iaq1101 queeley asthma - neha cert– always notify parents when a child has an asthma episode at...

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2011 NEHA AEC

IAQ1101 Asthma: Takes Our Children’s Breath Away

ASTHMAASTHMATAKES OUR CHILDRENTAKES OUR CHILDREN’’S S

BREATH AWAYBREATH AWAY

DEMOGRAPHICSDEMOGRAPHICS

�� Duval County Duval County

�� Located in North East FloridaLocated in North East Florida

�� Comprised of the cities/towns Comprised of the cities/towns

of Jacksonville, Jacksonville of Jacksonville, Jacksonville

Beach, Atlantic Beach, Beach, Atlantic Beach,

Neptune Beach, and BaldwinNeptune Beach, and Baldwin

�� Home to Naval Station Mayport Home to Naval Station Mayport

and Naval Air Station (NAS) and Naval Air Station (NAS)

JacksonvilleJacksonville

DEMOGRAPHICSDEMOGRAPHICS

�� County Population County Population –– 864,263864,263

�� RaceRace

�� 60.9 % 60.9 % -- CaucasianCaucasian

�� 29.5 % 29.5 % -- African AmericanAfrican American

�� 4.2 % 4.2 % -- AsianAsian

�� 2.9 % 2.9 % -- 2 or more races2 or more races

�� EthnicityEthnicity

�� 7.6 % 7.6 % -- HispanicHispanic

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2011 NEHA AEC


STATISTICSSTATISTICS

�� In 2007, the estimated total cost of asthma In 2007, the estimated total cost of asthma

in U.S.in U.S.–– 56 billion dollars56 billion dollars

�� Medical expensesMedical expenses

�� Missed days from work and/or schoolMissed days from work and/or school

�� Premature deathPremature death

�� Prevalence of asthma increased among Prevalence of asthma increased among

children from 2001children from 2001--2009 from 8.7 to 9.6%2009 from 8.7 to 9.6%


�� Asthma deaths among children residing in Asthma deaths among children residing in

Duval and Clay County is seven times Duval and Clay County is seven times

higher than Orange and Hillsborough higher than Orange and Hillsborough

County combinedCounty combined

�� Between 2007Between 2007--2009, Duval County had 2009, Duval County had

the highest asthma mortality rate in Florida the highest asthma mortality rate in Florida

at 16 deaths per 1,000,000at 16 deaths per 1,000,000

�� Florida Florida –– 8 deaths per 1,000,0008 deaths per 1,000,000


�� In 2005, children one In 2005, children one

to four years of age to four years of age

accounted for 979 accounted for 979

emergency room visits emergency room visits

related to asthma in related to asthma in

Duval CountyDuval County

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2011 NEHA AEC



�� Emergency Room VisitsEmergency Room Visits

�� Duval County vs. Benchmark CountiesDuval County vs. Benchmark Counties

��Duval County has a higher rate of ER Duval County has a higher rate of ER

visits due to asthma exacerbations in visits due to asthma exacerbations in

every age group except those 15every age group except those 15--19 19

yearsyears as compared to Hillsborough as compared to Hillsborough

and Orange Countiesand Orange Counties


2005 Asthma Related Hospitalizations in 2005 Asthma Related Hospitalizations in

Duval CountyDuval County

4.94.94.44.415 15 –– 19 years19 years

13.913.910.810.85 5 –– 14 years14 years

44.044.033.333.31 1 –– 4 years4 years

42.542.532.832.8< 1 year< 1 year

FloridaFloridaDuval Duval AgeAge


2005 Asthma Related Emergency Room 2005 Asthma Related Emergency Room

Visits in Duval CountyVisits in Duval County

45.445.446.046.015 15 –– 19 years19 years

75.875.894.494.45 5 –– 14 years14 years

165.3165.3194.2194.21 1 –– 4 years4 years

99.499.4116.2116.2< 1 year< 1 year

FloridaFloridaDuvalDuvalAgeAge

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2011 NEHA AEC



�� An estimated 1,500 ER visits per 100,000 An estimated 1,500 ER visits per 100,000

during 2006during 2006--2009 were made by children 2009 were made by children

4 years of age and younger due to asthma 4 years of age and younger due to asthma

