with nontoxic, fragrance-free and inexpensivealternatives using ingredients you probably alreadyhave in your kitchen! (page 11)

Start your investigation in the roomwhere symptoms happen most oftenor where you know a problem exists.For example, if your child coughs atnight or you are congested every

morning when you wake up, tacklethe bedrooms first. Your problemcould be dust mites, feather pillowsor mold.

But don’t stop there – continue onthrough each room of the house,spreading the hunt over several days,if necessary. Tackle one project orroom one day, week or month at atime. And do yourself a favor: Give upthe impossible dream of a germ-free,sterile home. You’ll wear yourself outand drive your family crazy if you tryto create it.

KITCHEN: SINK/CABINETCommon allergens and irritants: Mold, cockroaches, rodent droppings, cleaning supplies

Clues that there may be an indoor air problem:

l Water puddles or leaks around or near the faucet orhardware

l Loose or missing grout where the sink meets the coun-tertop

l Black or brown mold on the backsplash or countertop oraround the drain

l Dirty dishesl Scum or discoloration under the dish drain matl Odors coming from the garbage disposall Damp or wet plumbing pipes or flooring under sinkl Musty or damp smell inside cabinetl Black, brown or rust-colored areas on back wall, pipes orflooring under sink

l Gaps between pipes and wallboardl Warped or rotting wallboard or flooringl Black or brown rodent droppings (about the size of rice)l Dust clumps containing insect parts (cockroach nests)l Silverfishl Open or overflowing trash binl Pet food, bird seedl Cleaning products, particularly those containing perfumesor other strong smells



l Dust or slimy dark spots on top of orbeneath the refrigerator

l Mold, dust and water in the drippan (if you have one, the drip pan isusually beneath the refrigerator afew inches off the floor behind a kickplate)

l Sticky substance left from liquidspills underneath the refrigerator

l Dusty backside of the refrigeratorand wall

l Black or brown rodent droppings(about the size of rice) on the floor

l Moisture on refrigerator surfacesl Black growth on the door or doorseal (the flexible rubber gasket)

AIRepair:

l Keep the refrigerator top clutter-free to make dusting an easypart of your cleaning routine.

l Sprinkle salt in the drip pan toinhibit mold growth.

l Pull the refrigerator out fromthe wall. (You may want towear a dust mask if it’s been awhile since you did this!)Vacuum dust off refrigeratorcoils and fan; it will help reduceenergy costs, too!

l Damp mop the floor under therefrigerator each season.

l Place nontoxic, childproofrodent bait or traps behind therefrigerator. Check them often!

Common allergens and irritants: House dust, mold, cockroaches, rodent droppings

KITCHEN: REFRIGERATOR

KITCHEN: OVEN/STOVE


l Dust, dust clumps containingcockroach eggs and decayinginsects, decaying food androdent droppings found on thefloor or in the drawer

l Sticky, greasy filters on ovenexhaust fan

l Roaches appear when oven isturned on

AIRepair: l Periodically remove and clean thedrawer at the base of the oven andvacuum or mop the floor areaunderneath the oven.

l Use nontoxic, childproof cockroachand/or rodent traps or bait.

l Use an exhaust fan when cooking toreduce moisture and odors.

l Clean exhaust fan filter or screen toremove cooking grease build-up.

Common allergens and irritants: Dust, mold, cockroaches, rodent droppings

l Allergies are the 6th leadingcause of chronic disease in theU.S. and each year more than 50 million Americans experiencesymptoms of allergic diseases,including rhinitis, sinusitis, dermatitis, asthma, and foodallergy.1

l Allergic rhinitis, often called hayfever, causes symptoms such asitchy eyes, nose, throat or ears;watery eyes; runny nose andcongestion; wheezing; sneez-ing; headache; and fatigue.

l Perennial (year-round) allergicrhinitis is generally caused bysensitivity to indoor allergenssuch as house dust mites, animaldander, cockroaches and/ormold spores. Seasonal allergicrhinitis occurs in spring, summerand/or early fall, usually causedby tree, grass or weed pollensor airborne mold spores.2

l Allergic asthma is the most common form of asthma.Indoor environmental factorsthat can trigger symptomsinclude dust mites, molds, cockroaches, pet dander, andsecondhand smoke.3

l Some allergies can trigger anaphylaxis, a life-threateningreaction that can cause swellingof the throat and/or tongue anda severe drop in blood pressure.

1. The Allergy Report, AmericanAcademy of Allergy, Asthma &Immunology, 2000

2. Allergy Facts, American College ofAllergy, Asthma & Immunologyhttp://www.acaai.org/allergist/news/Pages/Allergy_Facts.aspx

3. Asthma Facts, EnvironmentalProtection Agency,http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf

Allergiesat aGlance


Common allergens and irritants: Mold, cockroaches, rodent droppings


l Food clinging to wastecan, compactor or recycle bin surfaces

l Odorsl Black or brown rodentdroppings in or nearwaste can, compactoror recycle bin

AIRepair:l Remove kitchen waste daily. l Do not use odor-maskingproducts. Odor alerts you toan allergen or irritant, rottingfood and/or moisture.

l Keep waste can, compactorand recycle bin surfaces andareas clean.

l Wash or rinse out bottlesand cans before placing inrecycle bins.

Common allergens and irritants: Mold, cockroaches, rodent droppings


l Green, gray, brownfuzzy growth on breador yeast-containingproducts

l Ashtraysl Spilled food orcrumbs

l Cockroaches, silverfishl Black or brownrodent droppings onshelving or in drawers

l Paper grocery bags

AIRepair:l Discard bread and other bakeryfoods when no longer fresh.

l Never allow anyone to smokein your home. (See page 14.)

l Store all food in airtight con-tainers or bags when not in use.

l Keep countertops clean andfree of crumbs or spills.

l Place childproof, nontoxic cockroach and/or rodent baitsin your kitchen. Follow packagedirections carefully.

l Throw away stacks of old paperbags. (They’re perfect hidingplaces for cockroaches!)

KITCHEN:WASTE CANS,COMPACTORS,RECYCLE BINS

KITCHEN:CUPBOARDS

ANDCOUNTERTOPS


l Black or brown growth on grout or surfaces,particularly in corners (check around shower,tub enclosure, floor near shower, tub orsink, under sink or on backsplash, behindtoilet tank or on floor at base of toilet)

l Missing grout in bath, shower or sink areasl Musty smelll Dust/mold clinging to the exhaust fan vent

coverl Fragranced or strong-smelling cleansers,personal hair and body care products

AIRepair:l Remove obvious signs of mold growth. (Seepage 11 for cleaning solution suggestions.)Mold stains may be difficult or impossible toremove from white grout or caulking. Whilethey can be unsightly, stains do not pose ahealth problem.

l Replace missing grout. Repair or replaceleaky faucets and pipes immediately. Yourlocal home hardware expert can help do-it-yourselfers or this may require plumbing skills.

l Use an exhaust fan or open a window while showering to remove excess humidity.Vacuum or wash exhaust fan vent covers toremove accumulated dust which may alsocontain mold.

l Wipe the shower walls and tub toys dryafter use.

l Use a mold-proof shower curtain. Keepenclosure doors and tracking clean and freeof mold build-up.

l Dry your feet and legs before stepping ontothe bathmat. Use a towel-style bathmatinstead of a plush carpet. It is easier to cleanand does not retain moisture as much asthicker or rubber-backed mats.

