Jasmine Williams, MPH, CHES Asthma Program Coordinator

1. Jasmine Williams, MPH, CHES Asthma Program Coordinator

2. Our Mission To saves lives by preventing lung disease and promoting lung health through: • Education • Advocacy • Research

3. What is Asthma?

4. Asthma…… Chronic life- long inflammatory condition that makes it hard to get air in and out of the lungs Asthma causes three primary changes in the lungs: • Inflammation or swelling • Tightening of the muscles around the airways • Excess mucous production

5. Normal Airway vs. Asthmatic Airway CAACP, 2004

6. What Causes Asthma?? WE DON’T REALLY KNOW!!! Complex Interaction between: • Genetics Factors- children are more likely to develop asthma if their parents have it • Environmental Factors – exposure to some viral infections as infants when the immune system is not fully developed may cause asthma

7. Asthma Remains a Serious Health Risk in the US Every day in America, approximately… 12.3 millionpeople have an asthma attack 2 millionpeople visit an emergency room due to asthma 500,000people are admitted to the hospital due to asthma 11people die from asthma American Lung Association. Epidemiology and Statistics Unit, Research & Program Services Division. Trends in Asthma Morbidity & Mortality. November 2007. www.lungusa.org. Accessed 2/25/08.

8. Childhood asthma accounts for 12.8 million days missed from school annually • The number-one chronic condition causing children to be absent from school and the third highest ranked cause of pediatric hospitalizations in the United States • On average, a child with asthma will miss one full week of school each year

9. Burden of Asthma in MS • 1 in every 14 adults have asthma • More women than men (8% v. 5%) • 1 in every 10 children have asthma • More African American children than Caucasian children (13% v. 8%) • More boys than girls (12% v. 8%) Source: Behavioral Risk Factor Surveillance System, 2007

10. Onaverage, 3 children in a classroom of 30 are likely to have asthma.* *Epidemiology and Statistics Unit. Trends in Asthma Morbidity and Mortality. NYC: ALA, July 2006.

11. Provide a Safe Environment By learning early warning signs and symptoms of an asthma episodes By learning asthma triggers and ways to reduce exposure By encouraging students to take asthma medications regularly or as prescribed by a healthcare professional By learning to act in the event of an asthma emergency

12. Asthma Signs & Symptoms

13. Early Warning Signs • Sudden mood changes and/or irritability • Trouble completing sentences without gasping for breath • Itchy chin or neck • Runny or stuffy nose, sneezing • Watery, itchy eyes • Stomach ache/poor appetite • Dark circles under the eyes

14. Asthma SymptomsWhat to Listen for… • Coughing or a persistent cough • Frequent clearing of the throat • Irregular breathing • Noisy, difficult breathing • Wheezing during exhaling

15. Asthma SymptomsWhat to Look for… • Perspiring • Vomiting due to hyperventilation • Restlessness during sleep • Fatigue that is not related to activity • Anxious or scared look • Unusual facial paleness • Flared nostrils • Pursed-lip breathing • Fast breathing/shortness of breath • Hunched-over body position

16. Asthma Triggers

17. Allergens Substances that cause allergic reactions Exposure increases airway inflammation and asthma symptoms Irritants Substances that irritate the lungs Exposure increases asthma symptoms or limits airflow Asthma Triggers

18. Common Asthma Triggers

19. Asthma Triggers: Allergens All warm-blooded animals produce flakes of skin (dander), feces, urine and dried saliva that can cause allergic reactions. • Best option - Keep animals out of classroom • Wash hands after contact with the pet • Isolate the pet Animal Allergens

20. Asthma Triggers: Allergens • Require humidity and human (skin) dander to survive • High levels are found in bedding, pillows, mattress, upholstered furniture, carpets, clothes and soft toys Dust Mites

21. Asthma Triggers: Pollen Pollens can cause the following symptoms: itchy watery eyes, runny nose, itchy throat, hives, fatigue, and irritability. • Asthma triggers found outdoors are harder to control. • Try: • Watching pollen levels. Pollen levels vary by seasons. Find out which seasons affect students the most. • Keep windows closed on high pollen-days as well as avoid outside activity. • Have parents talk with their child’s doctor about medications that can help reduce symptoms.

22. Asthma Triggers: Mold Mold or Fungus is found nearly everywhere in the environment. It poses serious health risk to students and staff, especially those with asthma.

23. Asthma Triggers: Cockroach • Tiny pieces of dead roaches and roach droppings end up in dust and the air we breathe. • Its important to make sure classrooms and other school spaces are free of pest because exposure to such pest can lead to: • Stuffy nose • Coughing • Wheezing • A feeling of chest tightness • Shortness of breathe

24. Asthma Triggers: Food Allergies

25. Asthma Triggers: Irritants

26. Asthma Triggers: Smoke Exposure to any type of smoke – cigarette, cigar and secondhand smoke, wood, coal, leaf burning, industrial waste, chemistry labs and or kitchen smoke can all irritate the lungs. • Reduce exposure by: • Preventing smoking on or around school campus • Encouraging and helping parents, faculty, and staff to quit smoking

27. Asthma Triggers: Fumes

28. Asthma Triggers: Irritants • Air pollution • Chemicals and strong smells

29. Other Asthma Triggers • Colds, flu, sinus problems • Exercise • Bursts of emotion • Some medicines in sensitive individuals • Anxiety • Obesity

30. Asthma Medications

31. Inhaled Medication Delivery Devices

32. Long-Term Control Medicines Also called “controllers” Prevent lung inflammation, but will not help during an asthma attack Must be taken for several days before positive effects are noted

33. Quick-Relief Medicines • Also called “rescue or relievers” • Relax the muscles around the airways and decrease the narrowing of the airways • Provide immediate relief lasting several hours • Used to prevent and treat Exercise Induced Asthma

34. Medications to Treat Asthma:Nebulizer Machine produces a mist of the medication Used for small children or for severe asthma episodes No evidence that it is more effective than an inhaler used with a spacer

35. Take Action

36. Asthma Action Plan Green zone - when symptoms are controlled Yellow zone – when symptoms are present Red zone – when symptoms do not go away or get worse

37. Emergency Response during Asthma Episode • Help to an upright position; speak calmly and reassuringly • Follow individualized action/emergency plan for use of quick-relief inhaler • If quick-relief inhaler or action/emergency plan not available, send to health office accompanied by peer or with staff member • Get emergency help from school nurse or designated emergency staff if any of the following: • Inhaler not helping • Breathing hard & fast • Nostrils open wide • Can’t walk or talk well If student has excessive coughing, wheezing, shortness of breath, or chest tightness:

38. Questions

39. We will breathe easier when the air in everyAmerican community is clean and healthy. We will breathe easier when people are free from the addictivegrip of cigarettes and the debilitating effects of lung disease. We will breathe easier when the air in our public spaces andworkplaces is clear of secondhand smoke.We will breathe easier when children no longerbattle airborne poisons or fear an asthma attack. Until then, we are fighting for air.

40. For more information, contact: American Lung Association in Mississippi Jasmine Williams, MPH, CHES Asthma Program Coordinator jwilliams@breathehealthy.org 601.206.5810