May is Asthma Awareness Month, and May 1st is World Asthma Day. As a leading chronic illness affecting children and adolescents across the country, managing pediatric asthma is imperative to the health of the younger generation. With asthma affecting so many school-aged children, implementing asthma management practices into schools, where children spend much of their time, is especially important. NEEF partners with the National Association of School Nurses (NASN) to implement environmental management of pediatric asthma in schools across the country, creating healthy, safe environments for students to grow and learn.  

What is asthma, and who is most affected?

Asthma is a disease that affects the lungs causing wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. When exposed to environmental triggers, such as outdoor and indoor air pollution, dust mites, mold, pet dander, and other allergens, these symptoms may become heightened, signaling an asthma attack.

Asthma is a leading chronic illness among children and adolescents in the US. Children are at a higher risk for developing the negative health effects of indoor air pollution due to their sensitivities to exposures and the amount of time they spend in school. School buildings tend to suffer from poor indoor air quality due to poor ventilation, design, maintenance, and cleaning. In a classroom of 30, about 3 students are likely to have asthma, and nearly one in two children with asthma miss at least one day of school each year because of their symptoms. Because so many children are affected by asthma, it is imperative to control asthma in schools, which can act as reservoirs for a host of allergens and pollutant exposures.

How can asthma symptoms be alleviated?

Exposure to environmental triggers plays a big role in a child's asthma symptoms. Environmental triggers may include outdoor and indoor air pollution, dust mites, mold, cleaning products, pet dander, and other irritating substances. When exposed to these triggers, taking asthma medication is the first step to alleviate symptoms. As a supporting step, controlling exposure to environmental triggers can help prevent asthma exacerbation in the first place. This may include vacuuming and cleaning daily; reducing exposure to second hand smoke; reducing presence of wet, mold-producing surfaces; and limiting outdoor activity when air quality is poor. The Environmental Protection Agency's Air Now offers daily Air Quality Index conditions for over 400 cities.

How can school environments be more asthma-friendly?

The Centers for Disease Control's (CDC) National Asthma Control Program (NACP) plays an integral role in promoting asthma-friendly schools. NACP partners with schools around the country in order to create safe and supportive learning environments for students with asthma. NACP funds many activities in schools, including school-based asthma management, indoor air quality and asthma trigger reduction, and educational training for school personnel. A number of state programs have deployed standardized asthma action plans for school nurses as well.

In addition, the Environmental Protection Agency (EPA) created Indoor Air Quality Tools for Schools which highlights how schools can evaluate and improve indoor air quality, develop an asthma action plan, and reduce environmental triggers by controlling the sources.  

NEEF has also participated in promoting asthma-friendly schools through the initiative Creating Asthma-Friendly Environments and Promoting Access to Guidelines-Based Care for Children with Asthma, which works to create environments that are free from asthma triggers and other impediments to living well with asthma. NEEF also partners with NASN to promote integration of environmental management of pediatric asthma guidelines into school nursing practices. NASN provides a host of asthma management resources from reputable organizations and government agencies around the country.

Sources:

• CDC. 2015. “Controlling Asthma in Schools”. Centers for Disease Control. April 26, 2018. https://www.cdc.gov/asthma/awareness_month/schools.htm
• CDC. 2017. “Learn How to Control Asthma”. Centers for Disease Control. April 26, 2018. https://www.cdc.gov/asthma/faqs.htm
• EPA. 2010. “Managing Asthma in the School Environment”. Environmental Protection Agency. 
• Healthy Schools Network, Inc. 2011. “Guide to Green Cleaning: Practices and Products for Schools”. Healthy Schools Network. February 14, 2018. http://www.healthyschools.org/downloads/Guide_to_Green_Cleaning_2011.pdf
• Matsui, et al. 2016. “Indoor Environmental Control Practices and Asthma Management. Pediatrics, 138(5). April 26, 2018. https://www.ncbi.nlm.nih.gov/pubmed/27940791
• NASN. 2017. Asthma. https://www.nasn.org/nasn-resources/practice-topics/asthma