Good Health Starts at Home Asthma and Allergies 1 April 2014.

Good Health Starts at HomeAsthma and Allergies

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April 2014

Learning Objectives

Knowledge: Describe symptoms and causes of asthma. Recognize medical interventions for asthma AND environmental control of asthma triggers

Comprehension: Identify asthma/allergy triggers in the home environment.

Application: List examples of low-cost action steps to reduce asthma triggers. Identify resources for more help and information

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Resource:Help yourself to a healthy home

• Indoor Air Quality

•Asthma & Allergies

•Mold & Moisture

• Carbon Monoxide

• Lead

•Drinking Water

•Hazardous Household Products

• Pesticides

•Home Safety

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Seven Tips for Keeping a Healthy Home

Keep It:

Dry

Clean

Pest-free

Ventilated

Safe

Contaminant-free

Maintained

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Asthma:

What is asthma?

A chronic inflammatory disorder of the airways

It is treatable, but not yet curable

It is not the same as allergies, but allergies MAY cause asthma

Not contagious

Can be life-threatening!

It can be controlled

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Asthma Facts

About 26 million Americans have asthma, including about 7 million children. It is the most common chronic childhood disease.

Asthma causes more hospital stays than any other childhood disease.

Cost of lost workdays for parents with asthmatic children is near $1 billion.

It is a leading cause of school absences.

Annual direct and indirect costs of asthma are more than $56 billion.

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Who suffers from Asthma

Children

Low-income, urban residents

Some minorities

Allergic individuals

People with hereditary disposition for asthma (genetics)

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What happens during an asthma attack?

Airways narrow, caused by:

tightening of the muscles that surround the airways

swelling of the inner lining

an increase in mucous production

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What happens during an asthma attack?

You Tube video: Asthma symptomshttp://www.youtube.com/watch?v=mmQeKUEfnBc

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http://www.youtube.com/watch?v=mmQeKUEfnBc

http://www.youtube.com/watch?v=mmQeKUEfnBc

What does an asthma attack feel like?

Jog in place for about 30 seconds

Place a straw in your mouth and breathe only through the straw by pinching your nose closed

How do you feel?

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Warning signs of asthma

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Warning signs of asthma

Strained breathing

Prominent neck muscles

Out of breath after physical activity

IMPORTANT: These symptoms don’t necessarily mean it is asthma

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Asthma can be controlled in 2 ways

There are excellent medicines available now that can control asthma--some must be taken on a daily basis.

Environmental “triggers” of asthma can be controlled to reduce asthma symptoms--which are different for everyone.

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What can you do to manage asthma?

Everyone needs a written Asthma Action Plan. This plan includes:

Medication

Identification and avoiding of asthma “triggers”

Peak flow monitoring (over age 5)

Emergency plan

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What to do if a child has an asthma attack

Reassure the child with a calming manner

Review Action PlanUse medication if necessary and available

Identify what triggered the symptoms and remove child from triggers

Inform parents/emergency contact if severe

Call 911 in emergency

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Types of medications:

2 main types

Controller or “everyday” medications

Intal, SingulairPulmocort, Aerobid

Azmacort, Serevent

These control inflammation in the lungs on an everyday basis

Rescue or “quick-relief” medications

Albuterol, Serevent

Xopenex, Ventolin

These help to control broncospasms--release “squeezing” of the airways

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Asthma medicines can be given in different forms

Metered-dose inhalersInhalers can be used with “spacers”

These are especially useful with young children

NebulizersPills

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Inhalers attached to spacers

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Peak Flow Meters

A portable device that can help measure air flow in and out of the lungs

May not be useful for children under the age of 5

Can be a good indicator of air flow in and out of the lungs in those over age 5

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Types of inhalers

You Tube videos:http://www.youtube.com/watch?v=AqBTKE_PStY

(Types of Asthma Medications)http://www.youtube.com/watch?feature=player_embedded&v=NUob1sfL3Ig