BATHROOM

Common allergens and irritants: Mold, fragranced cleaners, personal care products

A T H O M E


Dust mites look like ferocious monsters, but thousands could sit on a pinhead.They thrive in pillows, mattresses, upholstered furniture, stuffed toys and carpets:wherever they have a steady supply of human dander (shed flakes of skin).When inhaled, tiny dust-mite droppings trigger coughing, stuffy nose, itchy eyesor wheezing. Keep dust mites at bay by reducing room humidity levels below 50percent; washing bedding frequently; and using dust-mite-proof encasings on your mattress, box spring and pillows.

More information: www.epa.gov/asthma/dustmites.html.

Photograph courtesy of Precision Fabrics Group, Inc. maker of Pristine®


l Humidity levels above 50 percentl Upholstered furniture or carpet inbedroom

l Moldy smell from clothes hamper ordark spots on inside surfaces

l Moisture or dark areas on windowglass and/or window frame

l White powdery coating on shoes incloset

l Empty food containers, crumbsl Petsl Ashtraysl Hobby productsl Stacked books and magazinesl Deodorant sprays, room deodorizers,talc powders, perfumes, hairspray

AIRepair:l Purchase an inexpensive humiditygauge to measure indoor air humidity.Keep humidity levels between 30 and50 percent to minimize mold growthand dust mite populations.

l Limit upholstered furniture, whichbecomes a breeding ground for dustmites.

l Choose washablestuffed toys; washwith bedding in hotwater. Dry completely.Keep stuffed toys offthe bed.

l Use washable throwrugs and curtains (or usewindow shades or blinds instead).

l Put pillows and mattress inside specially designed dust-mite-proofcovers.

l Wash bedding weekly in hot (130°F)water.

l Vacuum and dust the bedroomonce each week. Use a HEPA (highefficiency particulate air) filteredvacuum.

l Vacuum mattress dust-mite coverswhen changing sheets or cleaningroom.

l Avoid carpeting in bedroom ifpossible. Existing carpet should bein good condition with no signs ofmold or dust accumulation. Paddingshould be in good condition – nosigns of crumbling or rotting. Simplywalking across a carpeted floor sendstiny allergens into the air.

Many factors affect indoor air humidity. For more, visit: www.

epa.gov/iaq/homes/hip-moisture.html.

You can purchase a HEPA vacuum cleaner or use replaceable filter bags designed to trap allergens

as small as .03 microns.

BEDROOMAND SLEEPING AREAS

Common allergensand irritants: Dustmites, mold, cock-roaches, pet dander,chemical fragrances

l Empty clothes hamper daily. Never store wet items inside.

l Do not allow clothing to pile on the floor or in corners.

l Water droplets form on windowsand window frames when air tem-peratures inside and outside the

house vary greatly. There arenumerous ways to fix theproblem – some arevery inexpensive. Seeyour local homehardware expertsfor suggestions.

l Find and stop thesource of humid-ity in the closet causing powdery moldto form on shoes. Leave light on incloset.

l Keep food out of the bedroom.l If allergic to pets, keep them out ofthe bedroom. (Pets usually adjust tothis change faster than their owners!)

l Avoid using the bedroom for hobbyprojects as these increase exposureto allergens, irritants and pollutants.

l Limit bedroom reading material;stacked books and magazines retainhumidity and encourage moldgrowth.

l Whenever possible, use unscentedpersonal hygiene and hair careproducts. Do not use scented candlesand odor-masking room deodorizers.

l Keep potted plants (a source ofmold growth) out of the bedroom.

l Use paints or wallpaper treatedwith mold inhibitors when redec-orating.

Never let anyone smoke in your home. (See page 14.)


A T H O M E


l Ashtraysl Fabric upholstered furniturel Petsl Carpeting and paddingl Food crumbs on carpet and under-neath couch cushions

l Stacked firewood or kindling, ashesor burned wood smell in the fireplace

l Kerosene heaters, wood stoves, coal stoves

AIRepair:l Never permit any person to smokeinside your home. (See page 14.)

l Secondhand, upholstered furnitureor antiques may contain mold,dust, dust mites and pet allergens.Replacement alternatives to considerinclude vinyl, leather or other washable-surface furniture.

l Keep pets off the furniture and outof the family room.

l If family members are diagnosedwith pet allergies, consider finding anew home for your pet or create safeand weather-protected living spaceoutside the home for your animal.

l Vacuum underneath and behindfurniture and underneath couch andchair cushions at least once a month.

l Vinyl beanbag chairs provide kid-friendly seating for watchingtelevision and playing games.

l Replace moldy carpet and padding(check in front of doors leading tothe outside of your home, in corners,etc.), preferably with hardwood orother hard-surface flooring. Avoidproducts requiring toxic glues orfumes when possible.

l If the floor beneath the carpet isconcrete, make certain the concretewas sealed or a moisture barrier orwood planking was placed betweenthe padding and floor before thecarpet was installed. If the basementhas ever flooded, don’t install carpetor wood flooring.

l Use paints or wallpaper treated withmold inhibitors when redecorating.

l Eat meals in the kitchen/dining area.Enjoy snacking while watching television, but remember to cleanunder couch, chairs, and cushionsafter eating.

l Use water-filled radiant electricheaters as a supplemental heatsource in place of wood or coalstoves, fireplaces and kerosenespace heaters.

LIVING ROOM

Recipes forSuccess

Clean mold and mildew with:l 1 tablespoon baking soda + 2 tablespoons white vinegar + 1 quart water

Disinfect with:l 1/2 cup borax + 1 gallon hot water

or...

l 1/4 cup baking soda + 1/2 cupwhite vinegar + 1 gallon warmwater (for toilet bowls)

Remove rust from countertopswith:l A paste of cream of tartar andlemon juice (allow paste to sit onrust spot for 15-30 minutes, scrubwith sponge, rinse)

Clean shower soap scum with:l Undiluted, heated white vinegar(put in spray bottle, spray on, letsoak for 15 minutes, apply dryborax, scrub)

Clean dirty shower grout with:l 2 cups baking soda + 1 cup borax+ 1 cup hot water

Clean glass and mirrors with:l 3 tablespoons white vinegar + 3/4 cup water

Deodorize and freshen mustyareas with:l Baking soda in an open containerl White vinegar in an open container

Clean drains monthly with:l Baking soda and vinegar (pour 1/2cup baking soda into drain followedby 1/2 cup white vinegar; let sit 30minutes, then flush with cool water)

Cleaning recipes from 101 Ways toReduce Allergens in Your Home byJayne Ruppenkamp

Common allergens and irritants: Dust mites, pet allergens, mold, secondhand smoke,

firewood, coal dust, kerosene

Keep Indoor Humidity Low

If possible, keep indoor humidity between 30 and 50 percent relativehumidity. Relative humidity can be measured with a moisture or humiditymonitor, a small, inexpensive ($10-$50) instrument available at manyhardware stores.


ATTICUNFINISHED


l Dampnessl Temperature and humidity differences from the rest of the house

l Musty smell; rodent or pet urine smell

l Silverfish, crickets, spiders or other insects

l Black or brown rodent droppings,particularly in corners or alongthe perimeter

l Mold spots or dust on coils ofdehumidifier

AIRepair:

l Look for the cause of dampness.Use a flashlight to look for cracksin the foundation or warpedwallboard or paneling. Lift carpeting along the edges to

check for mold growth. If interior walls are exposed,look for cracks in thefoundation. If found, youmay need to contact yourlandlord or an expert torepair the foundation of your home.

l If you plan to remodel an unfinished basement, contact yourheating and air-conditioning contractor to ensure your existingsystem can handle the increaseddemand of heating and coolingfinished spaces.

l Do not block air vents or restrictair flow around air handlingequipment (furnace, swamp cool-er, air conditioner, etc.). Keep areaclean and dry.

l Use a dehumidifier when humidityclimbs over 50 percent.