exacerbationsexacerbations

OVERVIEW OF ASTHMAOVERVIEW OF ASTHMA

�� DefinitionDefinition

�� Asthma is a chronic, Asthma is a chronic,

inflammatory disease of inflammatory disease of

the respiratory system the respiratory system

that causes the airways of that causes the airways of

the lungs to tighten and the lungs to tighten and

constrictconstrict

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2011 NEHA AEC



�� Common Signs & SymptomsCommon Signs & Symptoms

�� WheezingWheezing

�� Excessive coughing Excessive coughing

�� Chest tighteningChest tightening

�� Shortness of breathShortness of breath


�� Currently, there is no cure for asthmaCurrently, there is no cure for asthma

�� Asthma is the leading cause of missed Asthma is the leading cause of missed

school days among schoolschool days among school--aged childrenaged children

�� Children from lower income families and Children from lower income families and

those living in urban areas or unclean those living in urban areas or unclean

areas are more at risk for asthmaareas are more at risk for asthma


�� Asthma accounts for Asthma accounts for

many hours of many hours of

disrupted sleep and disrupted sleep and

routine activitiesroutine activities

�� Asthma and allergies Asthma and allergies

are often related and are often related and

influence one anotherinfluence one another

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2011 NEHA AEC


INDOOR ASTHMA INDOOR ASTHMA

TRIGGERSTRIGGERS

�� Animal danderAnimal dander

�� CockroachesCockroaches

�� RodentsRodents

�� Secondhand Secondhand

smokesmoke

INDOOR ASTHMA INDOOR ASTHMA

TRIGGERSTRIGGERS�� MoldMold

�� DustDust

�� Dust mitesDust mites

�� Perfumes & spraysPerfumes & sprays

OUTDOOR ASTHMA OUTDOOR ASTHMA

TRIGGERSTRIGGERS

�� PollenPollen

�� Air pollutionAir pollution

�� Cold air exposureCold air exposure

�� Secondhand Secondhand

smokesmoke

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2011 NEHA AEC


ASTHMA SMART SCHOOL ASTHMA SMART SCHOOL

PROGRAMPROGRAM

�� 35 Childcare Facilities35 Childcare Facilities

�� 23 Head Start Centers 23 Head Start Centers

�� 12 Daycare Centers12 Daycare Centers

�� Project TimelineProject Timeline

�� March 2009 March 2009 –– February 2011February 2011


PROGRAMPROGRAM

�� GoalsGoals

�� Develop an asthma awareness program Develop an asthma awareness program

to educate childcare centers on the to educate childcare centers on the

symptoms and environmental factors symptoms and environmental factors

that may exacerbate the conditionthat may exacerbate the condition


PROGRAMPROGRAM

�� GoalsGoals

�� Develop an asthma awareness Develop an asthma awareness

campaign to educate parents on the campaign to educate parents on the

symptoms, environmental factors, and symptoms, environmental factors, and

methods to assist asthmatic childrenmethods to assist asthmatic children

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2011 NEHA AEC



PROGRAMPROGRAM

�� GoalsGoals

�� Implement an asthma educational Implement an asthma educational

program that will help children to program that will help children to

participate in their asthma care and participate in their asthma care and

management management


PROGRAMPROGRAM

�� ObjectivesObjectives

�� Define asthmaDefine asthma

�� Identify common signs and symptoms Identify common signs and symptoms

associated with asthmaassociated with asthma

�� Educate children, parents, and staff Educate children, parents, and staff

about how to recognize common about how to recognize common

asthma triggers in the indoor asthma triggers in the indoor

environmentenvironment


PROGRAMPROGRAM


�� Educate children, parents, and staff on Educate children, parents, and staff on

methods to reduce indoor asthma methods to reduce indoor asthma

triggerstriggers

�� Identify methods to manage children Identify methods to manage children

diagnosed with asthma in the childcare diagnosed with asthma in the childcare

environmentenvironment

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2011 NEHA AEC



PROGRAMPROGRAM


�� Provide local resources Provide local resources

to families and childcare to families and childcare

providers whose children providers whose children

are affected by asthmaare affected by asthma


PROGRAMPROGRAM�� ActivitiesActivities

�� Partner IdentificationPartner Identification

�� Jacksonville Urban League Jacksonville Urban League

Head StartHead Start

�� Episcopal ChildrenEpiscopal Children’’s s

ServicesServices

�� Early Learning CoalitionEarly Learning Coalition


PROGRAMPROGRAM

�� ActivitiesActivities

�� Training MaterialsTraining Materials

�� IAQ Tools for Schools IAQ Tools for Schools –– EPAEPA

�� Asthma Home Environment Checklist Asthma Home Environment Checklist –– EPAEPA

�� Dusty The Asthma Goldfish and His Asthma Dusty The Asthma Goldfish and His Asthma