(American Lung Association: Quick Relief Medicines) 20

http://www.youtube.com/watch?v=AqBTKE_PStY

http://www.youtube.com/watch?v=AqBTKE_PStY

http://www.youtube.com/watch?feature=player_embedded&v=NUob1sfL3Ig



When emergency treatment is needed for asthma

Wheezing or coughing that does not get better after giving “quick-relief” medicines

Peak flow is less than 80% of bestDifficulty breathing that does not get better after asthma medicines

Too weak or tired

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Learning objective: Comprehension

Identify asthma/allergy triggers in the home environment

Allergens

MoldsDustAnimalsPollenFoodPests

IrritantsSecondhand smokeStrong odorsOzoneChemicals/cleaning compounds

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Other asthma triggers

Respiratory infectionscoldsfluoften worse at night after lying down

Exercise

Changes in weathercold airwindhumidity

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Indoor Air Pollution:

A Major Health Concern

Most people spend 90% of their time indoors

Toxin levels indoors may be higher than outdoors because of energy tight buildings

Most of the common asthma triggers are found indoors

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Five Most Common Indoor Environmental Triggers

Secondhand SmokeDust MitesMoldPetsPests

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Other Indoor Triggers:

Household Products

Vapors from cleaning solvents (non-water based), paint, liquid bleach, mothballs, glue

Spray deodorants, perfume

Bleach, pesticides, oven cleaners, drain openers, aerosol spray products

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Recognize asthma triggers

Not all triggers affect every person

3 Basic Strategies to improve indoor air quality:

1. identify the problem2. control the source3. mitigation--get rid of the

pollutant or triggering substance

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Pollen

Transported by wind

Grass, ragweed, pine, birch, oak trees

Can get indoors during pollen season

Close windows during pollen season

Caulk and weather-strip doors and windows

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Five most common indoor environmental triggers

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• Secondhand Smoke

• Dust Mites• Mold• Pets• Pests

Secondhand Smoke

Contains more than 4,000 substances (over 40 are carcinogenic)

Is particularly harmful to young children

Can trigger asthma attacks

Causes coughing, excess phlegm, reduced lung capacity, and other lung irritation

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By-products of smoke

Particles such as nitrogen dioxide and sulfur dioxide may cause decreased lung function

Increased risk of respiratory tract infections (bronchitis, pneumonia)

Not only tobacco smoke—asthma triggers also include burning wood, candles, coal, kerosene, and natural gas

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Avoiding Secondhand Smoke

Action Steps:

Do not allow smoking indoors or in vehicles

Limit use of fireplaces and candles

Use exhaust fan over gas stoves

Smoke particles stick to clothing--can affect young child when held in arms

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“Please don’t smoke around kids!”

“Please don’t smoke around kids!”




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• Dust Mites

• Mold• Pets• Pests

Dust mites

Too small to be seen

Found almost everywhere!

Live in soft bedding

Feed on dead skin cells

Mites and mite droppings can be asthma triggers

Live in warm, humid places

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Dust mite triggers

Action Steps:

Wash sheets and blankets once a week in very HOT water (130 F) and dry in HOT dryer

Use air conditioner in summer to lower humidity levels

Best humidity levels are between 30-50%

Remove carpets if possible

Use microfiber cloths

Vacuum often with HEPA vacuum or microfiltration bags

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Dust mite triggers

Action Steps:

Cover mattresses and pillows in dust-proof (allergen-impermeable) zippered covers

Vacuum mattress, chairs, and carpeting

Replace pillows every 5 years

Limit stuffed animals in bedrooms

Freezing also kills dust mites

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Pad

PlasticCover

37CrCredit for picture: National Center for Healthy Housing




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Molds

A type of fungusGrow on damp surfaces

Molds grow by releasing spores

Grow on organic materials: wood, drywall, wallpaper, carpet, and foods

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Avoiding Mold Triggers

Action Steps:

•Mold problems are caused by excess moisture

Correct the moisture problem first!