Common allergensand irritants:

Mold, cockroaches,pet dander, rodent

droppings


l Sounds of birds or animals in theeaves

l Birds flying into eavesl Bird or other animal droppings,carcasses

l Wet or warped interior walls, studs,flooring

l Daylight visible in areas that shouldnot be exposed

l Moldy, damp or rotten smelll Matted or moldy-looking insulation

AIRepair:

l Bird and animal proof your attic.l Seal any gaps leading to living spaces, such as around light fixturesor heating and air-conditioningvents. You may want to contact aheating and air-conditioning contractor to do this for you.

l Determine cause of wet or warpedwalls, studs or flooring.

l Repair cause (construction faults or storm damage) of problem andreplace damaged insulation andstructures. Check your homeowner’sinsurance policy. Damages may becovered. If you do not own yourhome, notify the landlord as soon asyou discover the problem.

Common allergens and irritants: Mold, insulationfibers, dust, bird and/or

rodent droppings

BASEMENTFINISHED

AND UNFINISHED

l Clean dehumidifierdrip pan accordingto manufacturer’sinstructions.

l Leave the lights on (mold prefersdark spaces) inbasements withlimited windows.

l Avoid using carpet on concretebasement floors.

l Ideally, apply a water sealant tooutside walls before finishingbasement interior.

l Replace cardboard storage boxeswith plastic containers with lids.

l Wash mold off hard surfaces anddry completely. Moldy ceiling tiles,carpets, wood, furniture, etc.,should be removed (wear a dustmask and goggles) and replaced.

l Be certain to fix the cause ofthe mold!

l Use childproof, nontoxic cockroach, insect or rodent bait or traps.

l Do not use the basement for sleeping purposes. Family members with asthma or allergies should minimize timespent in the basement.


A T H O M E

Home builders increasingly attach the car garage directly to thehome – sometimes off the kitchen, underneath a bedroom or next tothe family room.

When used to store old paint cans, gasoline, lawn mowers, pesticides,wood stains, woodworking projects and/or household cleaners, thegarage becomes the most toxic room in the house. Chemicals seep intoyour breathing space through tiny cracks and gaps between thehome’s foundation and walls.

Families also often put recycling bins and trash cans inside the garage;however, failure to keep this area clean will attract rodents, cockroachesand other unwelcome allergens and irritants.

Common allergens and irritants: Chemicals, cockroaches, rodent droppings

Your laundry area may be down the hallof your apartment building, in your kitchen,outside your bedroom door, in the base-ment or in the garage. However, alwayskeep your laundry area clean and dry toeliminate mold, a sign of high air moisturecontent and possible hidden water damage.

Common allergens and irritants: Mold, dust


l High humidity or moisture levelsl Wet clothes left in the washing machinel Wet clothing pilesl Clothing lint and dust on floor and wallsnear washer and dryer

l Cleaning agents such as bleach or heavilyscented fabric cleaners and softeners

AIRepair:l Pull the washing machine away from the wall. Use the flashlight to look for plumb-ing leaks. Tighten pipes and hoses ifneeded. Clean the floor before replacingthe washing machine.

l Pull the dryer away from the wall. Usethe flashlight to check the exhaust hose.It should be vented to the outside of thehouse. Turn the dryer on while theexhaust hose is still attached to the wall.Then go outside your home and find theexterior vent. Do you feel warm air com-ing out? If so, that’s good news. If it isweak or you don’t feel any air at all, youhave a problem that needs to be fixed.Either your exhaust hose is clogged withlint or it is not properly vented to theoutside of your home. Clean the floorand walls before replacing the dryer.

l Ask your landlord to keep your laundryfacility neat and dry with plenty of freshair ventilated into the area.

l Bleach is an airway irritant known to produce symptoms in some adults andchildren with asthma. Avoid using bleach.

l Use unscented laundry products.

LAUNDRY AREA


l Attached garagel Car(s) inside garagel Gasoline-powered tools andequipment

l Cleaners, pesticides and otherstrong-smelling chemicals

l Trash cans, recycle bins

AIRepair:

l Switch to electric or human-powered lawn mowers, hedgecutters and other tools.

l Paint should never be stored in the garage; temperature

Know Your AllergensA board-certified allergist can provide allergy testing and con-sultation to help you find out which things in your home may becausing your symptoms or making them worse.

Focus your indoor air repair actions and budget on those areasmost likely to cause symptoms. For example, if your biggestproblem is dust mites, concentrate on reducing humidity andallergy proofing the bedroom first.

GARAGE

extremes cause it to go bad rapidly. When finished painting aroom, pour a small amount ofpaint into a clean glass jar with atight-fitting lid. Label with date,color, manufacturer and room itwas used in before storing in apart of your home where it willnot be exposed to temperaturechanges.

l Dispose of unused lawn and garden powders, sprays and pellets.

l If using the garage for hobbiesor fix-it projects, make sure it iswell ventilated.

l Do not leave car running ingarage.


Secondhand smoke is a mixture ofthe smoke given off by the burningend of a cigarette, pipe, or cigar,and the smoke exhaled by smokers.It contains more than 4,000 sub-stances, several of which are knownto cause cancer in humans or ani-mals.

EPA has concluded that exposure tosecondhand smoke can cause lungcancer in adults who do not smoke.It has also been shown in a numberof studies to increase the risk ofheart disease.

Children are particularly vulnerableto the effects of secondhand smokebecause they are still developingphysically, have higher breathingrates than adults, and have littlecontrol over their indoor environ-ments. Children exposed to highdoses of secondhand smoke, such asthose whose mothers smoke, runthe greatest relative risk of experi-encing damaging health effects.

If you smoke at home, consider howit affects your child’s health:

More frequent and severe asthma attacks

Secondhand smoke irritates the

airways and triggers asthma symp-toms. According to the Centers forDisease Control and Prevention, chil-dren with asthma who breathe sec-ondhand smoke have more severeasthma episodes and lower lungfunction than children with asthmawho are not exposed to smoke.Inhaling secondhand smoke mayactually cause asthma in some chil-dren. A study in the AmericanJournal of Respiratory and CriticalCare Medicine found that thenumber of children diagnosed withasthma at age 6 or younger wastwice as high in families whosmoked as in nonsmoking families.

Greater risk of lower respiratorytract infections (bronchitis andpneumonia)

According to the EnvironmentalProtection Agency, secondhandsmoke exposure causes 150,000 to300,000 lower respiratory tractinfections every year in children18 months or younger, resulting inas many as 15,000 hospitalizationsper year. Secondhand smoke canalso aggravate sinusitis, bronchitis, cystic fibrosis and chronic respiratory problems like cough and postnasaldrip.

What do most children with asthma who are treated in hospital emergencydepartments have in common? They live with family members who smoke at home.

What is the best way to eliminate tobacco smoke from the home?Do not allow any person to smoke in your home or near windows and doors leading to your home.

Why is it so important to have a Smoke-free home?

More frequent ear infections

Inhaled secondhand smoke irritatesthe Eustachian tube (the tube connecting the back of the nosewith the middle ear) and causes abuild-up of fluid in the middle ear.