Triggers Triggers FunbookFunbook –– EPAEPA

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2011 NEHA AEC



PROGRAMPROGRAM

�� Assessment of Educational ToolsAssessment of Educational Tools

�� Appropriateness of MaterialsAppropriateness of Materials

�� AgeAge

�� Reading ComprehensionReading Comprehension

�� ExercisesExercises


PROGRAMPROGRAM


�� Training MaterialsTraining Materials

�� Little House of Triggers Little House of Triggers –– DCHDDCHD

��Asthma Triggers Coloring Book Asthma Triggers Coloring Book –– DCHDDCHD

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2011 NEHA AEC


Parents should make sure the bathroom stays clean and dry!

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2011 NEHA AEC


No smoking in the house!


PROGRAMPROGRAM

�� Educational Materials Educational Materials

�� Daycare providersDaycare providers

�� Online TrainingOnline Training

�� Adopted by Tallahassee Asthma ProgramAdopted by Tallahassee Asthma Program

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2011 NEHA AEC


ASTHMA TRIGGERS IN THE CHILDCARE ENVIRONMENT

� Animals and Pests– Keep classroom pets in clean, caged environments

– Isolate classroom pets away from children diagnosed with

asthma or known allergies

– Place animals away from air vents to avoid circulation of

dander

– Place animals away from upholstered furniture and stuffed

toys

– Opt to keep an animal free facility

ASTHMA TRIGGERS IN THE CHILDCARE ENVIRONMENT

� Mold and Moisture Control

– Fix plumbing and moisture problems as soon as possible to minimize or prevent mold growth

– Provide adequate ventilation in the classroom

– Report signs of water damage and/or mold growth as soon as noted

– Avoid installing carpet in areas likely to be exposed to moisture

PREVENTING AND MANAGING ASTHMA EPISODES

� Managing Children with Asthma

– Ensure appropriate staff are aware of their students’ asthma status and how to respond

– Always notify parents when a child has an asthma episode at school even if it is resolved

– Be sure that staff know when it is appropriate to call 911 for additional help

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2011 NEHA AEC



PROGRAMPROGRAM


�� Site VisitsSite Visits

��Asthma Trigger Identification Asthma Trigger Identification

��ChecklistChecklist


PROGRAMPROGRAM

�� Checklist CriteriaChecklist Criteria

�� Cleanliness of classroom/kitchen areasCleanliness of classroom/kitchen areas

�� Classroom petsClassroom pets

�� Signs of leaks/moldSigns of leaks/mold

�� Excess dustExcess dust

�� Noticeable odorsNoticeable odors

�� Excess clutterExcess clutter

�� LinensLinens

Room is free from pests and vermin

Ensured that food is not stored in classroom overnight

Trash removed from classrooms daily

Rooms are free of excessive clutter

Rooms are cleaned and vacuumed regularly

N/ANoYesPotential Sources of Asthma Triggers

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2011 NEHA AEC



PROGRAMPROGRAM

�� ChildrenChildren

�� Allergies?Allergies?

�� Asthma?Asthma?

�� What to do?What to do?

�� Documentation?Documentation?


PROGRAMPROGRAM

�� Pre/Post TestPre/Post Test

�� 10 multiple choice/answer questions10 multiple choice/answer questions

��DefinitionDefinition

��Symptoms and causesSymptoms and causes

��Common triggersCommon triggers

��Trigger reductionTrigger reduction

��ManagementManagement


PROGRAMPROGRAM

�� Test QuestionsTest Questions

�� Identify common indoor and outdoor triggers Identify common indoor and outdoor triggers

for asthma. Select all that apply.for asthma. Select all that apply.

___ Cold weather___ Cold weather ___ Tobacco smoke___ Tobacco smoke

___ Pollen___ Pollen ___ Perfumes ___ Perfumes

___ Pet dander___ Pet dander ___ Mold___ Mold

___ Fresh, clean air___ Fresh, clean air ___ Cockroaches___ Cockroaches

___ Dust/Dust mites___ Dust/Dust mites ___ Gas from indoor ___ Gas from indoor

fufuelel--burning burning

apappliancespliances

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2011 NEHA AEC



PROGRAMPROGRAM

�� Test QuestionsTest Questions

�� True or False (Circle One). There are True or False (Circle One). There are

both hereditary and environmental both hereditary and environmental

factors that contribute to asthma.factors that contribute to asthma.

