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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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
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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Learning objective: Comprehension
Identify asthma/allergy triggers in the home environment
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!”
Learning objective: Comprehension
Identify asthma/allergy triggers in the home environment
Five most common indoor environmental triggers
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• Secondhand Smoke
• 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
Learning objective: Comprehension
Identify asthma/allergy triggers in the home environment
Five most common indoor environmental triggers
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• Secondhand Smoke
• Dust Mites• Mold• Pets• Pests
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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Learning objective: Comprehension
Identify asthma/allergy triggers in the home environment
Five most common indoor environmental triggers
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• Secondhand Smoke
• Dust Mites• Mold• Pets• Pests
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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Learning objective: Comprehension
Identify asthma/allergy triggers in the home environment
Five most common indoor environmental triggers
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• Secondhand Smoke
• Dust Mites• Mold• Pets• Pests
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
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