Greater risk of Sudden Infant DeathSyndrome (SIDS)

Mothers who smoke while pregnantare more likely to have their babiesdie of SIDS. Babies who are aroundsecondhand smoke—from theirmother, their father, or anyoneelse—after they are born, are alsomore likely to die of SIDS than chil-dren who are not around second-hand smoke.

www.epa.gov/smokefree


A T H O M E

U.S. Asthma Statisticsl Asthma prevalence increased from7.3% in 2001 to 8.6% in 2011, when25.9 million persons had asthma.1

l 18.9 million adults aged 18 and over 2

l 7.1 million children aged 0–17 years 3

l Females have higher asthma prevalence than males (9.9% compared with 6.2%) 2

l Adults of multiple races have the highest asthma prevalence (14.5%) 2

l 14.2 million physician office visits4; 1.3 million outpatient visits5; and 1.8 million emergency department visits for asthma 6

l Number of deaths per year: 3,404 7

l 34% higher among females than males 8

l 75% higher for black persons than white persons 8

l 6.3 times higher for adults (over 18) than children 8

l Number of hospital discharges with asthma as first-listed diagnosis:439,000 9

l Average length of hospital stay: 3.6 days 9

l 10.5 million school days and 14.2 million work days missed by peoplewho experienced at least one asthma attack during the year 8

l Medical expenses associated with asthma increased from $48.6 billion in 2002 to $50.1 billion in 2007 10

l 3 in 5 people with asthma limit their physical activity 11

l 1 in 5 children with asthma went to an emergency department for asthma-related care in 2009 11

1 Summary Health Statistics for the U.S. Population: National Health Interview Survey, 2011; National Center for Health Statistics data briefSeries 10, Number 255; Centers for Disease Control and Prevention;

2 Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2011; National Center for Health Statistics data brief Series 10,Number 256; Centers for Disease Control and Prevention;

3 Summary Health Statistics for U.S. Children: National Health Interview Survey, 2011; National Center for Health Statistics data brief Series10, Number 254; Centers for Disease Control and Prevention

4 National Ambulatory Medical Care Survey (NAMCS): 2010 Summary Tables, table 13; Centers for Disease Control and Prevention

5 National Hospital Ambulatory Medical Care Survey (NHAMCS): 2010 Outpatient Department Summary Tables, table 11; Centers for DiseaseControl and Prevention

6 National Hospital Ambulatory Medical Care Survey (NHAMCS): 2010 Emergency Department Summary Tables, table 12; Centers for DiseaseControl and Prevention

7 Deaths: Final Data for 2010, tables 10, 11; National Vital Statistics Reports, Vol. 61, No. 4; May 8, 2013; Centers for Disease Control andPrevention

8 National Surveillance of Asthma: United States, 2001-2010, Vital and Health Statistics, Series 3, Number 35, November 2012, Centers forDisease Control and Prevention

9 National Hospital Discharge Survey: 2010 table, Average length of stay and days of care; Centers for Disease Control and Prevention

10 Vital Signs: Asthma Prevalence, Disease Characteristics, and Self-Management Education – United States, 2001-2009; Morbidity andMortality Weekly, May 6, 2011; Centers for Disease Control and Prevention

11 Asthma’s Impact on the Nation, 9/23/2013; National Asthma Control Program, National Center for Environmental Health, Centers forDisease Control and Prevention

Asthmaat a Glance

l Exposure to allergens, irri-tants, respiratory infections,dry or cold weather or exercisecan cause asthma symptoms tobecome more noticeable.

l When asthma happens,swollen airways fill with fluidand mucus, restricting breathingspace. The muscles surroundingthe airways tighten (broncho-spasm).

l Asthma medications treat andprevent inflammation,swelling and bronchospasm,but the first step to controllingasthma is avoiding exposure toallergens and irritants in yourenvironment that set offsymptoms.

l Children exposed to second-hand smoke have more severeasthma episodes and lowerlung function than those notexposed to smoke.1

1 “Involuntary Smoking and AsthmaSeverity in Children,” Chest, 2002,122(2):409-415


AIRepair Friends and Neighbors

Room air cleaners are found ondepartment, variety and hardwarestore shelves throughout the country.Do they really reduce symptoms? Ifyou buy one, will it clean your indoorair well enough that can you sleepwith your cat and dog and smoke inyour home?

Most of AANMA’s AIRepair tips areeasy to make part of your cleaningroutine. Some suggestions takemore time than others. You may dis-cover serious problems that requireexpert help. Then again, you mayhave friends who will swap theirplumbing or carpentry skills for yourbabysitting and cooking talents.

Once you’ve completed your inspec-tion, create a plan for tackling theto-do list using AANMA’s AIRepairChecklist. Don’t try to accomplisheverything in one day. For thoseitems that cost more money thanyou’ve currently budgeted, look forcreative ways to save money to makethe repairs as soon as you are able.

You are not alone! One-third toone-half of all buildings have dampconditions that may encouragemold and bacteria. Every home hasdust mites. And no area of the U.S.is immune to rodent or cockroachinfestations.

There is a wealth of fascinating andhelpful information, photographs,links and services that can be foundFREE on the Internet. If you don’thave Internet access at home, visityour local library and ask someoneto teach you how to go online.

www.buildingforhealth.com –Building for Health Materials Center800.292.4838

www.ecomall.com – searchengine/directory for environmentallyfriendly products

Other useful Web sites:

Room Air Filters

www.nari.org - National Associationof the Remodeling Industry providesconsumer information on remodel-ing, including help finding a profes-sional remodeling contractor847.298.9200

www.ascr.org - Restoration IndustryAssociation301.231.6505

www.HomeMoisture.org – NorthDakota State University ExtensionService

www.nadca.com – The HVACInspection, Maintenance andRestoration Association

www.nclr.org – National Council ofLa Raza (Spanish resources)202.785.1670

www.hispanichealth.org – NationalAlliance for Hispanic Health866.783.2645

Air cleaners do not replace the need toeliminate or reduce indoor air aller-gens and irritants known to producesymptoms. Be wary of any manufacturermaking health claims. Ion generatorsand electronic air cleaners may pro-duce ozone, a lung irritant. For moreinformation on room air filters, visitwww.epa.gov/iaq/pubs/airclean.html.

Helpful ResourcesAllergy & Asthma NetworkMothers of Asthmatics800.878.4403aanma.orgSpanish resources available

U.S. Environmental Protection AgencyIndoor Air Quality InformationClearinghousewww.epa.gov/iaq/ia-intro.html Spanish resources available

Centers for Disease Control and Preventionwww.cdc.gov/nceh/airpollutionSpanish resources available

American Industrial HygieneAssociation703.849.8888 www.aiha.org

American Society of Home Inspectors847.759.2820 www.ashi.orgSpanish resources available

American Lung Association® HealthHouse® Program800.788.5864 [email protected]


A T H O M E

Home improvementassistance

To locate contractors: check the Internetor telephone book for organizations that can provide professional services or recommendations:l Local Home Builders Associationl Local Board of Realtorsl Local remodelers’ or contractors’ organizations

l Local Better Business Bureau

Construction or drainage matters:Contact your city or county planningoffice, building inspector’s office, orlibrary for information on applicablebuilding codes and inspection/permitrequirements; local stormwater ordi-nances; local subdivision and zoningordinances; and local flood damageprotection ordinances and maps requiredby the National Flood InsuranceAdministration (NFIA). Other sources:l Local/county Soil Conservation ServiceAgency

l City/county hydrologist or engineerl Agricultural Extension Servicel Professional engineer or hydrologistl University Civil Engineering orAgricultural Engineering departments;ask about experts in drainage, foundation and structures

l Professional/commercial house inspectors

Financial aidMedical insurance company – call yourbenefits office; ask if your insurancecovers physician-recommended deviceslike air cleaners or dust-mite-proofmattress covers to improve your health.