�� True or False (Circle One). Asthma and True or False (Circle One). Asthma and

allergies can be related.allergies can be related.


PROGRAMPROGRAM

Little House of Triggers ActivityLittle House of Triggers Activity

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2011 NEHA AEC



PROGRAMPROGRAM

�� Results Results –– OverallOverall

�� 35 childcare centers participated35 childcare centers participated

�� 994 children participated994 children participated

�� 121 teachers/staff participated121 teachers/staff participated

�� 227 children with asthma/recurring 227 children with asthma/recurring

respiratory ailmentsrespiratory ailments

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2011 NEHA AEC



PROGRAMPROGRAM�� Health Zone 1Health Zone 1

�� Zip codes: 32202, 32204, 32206, 32208, Zip codes: 32202, 32204, 32206, 32208,

32209, 3225432209, 32254

�� 26 childcare facilities 26 childcare facilities

�� Health Zone 2Health Zone 2

�� Zip Codes: 32207, 32211, 32216, Zip Codes: 32207, 32211, 32216,

32224, 32225, 32246, 3227732224, 32225, 32246, 32277

�� 5 childcare facilities5 childcare facilities


PROGRAMPROGRAM



32215, 32221, 32222, 3224432215, 32221, 32222, 32244

�� 1 childcare facility1 childcare facility



32226, 3223432226, 32234

�� 3 childcare facilities3 childcare facilities


PROGRAMPROGRAM

�� Results Results –– Asthma TriggersAsthma Triggers

�� At least 80% of the children able to At least 80% of the children able to

correctly identify 3 or more asthma triggerscorrectly identify 3 or more asthma triggers

��Triggers correctly identified without hintsTriggers correctly identified without hints

�� Dog/CatDog/Cat

�� CockroachCockroach

�� RodentRodent

�� FlowersFlowers

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2011 NEHA AEC



PROGRAMPROGRAM


�� Triggers correctly identified with hintsTriggers correctly identified with hints

��Perfume/sprayPerfume/spray

��CigaretteCigarette

��DustDust

��BleachBleach


PROGRAMPROGRAM


�� Pictures of mold and a water leak were Pictures of mold and a water leak were

not readily recognized by most children not readily recognized by most children

�� A picture of a dust mite was not A picture of a dust mite was not

recognized by any of the children recognized by any of the children

participatingparticipating


PROGRAMPROGRAM

�� Results Results –– Preventing/Reducing TriggersPreventing/Reducing Triggers

�� After receiving education, children were After receiving education, children were

able to successfully identify at least three able to successfully identify at least three

ways to minimize asthma triggers in the ways to minimize asthma triggers in the

school and home environmentschool and home environment

��SweepingSweeping

��VacuumingVacuuming

��Taking out the trashTaking out the trash

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2011 NEHA AEC



PROGRAMPROGRAM

�� ChallengesChallenges

�� Schedules of facilities participatingSchedules of facilities participating

��School year calendarSchool year calendar

�� Parent participationParent participation

��Only 9 parents participatedOnly 9 parents participated

��Parental figuresParental figures

��Centers have similar challengesCenters have similar challenges


PROGRAMPROGRAM

�� AccomplishmentsAccomplishments

�� Florida Asthma Coalition Florida Asthma Coalition WebinarWebinar

�� Department of Children and Families Department of Children and Families

TrainingTraining

�� Extension of the Asthma Smart School Extension of the Asthma Smart School

Program to conduct training in 46 Program to conduct training in 46

additional childcare facilitiesadditional childcare facilities


PROGRAMPROGRAM

�� AccomplishmentsAccomplishments

�� Distribution of Distribution of ““Little House of TriggersLittle House of Triggers””

and and ““Asthma Coloring BookAsthma Coloring Book”” nationally nationally

by EPAby EPA

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2011 NEHA AEC


QUESTIONSQUESTIONS

CONTACT INFORMATIONCONTACT INFORMATION

Monica Queeley, R.N. B.S.N.Monica Queeley, R.N. B.S.N.

Duval County Health DepartmentDuval County Health Department

Division of Environmental Health and SafetyDivision of Environmental Health and Safety

900 University Blvd. N. Ste. 300900 University Blvd. N. Ste. 300

Jacksonville, FL 32211Jacksonville, FL 32211

(904) 253(904) 253--12851285

[email protected][email protected]

iaq1101 queeley asthma - neha cert– always notify parents when a child has an asthma episode at...

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