Maintain low indoor humidity (between 30-50%)

Warm air holds more water than cold air

Fix leaky plumbing

Empty and regularly clean refrigerator drip pans

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Avoiding Mold

Action Steps:

•Run a bathroom fan during bathing—make sure the fan works

Exhaust the dryer to the outdoors

Control moisture in the crawlspace

Replace carpet with hard-surface floors in basement

Use air conditioner to lower humidity

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More on Mold

Don’t need to test for mold--if you see it or smell it--then you have mold

Clean up small areas with a bleach solution:

1 part bleach to 10 parts waterBUT—you don’t have to use bleach!

Limit houseplants--since soil/leaves contain mold--at least in bedrooms

Clean when children are not present

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Pets

Skin flakes, urine, and saliva of warm blooded animals can be asthma triggers

Triggers can remain inside for several months after an animal is removed, even with cleaning

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Avoiding Pet Triggers

Action Steps:

Try to keep pets outdoors only—if possible

Keep pets off beds and out of bedrooms

Keep pets off fabric-covered furniture

Use a HEPA vacuum to vacuum up pet fur

Keep litter boxes, pet beds, and cages away from sleeping areas

IF pets get on beds, wash bedding in very HOT water

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Pests (especially Cockroaches)

Many people are allergic to the body parts and droppings of cockroaches

People who have dust allergies frequently have cockroach allergies

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Avoiding Pests

3 steps to avoid pests indoors:

1.Prevention

2.Identification

3.Control

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Preventing Pests

Get rid of places for pests to hide and sources of food and water

reduce clutter (boxes, stacks of newspapers, grocery bags)

do not leave food or garbage out

clean up food spills and crumbs

caulk cracks and crevices

Pest-proof living space

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Action Steps

Controlling Pests

Make sure you identify the pest before using pesticides

Use less toxic baits, boric acid, or traps first--before using toxic pesticides

If you use sprays: Limit spray to infested area

Ventilate room--sprays may be a trigger for asthma or cause lung irritation

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IPM

IntegratedPest

Management

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52credit for picture: National Center for Healthy Housing

Air Cleaners and Filters

Action StepsUse air cleaners only as a last resortHEPA filters (High Efficiency Particulate Air)Do not use air cleaning devices that produce ozone

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Air Cleaners and Filters

Action Steps:Know the size of the room to be treated before purchasing the air conditioning/heater unitClean or change filters frequentlySome gases and very small particles are difficult to removeIf updating an old unit, get an energy efficient one.

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Other Asthma Triggers

ExercisePeople with asthma should be able to exercise

Sometimes, taking inhaler medicine before exercising may help

Colds/Flu/Respiratory infectionsOften these illnesses will trigger asthma symptoms or make them worse--get a flu shot

Cold weather sometimes triggers asthma

Strong fragrances

Pollens

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Let’s reflect: Application

Action Steps to control asthma

Make sure everyone with asthma has an Asthma Action Plan

Be aware of medicines used to treat asthma and have emergency contact numbers in case of asthma episodes

Control the environment to prevent triggers: dust, pests, mold, secondhand smoke, strong odors, and cleaning solvents

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Resources for Asthma & Allergies

The U.S. Department of Housing and Urban Development www. Healthyhomes.hud.gov

The U.S. Environmental Protection Agencywww.epa.gov/asthma

The American Lung Associationhttp://www.lung.org/lung-disease/asthma/

Centers for Disease Control and Preventionhttp://www.cdc.gov/asthma/

•AsthmaCommunity Pharmacists, www.epa.gov/asthma

•MoldFire & Water Cleanup and Restoration Service

companies, www.epa.gov/mold•Pests

Pest Control Companies—ask if they use IPM•Secondhand Smoke

Smoking Cessation: smokefree.gov, state Health, Department Quitline

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Thank you!Questions? Comments?

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Good Health Starts at HomeAsthma & Allergies

Good Health Starts at Home Asthma and Allergies 1 April 2014.

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