Local utility company – ask if they offerfinancial help for renovations toimprove air quality.

State, county or city health departments – call your Public HealthDepartment; ask what division can help you with indoor air qualityrenovations. Check online or look in the government pages of yourlocal telephone book for offices that deal with family health; environ-mental health; preventive health; community and family health servic-es; primary care and family health.

For a state-by-state list of public health officials and telephone numbers,visit www.statepublichealth.org, or call the Association of State &Territorial Health Officials (ASTHO), 202.371.9090.

Places of worship – local churches, synagogues, mosques and otherreligious groups often have compassionate aid for people in need; youdo not always need to be a member of the congregation.

National service organizations offer personal and financial help topeople in need. Look in your telephone book for local chapters of theAmerican Red Cross, Kiwanis International, the Lions Club, RotaryInternational, or the Salvation Army.

Help dealing with insurance companies, builders or landlords

Find out about neighborhood associations, tenants’ rights groups and community groups dealing with asthma. Local asthma coalitions may be able to provide resources.

Check online or in the telephone book forConsumer Affairs organizations; try yourlocal government, newspapers or televisionstations.

The nonprofit Patient Advocate Foundationcan provide help with insurance claims andother financial problems: 800.532.5274; www.patientadvocate.org.Spanish resources available.

For information on federal and state regulations, contact U.S.Department of Housing and Urban Development (HUD), 800.669.9777;www.hud.gov. Spanish resources available.

States and counties have their own tenant laws. Contact your localgovernment Housing department to find out about your laws; askabout Housing Rights Committees.

18 • AANMA Indoor AIRepair at Home breatherville.org

Indoor AIRepair ChecklistDate Room Clue/Source Action Date Fixed

10/23/13 Joey’s Room Moisture and mold on Removed mold, caulked windows, 11/15/13window frame cleaned rain gutter outside window

Use this chart to note allergens and irritants found in your home and create a to-do list of clean-up actions.

800.878.4403 AANMA Indoor AIRepair at School • 19

AIRepair™INDOOR

A T S C H O O L

When children with asthma go offto school each day, they carry morethan just their backpack and lunch –they also tote a load of worries: Will Icough during gym today? Will I needmy inhaler during the math test? WillI get that tight feeling in my chestagain while I ride the bus?

It’s no wonder they have trouble con-centrating. What can you do?

Working together, parents, teachersand other school staff can create ahealthy learning environment.

Five tips:

1. Recognize asthma is a serious,potentially life-threatening con-dition. Establish a plan to pre-vent and respond to emergen-cies.

2. Follow the written asthma man-agement plan provided by thechild’s healthcare provider.Identify and avoid activities andirritants that set off breathingproblems. Treat symptoms whenfirst noticed.

3. Teach the child to listen to hisbody’s early warning signals anduse medications responsibly.

4. Identify and eliminate allergensand irritants in the classroom.

5. Maintain clean indoor airthroughout the school building.

Helping Parents, Students and Teachers Breathe Easier


Common Allergensand Irritants Found in theClassrooms

Even the most perfectly maintainedsystem cannot protect students andstaff from allergens, irritants andother airborne pollutants that startin the classroom.

l chalk dustl dry erase markersl paints and glues l strong odors, such as perfumes or room deodorizers

l chemicals from science or art projects

l upholstered furniture l rug mats or nap padsl classroom pets or visiting furry animals

Allergens, irritants and indoor air pollutants are everywhere. It is impossible to rid a school of every germ, pollen grain,dust mite, mold spore or pest. However, there are common-sense precautions to take. Some can be taken by parents andteachers in the classroom; others require school maintenance.

Indoor Air Pollutants

Finding the Source

AIREPAIRThe EPA has identified five steps to reduce asthma triggers in schools:

1. Clean up mold and control moisture2. Control cockroach and

other pest allergens

3. Remove animalallergens

4. Eliminate secondhandsmoke exposure

5. Reduce exposure todust mites

Asthma affects each person in adifferent way. Some people reactwhen they inhale or touch things to

which they are allergic, such asanimal dander, dust mites or mold.Others cough when the air is full ofirritants such as smoke or strongodors. Still others find it hard tobreathe during exercise.

Asthma symptoms can developrapidly within minutes, or gradually,over hours or even days. Don’tassume that because the child didn’tbegin coughing when the puppycame to visit it was not a problem.The irritation from the animal dandercould grow slowly, turning intobreathing problems that keep thechild up half the night.

Some common factors thatset off asthma symptoms:

Allergens in the air: animal dander,mold, pollen, dust mites, cockroachand rodent allergens

Irritants in the air: smoke, householdchemicals, strong odors, air pollution,including fumes from idling schoolbuses and cars

Activities: exercise

Weather-related factors: changes inair temperature and humidity levels

Food allergens

Other illnesses: rhinitis, sinusitis, gastroesophageal reflux, viral infections

Emotions: stress, crying, laughing


A T S C H O O L

1. Clean UpMold and Control Moisture

Molds are a natural part of ourworld. Outdoors, they break downorganic matter such as fallen leavesand dead trees. Indoors, they stainand damage walls and furnishings.Mold growth can also attract cock-roaches, dust mites and other pestsand cause health problems.

Molds reproduce by sending billionsof tiny spores into the air, travelingon breezes until they land on adamp surface where they can multiply. Invisible to the nakedeye, as many as 250,000 sporescould fit on the head of a pin.

Inhaling or touching mold sporesmay cause sneezing, runny nose,red eyes, coughing, wheezing orskin rash (dermatitis), even amongpeople not allergic to it. Symptomscan be immediate or delayed.

Clues that indoor mold might be present:

l Black spots in dark, warm, humid areas such as– Bathrooms– Locker and shower rooms– Basements – Under sinks– Utility areas and mechanical rooms

l Musty smell among stored papers or booksl Black or brown spots in closed-in areas:– Underneath and behind furniture– Behind cabinets – In coat closets

l Discolored or damp carpeting and/or padding, especially underneathwindows, against outside walls and under water fountains

AIRepair:l Fix the water or moisture problem. The mold will return if you don't.It could be as simple as moving a cabinet away from the wall, storingpapers in plastic bins, or cleaning the area around the water fountaindaily. Other times, it may require caulking around leaky windows,removing mold-infested carpets, or fixing a plumbing problem behinda wall.

l Dry water-damaged areas and items within 48 hours to prevent moldgrowth.

l Clean up the mold. If the moldy area is on a washable surface, clean itusing equal parts of white vinegar and water. Avoid using bleach asthis can irritate breathing passages. Use a dust mask and goggles toshield nose, mouth and eyes from airborne spores while cleaning.Larger areas of mold (greater than 10 square feet) should be cleanedby a professional following guidelines established by theEnvironmental Protection Agency.

AIREPAIR

Schools Breathe, Too

Many factors affect indoor air quality in schools:

l Building design and buildingmaterials used

l Number of students and staff ineach classroom and building

l Types of activities performedinside

l Size, type, location and age of air handling equipment

l Maintenance and cleaning processes

Maintained properly, the school’s airhandling system traps and filtersmany particles but does not purifydirty, polluted air. So, for example, ifschool buses or cars pick up and dropoff students in the back of the schoolnear air handling equipment,exhaust fume particles will travelthroughout the school’s supply lines.And that’s not healthy for anyone.

