Asthma and Allergies

1. Asthma and Allergies Laura B. Booth Extension Associate, Environmental Health Education Alabama Cooperative Extension System Auburn University

2. Topics Covered • What is asthma? • Who is most at risk to get asthma? • What does the indoor environment have to do with asthma? • How can you reduce exposure to indoor asthma triggers? • What can I do to help educate others about indoor asthma triggers?

3. 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!

4. Asthma Facts • About 17 million Americans have asthma, including about 5 Million children It is the most common chronic childhood disease. • Asthma causes more hospital stays than any other childhood disease • Cost of lost workdays of parents with asthmatic children is near $1 billion • It is a leading cause of school absences

5. Who is most at risk to suffer from asthma? • Children • Low-income, urban residents • Some minorities • Allergic individuals • People with hereditary disposition for asthma (genetics)

6. What happens during an asthma episode? • Airways narrow, caused by: • tightening of the muscles that surround the airways • swelling of the inner lining • increase in mucous production

7. What does an asthma episode feel like? • Jog in place for 2 minutes • Place a straw in your mouth and breathe only through the straw by pinching your nose closed • How do you feel?

8. Coughing (especially when it is not a cold) Wheezing (a squeaking sound when breathing) Fast breathing Poor skin color Shortness of breath Hunched over posture Restless during sleep Fatigue Space between the ribs may sink in when breathing Anxiety Vomiting Warning Signs of Asthma

9. 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

10. Asthma can be controlled! • There are excellent medicines available now that can control asthma--some must be taken on a daily basis • Environmental “triggers” of asthma--which are different for everyone--can be controlled to reduce asthma symptoms

11. What can you do to manage asthma? Everyone needs a written Asthma Action Plan; this includes: • Medication • Identification and avoiding of asthma “triggers” • Peak flow monitoring (over age 5) • Emergency plan

12. What to do if a child has an asthma episode • Reassure the child with a calming manner • Review Action Plan • Use 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

13. Controller or everyday medications Intal, Singulair Pulmocort, 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 Types of medications2 main types

14. Asthma medicines can be given in different forms • Metered-dose inhalers • Inhalers can be used with “spacers” • These are especially useful with young children • Nebulizers • Pills

15. Inhalers attached to spacers

16. 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

17. Treatment is needed quickly for asthma • Fever over 100 F • Wheezing or coughing that does not get better after giving “quick-relief” medicines • Peak flow is less than 80% of best • Difficulty breathing that does not get better after asthma medicines • Too weak or tired

18. Allergens Molds Dust Animals Pollen Food Pests (cockroaches) Irritants Secondhand smoke Strong odors Ozone Chemicals/cleaning compounds Common Asthma Triggers

19. Other asthma triggers Viral respiratory infections • colds • flu • often worse at night after lying down Exercise Changes in weather • cold air • wind • humidity

20. 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

21. 5 Most Common Indoor Environmental Triggers Secondhand Smoke Dust Mites Mold Pets Cockroaches

22. 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

23. Recognize asthma triggersto control indoor air • Not all triggers affect every person • 3 Basic Strategies to improve indoor air quality: • identify the problem • control the source • mitigation--get rid of the pollutant or triggering substance

24. 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

25. 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

26. Byproducts 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--also caused by burning wood, candles, coal, kerosene, natural gas

27. Avoiding Secondhand Smoke • Do not allow smoking indoors or in vehicles • Limit use of fireplaces and candles • Exhaust fan over gas stoves • Smoke particles stick to clothing--can affect young child when held in arms

28. 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

29. Avoiding Dust Mite Triggers • Wash sheets and blankets once a week in very HOT water (130 F) • Use air conditioner in summer to lower humidity levels • Remove carpets if possible • Damp clean hard surfaces • Vacuum often with HEPA vacuum or microfiltration bags • Low indoor humidity-between 30-50%

30. Avoiding Dust Mite Triggers • Cover mattresses and pillows in dust-proof (allergen-impermeable) zippered covers • Vacuum mattress, chairs and carpeting • Replace pillows every 5 years

31. Pets/Animals • 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

32. Molds • A type of fungus • Grow on damp surfaces • Molds grow by releasing spores • Grow on organic materials: wood, drywall, wallpaper, carpet, foods

33. Avoiding Mold Triggers • 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

34. Avoiding Mold Triggers • Run a bathroom fan during bathing • 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

35. 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-- • 1/2 cup of bleach to 1 gallon of water • Limit houseplants--since soil/leaves contain mold--at least in bedrooms • Clean when children are not present

36. Pests (especially Cockroaches) • Many people are allergic to the body parts and droppings of cockroaches • People who have dust allergies frequently have cockroach allergies

37. Avoiding Pests • Avoiding pests like cockroaches is hard to do in Alabama--we have mild winters, humidity and lots of rainfall • 3 steps to avoid pests indoors: • Prevention • Identification • Control

38. 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

39. 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

40. Air Cleaners and Filters • Use Air Cleaners only as a last resort • HEPA filters (High Efficiency Particle Air) • Do not use air cleaning devices that produce ozone

41. Filters/Air Cleaners • Know the size of the room to be treated before purchasing the unit • Keep filters changed or cleaned frequently • Some gases and very small particles are difficult to remove

42. Other Asthma Triggers Exercise • People with asthma should be able to participate in exercise • Sometimes, taking inhaler medicine before exercising may help Colds/Flu/Respiratory infections • Often these illnesses will trigger asthma symptoms or make them worse--get a flu shot Cold weather sometimes triggers asthma

43. Review of Actions to Control Asthma • Make sure everyone with asthma has a 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

44. For More Information Alabama Cooperative Extension System Asthma Web site: www.aces.edu/asthma The U.S. Environmental Protection Agency (EPA) www.epa.gov/asthma The American Lung Association 1-800-LUNG-USA

45. Credits Thanks to the Healthy Indoor Air for America’s Homes project: www.healthyindoorair.org for photos and drawings used and for background information