Clues that yourschool’s air handling system needs servicing:

l Black or gray powdery duston ceiling tiles, walls and vent covers

l Standing water underneathor near the air handling unit

l Dead animals, insects, bird or rodent nests in or near outdoor units

AIREPAIR

Moisture control is the key to mold control.


2. Control Cockroach and Other Pest Allergens

Found in just about any school inAmerica, cockroaches, mice and ratsare often-overlooked causes of aller-gy and asthma symptoms amongschoolchildren and school staff.

Microscopic proteins from pest waste(urine and fecal pellets) and salivacan travel through the air and causeallergy and asthma symptoms wheninhaled. Symptoms may be immedi-ate or delayed.

Because these lightweight particlesremain in the air hours after beingstirred up, the best pest managementprograms begin by removing theproblem at its source, repairing damage, and making the school environment less attractive to pests.

To fight pests, remove their food andwater source; fix plumbing leaks,moisture or mold problems; andenforce safe food handling and storage policies.

AIREPAIR

Clues that pests are in the classroom:

l black or brown pellets about the size of rice or slightly larger (mousedroppings)

l dead cockroaches l urine stains or smelll dust clumps that have insect droppings and decaying insect partsin them

l nestsl greasy smears on walls (which could indicate possible rat runs)

Pest treatment in the schools is best left to professionals, but teachers cando their part to keep pests away from their classrooms.

AIRepair:l Store food and water in tightly closed containers in the classroomovernight; this includes items for class or science projects.

l Fix plumbing leaks. l Remove clutter where cockroaches and other pests can hide. l Seal cracks in walls and under sink areas.l Use poison baits, boric acid or traps before using pesticide sprays. l Store dumpsters away from the school building.

Pesticide tips:

l Use Integrated PestManagement (IPM) practicesinstead of pesticides wheneverpossible. Visit www.epa.gov/pesticides/ipm.

l Notify parents and school staffbefore applying pesticides.

l Schedule pesticide applicationswhen areas will be unoccupiedand can be well ventilatedbefore occupants return.

l Use pest control chemicals instrict accordance with regula-tions and follow instructions onthe container.


A T S C H O O L

3. RemoveAnimal Allergens

4. EliminateSecondhandSmoke

Whether they live in the classroomor visit for show-and-tell, warm-blooded animals such as hamsters,birds, rabbits, cats and dogs cancause allergy and asthma symptomsin sensitive students and teachers.

Allergy symptoms (immediate ordelayed) range from itchy eyes orskin to red welts (hives) on the skin,sneezing, nasal congestion, shortnessof breath, wheezing or coughing.

Secondhand smoke – whether from the burning end of a cigarette orexhaled by a smoker – is an irritant that can set off asthma symptoms.

A 2011 Center for Disease Control and Prevention (CDC) report found that18.1 percent of high school students and 4.31 percent of middle school stu-dents polled said they smoked. Despite federal and state laws prohibitingsmoking on school grounds, secondhand smoke continues to be a problem.

Even so-called “safe” pets such aslizards, chameleons and snakes cancause problems, particularly if theyeat live foods such as grasshoppers,mealworms, mice and rats. The petsand their food sources produce wasteproducts that decay and provokeallergy or asthma symptoms.

The tiny protein particles from theanimal’s urine, saliva and dander flyinto the air when the pet or its cage

is handled or cleaned. If they getinto the school’s air handling systems, the allergens move fromone part of the school to another.

l Prohibit smoking on schoolgrounds (indoor and outdoor),on school buses and atschool-sponsored events.

l Clearly communicate theschool's smoking policy tostudents, staff and visitors,including punishments forviolations.

l Develop smoking preventionprograms and education onhow to stop smoking for stu-dents and school personnel.

AIREPAIR

The Pro-ChildrenAct of 1994

prohibits smoking in kindergarten, elementary and

secondary schoolsthat receive

federal funding.

Parents:Take a good look around your child’s school and

classroom. Note the problems you see and share this

information with teachers and school administrators.


5. Reduce ExposuretoDust Mites

l Use only washable stuffed animals in the classroom and wash themweekly in hot water.

l If your child uses a nap pad or pillow at school, take your own andcover it with a dust-mite-proof zipped cover. Keep a washable cottoncover to use over the nap pad. Take covers home and wash in hotwater at least twice a month.

l Replace upholstered furniture. A wooden rocking chair with washable cushions and a collection of vinyl bean-bag chairs make good alternatives.

l Encourage your school to consider replacing carpeting with solidsurface flooring. Carpets hold onto fine dust particles, animal dander,mold, dust mites, food crumbs, dirt and bacteria. Even with dailyvacuuming, these particles are impossible to remove. (Just lift acarpet’s edge and look underneath.) People walking across thecarpet send powdery allergens swirling into the air where they can be inhaled.

AIREPAIR

Many children with asthma alsohave allergies to dust mites.

Too small to be seen with the nakedeye, dust mites set up housekeepingwherever they find humidity and asteady food source. They particularlylike to dine on shed flakes of humanskin (dander), decaying food crumbsand mold. In schools, they’re likely tobe found in carpets, naptime floormats, pillows, stuffed toys and upholstered furniture.

The Environmental Protection

Agency (EPA) Indoor Air Quality

Tools for Schools program has

helped hundreds of schools

throughout the country

maintain healthy air in their

facilities and create a safe

learning environment. Find out

how this innovative program

can help your school. Visit

www.epa.gov/iaq/schools or

call 800-490-9198 to order.

Tools for Schools


A T S C H O O L

Many asthma medications can begiven daily at home to controlsymptoms at school. However,since breathing problems canappear unexpectedly, children withasthma need immediate access toprescribed quick-acting inhaledbronchodilators.

Oral medications should be storedin the school clinic.

Some asthma medications causechildren to feel sleepy, irritable,shaky or unable to sit still in theclassroom. Teachers should tellparents if these are a problem inthe classroom, so they can talkwith the child’s healthcare teamabout adjusting medications.

While asthma medications areimportant, they do not eliminatethe need to maintain healthyindoor air quality.

Anaphylaxis

Some children with asthma alsohave anaphylaxis, a life-threateningallergic reaction. The throat, tongueand lips swell and block breathingpassages. Usually caused by a beesting or food allergy, the reactionmust be treated immediately. Thekey to preventing serious problemsfrom anaphylaxis – includingdeath – is using epinephrine assoon as possible.

Auto-injectable epinephrine can beself-administered or be given by anadult. Afterward, the child should betaken immediately to the hospital.The medication wears off after 20minutes. A second injection mayneed to be given on the way to thehospital, so two auto-injectors shouldbe with the child at all times.

Managing Medicationsat School

Steps parents cantake to manage asthma at school:

l Get a written asthma manage-ment plan from your child’sdoctor before each schoolyear begins. The plan will list:– allergens, irritants andactivities that cause asthmaor allergy symptoms in yourchild

– your child’s early warningsigns that an asthmaepisode is progressing andneeds medical attention

– names and dosages of medications to be used athome and at school

l Ask your healthcare providerto check your child’s inhalertechnique to be sure he isusing it correctly.

l Complete and return allemergency care forms beforethe first day of school.

l Give a copy of the manage-ment plan to your child’steachers, coaches and schoolnurse and discuss any questions.

TIPS

All states have laws that protect students’ rights to carry

and use their prescribed lifesaving asthma medications at

school and 49 have similar laws regarding anaphylaxis.

Check the laws in your state and find more resources to

help students breathe easier at BreatheAtSchool.org

When is a child old enough to handle his own medications?There is no magic age when a child automatically becomes ready to carry hismedications at school and take them on his own or with adult supervision. It is a gradual learning process. Teach your child to take responsibility for hisown medications at home, where you can watch and help, before taking themto school. To get your child ready, teach him to do the following:

l Know the names of each medication and when to use eachl Know how to avoid allergens and activities that cause his symptomsl Know what to do when symptoms first appear and when to ask for helpl Show his healthcare provider that he can use the inhaled medicationcorrectly


CommonMedication Myths

Myth #1: Inhaled asthma medicationsmake students high.

Myth #4:Inhaled medications shouldbe locked in a cabinet inthe school clinic.

Myth #2: Inhaled bronchodilatorscan be dangerous if usedby classmates who do nothave asthma.

Myth #3:Students with asthma oftensay they need to use inhaledmedications as an excuse toget out of the classroom,doing school work or participating in physical education classes.

Inhaled bronchodilators are the inhaled medication used mostoften by students at school. Common names include, ProAir™,Ventolin®, Proventil® and Xopenex®. Bronchodilators relaxtwitchy airways and make it easier for the student to breathe;they are not intoxicating and do not make students high.

Inhaled bronchodilators will not improve the breathing orharm the airways of students who do not have asthma. Usersmay feel jittery, as if they just drank a cup of strong coffee, but only for a short time. Most will not like the taste of themedicine.

Students with asthma are no different from their classmateswhen it comes to avoiding things they don’t like. However,restricting a student’s access to lifesaving medications isdangerous, so teachers should assume the student needs itwhen asking for it. Students who’ve developed the skills and maturity to carry and use inhaled bronchodilators bythemselves do not need to leave the classroom to get them.

Most children with asthma will experience symptoms at schoolfrom time to time, but they’re not likely to begin while the stu-dent is standing in front of the clinic with a trained healthcareworker standing nearby. More often, symptoms will begin inthe classroom, playground, gym, or even on the bus, or whilewalking to and from school.

Sending a coughing or wheezing student on a trek to the clinicor making him wait as a classmate retrieves the prescribedinhaler from a locked cabinet wastes precious time and mayplace the student at risk of death. Keep the bronchodilatorinhaler with the child at all times and store back-up medicationlabeled with the child’s name and prescribing instructions inthe locked cabinet with the asthma management plan.

AANMA’s volunteer Outreach

Service Coordinators work with

schools and communities across

the country. We asked them

what parents, teachers and

school administrators need to

remember to keep students

healthy at school.

ExperiencedVoices

Take information around the

school to all personnel who

will come in contact with

your child. Don’t forget

the school librarian! Don't

assume that the office or the

nurse will reach everybody

who needs to know. Cathy Boutin Teach your child to keep

track of the number of doses

used in inhalers, and not to

exceed the number of doses

listed on the canister even if

it seems medication remains.

Always keep a back-up

inhaler in the clinic at school.

Check the expiration date on

each inhaler.Dianne Danzig

Notify the school if you have

changes to the Emergency

Contact Information Card.

Provide telephone numbers,

names, at least two back-up

contacts, and the name and

phone number of your child’s

physician. Connie Carcel

If you want the right mes-sage to be given about thecare of your child at school,deliver it yourself. Don’tleave this job to your childor scribble a note onto apiece of paper.

Christy Olson, RN

Teach your child to know andstay away from asthma triggersand when to ask for help.

Lisa Blemmer

It is the nature of asthmasymptoms to change periodi-cally. When this causes achange in your child’s med-ications or the overall treatmentplan, contact the schoolnurse and your child’s teachersright away. Let them knowwhen your child is headinginto an episode but is healthyenough to attend school.And tell them when yourchild has been to the emer-gency department or hospi-talized for symptoms.

Sue Cook

Advice forParents

From the time they are little,teach your children to knowearly warning signs and howto take care of their ownasthma symptoms.

Christy Olson, RN


A T S C H O O L


Tell the parents if their childis experiencing cough, short-ness of breath, wheezing orchest tightness or using theirbronchodilator inhaler moreoften than their managementplan suggests.

Darcy Ellefson

It’s important for parents of children with asthma to communicatewith the school. If I know what sets off a student’s asthma I can planahead to prevent problems. Most teachers are willing to do anythingthey can to help students stay healthy and safe so they can come toschool and learn. I know that students with asthma have anincreased struggle when they catch a common cold. Parents shouldremind their children to wash their hands regularly and to dress inlayers because the temperature fluctuates in buildings and outsideand students should be prepared to go out.

Christine Whitley, special education teacher

Remember that what you

do in the classroom makes a

huge impact on the air

quality in the classroom and

on your students’ health.

Furry classroom pets, stuffed

animals, floor pillows,

carpeted rest mats, large

area rugs, stuffed animals,

pet visitation days, smelly

science experiments and

perfumes can cause

breathing problems for

some students. Cathy Boutin

Children must have fast,

easy access to their

bronchodilator inhaler. Dianne Danzig

Make sure you know which

children in your class have

allergies and asthma (and

other chronic health condi-

tions). Have the information

readily available for

substitute teachers and

for specialists that may visit

or work with your class. Theresa Grill

Talk with the parents; letthem voice their concernsand work with them to meettheir children's needs.

Pat Smith

Advice forTeachers

Advice from aTeacher

Please don’t think I am over-protective or obsessed withmy child's allergies and asthma.I am not trying to isolate mychild from others, but when aclassmate gets a cold, he has arunny nose for five days.When my child gets a cold,he has to be on oral cortico-steroids, take nebulizer treat-ments four times a day, andstay home from school.

Cassie Kelly

A T S C H O O L

Indoor AIRepair Notes


8229 Boone Boulevard, Suite 260, Vienna VA 22182800.878.4403 • www.aanma.org

Follow us www.facebook.com/aanma www.twitter.com/aanma

Allergy & Asthma Network Mothers of Asthmatics (AANMA) engages,educates and empowers families to win over allergies and asthma.

Since 1985, it’s been our mission to end needless death and suffering due to asthma, allergies and related conditions.

Join at no cost to you by visiting www.aanma.org/join.

Breathe Better Togetherwith AANMA!

800.878.4403 AANMA Indoor AIRepair at Play • 31

Who doesn’t like to play? No matter what your age, playing isgreat fun!

Play gives children a chance to learnabout themselves and other people –how to share and take turns, how tobe patient and fair, how to be agood sport. It also builds creativity,imagination and physical skills.

However, a playmate’s runny nosecan lead to your child’s asthmaattack. A simple birthday party invitation can set your mind racingabout allergens, irritants and otherpollutants that can make your childsick. And holidays leave familymembers thinking you’re simplyoverprotective.

How do you keep asthma symptomsfrom interfering with fun? How do

you safely let children explore theworld through their own eyes, outside your protective reach?

When children with asthma can’tescape the allergens, irritants andpollutants that set off breathingproblems, play loses its fun. Whenwas the last time you felt like playingwhen you couldn’t breathe?

Children with asthma don’t want tolive in a bubble. They want to runand play with their friends; go to parties and sleepovers, take danceclasses and drum lessons, and simplyHAVE FUN !!!

The good news is – they can, withplanning and communication.

The key is to minimize risk and maximize fun.

The Business of Being a Kid

AIRepair™INDOOR

A T P L A Y

32 • AANMA Indoor AIRepair at Play aanma.org

Nothing can ruin a play day at the community center or a sleepover at a friend’s home faster than overwhelming exposures to these symptom-starters:

Dust mitesl in carpets, upholstered furniture, bedding, pillows and stuffed animals

Cockroaches, mice and other pestsl in family rooms and bedrooms as well as kitchens – anywhere traces offood, water and dirty dishes are allowed to linger

Moldl wherever humidity levels are high; if you smell something musty, it’s moldy

Petsl not just dogs and cats – all furry animals produce dander, including mice,guinea pigs, gerbils, hamsters, rabbits and ferrets

l birds and reptiles – as well as their food and cages – also release allergensand irritants

Secondhand smokel a powerful irritant that can quickly set off coughing and wheezing

Other irritantsl strong scents, including art supplies and candlesl dust from construction and remodeling projectsl offgassing (chemical smells) from new carpets, flooring and cabinetsl latex balloons l pesticide sprays and toxic chemicals, often as irritating as the pests they killl cosmetics, such as perfumes, nail polish and nail polish remover

No scentsMany children’s products arescented – art markers, paints,crayons, disposable wipes, bubble baths, shampoos andmore. However, even theunscented products may havemasking fragrances that coverunpleasant odors. Maskingscents added at low concentra-tions are not always listed onthe label.

Healthy hobbiesWoodworking, sanding, usingspray paints, sculpting andother creative hobbies sendtiny pieces of dust into the air.The ones that fall to theground quickly are actually lessof a problem than those thatstay in air for longer periods.

Whenever possible, keep indoorwork or hobby spaces wellventilated and wear dust orvapor masks to protect the airways. Seal off rooms underrenovation from the rest of thehouse: Cover air vents and sealoff windows and doors withplastic.

Take stinky or dusty projects outside!

Asthmaand AllergyFun Busters

Sensible Crafts


A T P L A Y

When we go to someone’s house inthe winter, I always ask them not tohave a fire going in the fireplace. Sofar nobody has seemed offended.The request usually opens a dia-logue about asthma. I have foundthat most people don’t realize theseriousness of asthma.

Beth Allen, Palatine, IL

If our son is invited to play at someone's house or go to a party,we ask about smoking; if it's notnonsmoking, he doesn't go.

Gigi Gerben, Venetia, PA

Before we make a play visit, weinvite the mother and child to ourhome. That way we have a prettygood idea of the other family'sfeelings about helping with exposure to things that might cause a reaction. If we don't feelgood about the other family's attitude, we just politely invite the child to come to our house.

Gayle Schroader, Taylor, SC

It is really difficult if the invitingfriend has a parent who smokes. We taught our children to assertthemselves to ask the smoker tosmoke outside because of their asthma. If that wasn't possible, ourchild would go to another level ofthe house to wait out the smoke.While that wasn't ideal, it did help.We have asked parents not tosmoke while driving our children intheir vehicle; they don't getoffended when they understandwhat could happen.

Laura Smith, Dallastown, PA

It is important to know about cultural practices that may exist ata friend’s house, such as use ofincense or candles. You can nicelytell the parent: “Jeremy’s asthmaacts up when I use strong perfumesor soap....he’d really love to come

Parties and sleepovers can be stressful. To make sure our daughterenjoys the event without worry wemake sure the host of the eventthoroughly understands the significance of her allergies andunderstands what measures totake if an outbreak begins. If weare still not comfortable, we go to the event with her or do an alternative "special outing" of her choice.

Michael Cason, Centreville, VA

For parties, we send her own blankets and pillow with an allergypillow cover on it, request she doesnot sleep on carpeted floor, makesure she takes all her meds withher, and wash all her bedding andclothing when she comes home. For family vacations, we make surethere are no feather pillows in motelrooms and do not use the big comforter on tops of beds.

Cindi Shea, RN, BA, AE-C, Beckley, WV

When he goes to a friend’s homeovernight or just to birthday partieshe always carries his inhaler. We let the adults in charge knowabout his asthma and they alwaysknow how to reach us if he has a problem. Our son has never beenembarrassed or had problems withanyone; in fact, he will tell youanything you need to know aboutasthma and why he has to do whathe does every day to stay healthy.

DaLynn Walker, Windsor, CO

over and play at your house, but I just wanted to know if you sometimes burn candles or use any special scents at your house tomake sure he can stay away fromthem and enjoy the playdate!”

Lois Wessel, RN, CFNP, Tysons Corner, VA

AIRepair Tips from AANMA Members

Play Datesand BirthdayParties

Slumber Partiesand OvernightsAway from Home

34 • AANMA Indoor AIRepair at Play aanma.org

I have my daughter enrolled in ballet,swimming and basketball classes.Since she needs a change of clothingfor each of these activities, I separatethem into sealed plastic bags insideof her individual carrying bags. Ido this to prevent any allergensfrom accumulating inside gym lockers, since you don't know whatgets thrown inside those lockers.

Ivette Davila-Richards, Brooklyn, NY

When my son was invited to a lasertag party, I had no idea what itreally was. When I went with him tocheck it out, the first sign I read wasa warning to patients with asthmathat there is a fog that the playersrun around in that could be haz-ardous. We sat down and did atreatment prior to the game, just incase, and I talked to several of hisbuddies who agreed to keep an eyeon him. I was very nervous, but hisfriends were wonderful and veryproud to have been given such animportant task which they tookvery seriously. I generally hangaround quite a few parties andhelp.

Andrea Holka, Malcolm, NE

Our sons wanted to join a children'sbowling league after school onMondays. To our dismay the parents’smoking became a huge problemfor them. They approached themanager and told her that thesmoke left them sick and had evenled to an ER visit. They talked herinto requiring the parents to keepthe general bowling area smoke-free during the children's leaguetime. Others could go outside or tothe enclosed bar area to smoke.“No smoking” signs were postedeach Monday and parents caughtlighting up were asked to leave.

Maureen Damitz, Chicago, IL

Our daughter takes karate andgymnastics, both held indoors. Toprevent problems, we tote our'medicine bags' everywhere. Theseare insulated (particularly importanton an extreme weather day)lunchbags that easily hold all thenecessary medicines. The pocket onthe outside holds an emergencyletter listing her medications, dosesand times to be given.

Donna Biroczky, Fontana, CA

When we visit relatives we bringalong our son's dust-mite-proofinggear – including mattress cover,pillows and blankets. Often ourfamily and friends understand how sensitive he is to dust andtake the extra initiative to speciallydust-proof the bedroom or eventhe entire house for him. Whenrenting a vacation home, wealways request accommodationsthat have no animals or smokingallowed, with a minimum amountof carpet.

Jennifer Frey, Millbrae, CA

We contact hotel managers andmuseums before a trip to find outif there is any painting going on. If so, we don't go. Once, a museummanager told us there was a smallamount of trim being painted. Weexplained our situation and shesent the painters out of the build-ing to return on a day when themuseum would be closed. Becauseof the excellent ventilation system,we were able to enjoy the museumwith the boys and no one couldtell that there had been any painting done earlier that day.

Gayle Schroader, Taylor, SC

Community Center Classesand Events

Travel

A T P L A Y

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Word JumbleUnscramble the words,then unscramble the circled letters to answerthe clue.

Check out these additional “kids” resources on environmental controls:

Games, Quizes and Projectswww.epa.gov/students

National Institute ofEnvironmental Health Scienceskids.niehs.nih.gov

BreatheHabit, Exit, Inhale, Exhale, Airway, Smart, Asthma

Clue:What clean air helps you do...

T I B H AX E I TE N A L I HX A H L E EW R A A Y IM A R S TH M A S A T


Answers to Word Jumble:Answer to the Clue:

8229 Boone Blvd., Suite 260Vienna, VA 22182

Phone: 800.878.4403www.aanma.org

air epair indoor - aap.org · so thick with them they would hide your hand. so where did they go...

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