Healthy Home Solutions Lesson 8: Asthma and Allergies

1. Healthy Home Solutions Lesson 8: Asthma and Allergies <presenter name here>

2. 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 Learning objectives

3. “An estimated 39.5 million people (12.9%), including 10.5 million (14.0%) children in the Unites States had been diagnosed with asthma in their lifetimes. • The estimated total cost of asthma to society, including medical expenses ($50.1 billion per year), loss of productivity resulting from missed school or work days ($3.8 billion per year), and premature death ($2.1 billion per year), was $56 billion (2009 dollars) in 2007. • During 2001–2011, the number of persons with asthma in the United States increased by 28%. Why do we care? Source: Centers for Disease Control and Prevention. (2013). Asthma facts: CDC’s National Asthma Control Program Grantees. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention

4. Many people spend 90% of their time indoors • Indoor air may contain pollutants and asthma triggers • Many common asthma triggers are found indoors Why do we care?

5. Resource:Help yourself to a healthy home

6. Keep It: • Dry • Clean • Safe • Well-ventilated • Pest-free • Contaminant-free • Well-maintained Seven principles of healthy homes

7. Chronic inflammatory disorder of the airways • It is not the same as allergies, but allergies MAY cause asthma • Not contagious • It is treatable, but not yet curable • Can be controlled • Can be life-threatening! What is asthma?

8. Children • Low-income, urban residents • Some minorities • Allergic individuals • People with hereditary disposition for asthma (genetics) Who suffers from asthma?

9. Airways narrow, caused by: • Tightening of the muscles that surround the airways • Swelling of the inner lining • Increase in mucous production What happens during an asthma attack?

10. YouTube video: Asthma symptoms • http://www.youtube.com/watch?v=mmQeKUEfnBc What happens during an asthma attack?

11. 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? What does an asthma attack feel like?

12. 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 • Vomiting Warning signs of asthma

13. Strained breathing • Prominent neck muscles • Out of breath after physical activity • IMPORTANT: These symptoms do not necessarily indicate asthma Warning signs of asthma

14. Medication Reduce triggers Environmental “triggers” of asthma can be controlled to reduce asthma symptoms (which are different for everyone) Asthma can be controlled in two key ways • There are excellent medicines available now that can control asthma; some must be taken on a daily basis

15. Create an asthma action plan

16. 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 If a child has an asthma attack

17. Controller or “everyday” medications Rescue or “quick-relief” medications These help to control broncospasms; release “squeezing” of the airways: Albuterol, Serevent Xopenex, Ventolin Two main types of medications • These control inflammation in the lungs on an everyday basis • Intal, Singulair • Pulmocort, Aerobid • Azmacort, Serevent

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

19. Inhalers attached to spacers

20. 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 Peak flow meters

21. Types of Asthma Medications Quick Relief Medicines http://www.youtube.com/watch?feature=player_embedded&v=NUob1sfL3Ig Types of inhalers(YouTube videos) • http://www.youtube.com/watch?v=AqBTKE_PStY

22. 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 When emergency treatment is needed for asthma

23. Common home environment asthma/allergy triggers

24. Not all triggers affect every person • Three basic strategies to improve indoor air quality: • Identify the problem • Control the source • Mitigation; get rid of the pollutant or triggering substance Recognize asthma triggers

25. Learning objective: ComprehensionIdentify five common asthma/allergy triggers in the home environment

26. 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 Secondhand smoke

27. 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 Smoke by products

28. “Please don’t smoke around kids!” 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; this can affect young child when held in arms Avoiding secondhand smoke

29. 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 Dust mites

30. Wash sheets and blankets once a week in HOT water; then use dryer • Use air conditioner in summer to lower humidity levels • Keep indoor humidity levels between 30-50% • Remove carpets if possible • Use microfiber cloths to clean and dust • Vacuum often; use a HEPA vacuum if possible Dust mite action steps

31. 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 • Freeze items that can’t be washed Dust mite action steps Pad Plastic Cover

32. Dust mites action stepsCredit for picture: National Center for Healthy Housing

33. A type of fungus • Grows on damp surfaces • Grows by releasing spores • Grows on organic materials: Wood, drywall, wallpaper, carpet, and foods Mold

34. Mold problems are caused by excess moisture; correct the moisture problem first! • Maintain low indoor humidity (between 30-50%); note that warm air holds more water than cold air • Fix leaky plumbing • Empty and clean refrigerator drip pans regularly Mold action steps

35. 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 Mold action steps

36. There is no real 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 water • You don’t have to use bleach! Consider soap and water • Clean when children are not present • Limit houseplants (at least in bedrooms); soil/leaves contain mold More on mold

37. 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 Pets

38. 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 hot water Pet triggers action steps

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

40. 3 steps to avoid pests indoors: • Prevention • Identification • Control Avoiding pests

41. 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 Preventing pests

42. Make sure you identify the pest before using pesticides • Use less toxic baits, boric acid, or traps before using more toxic pesticides • If you use sprays: • Limit spray to infested area • Ventilate room; sprays may be a trigger for asthma or cause lung irritation Action stepsto control pests

43. Integrated pest management methods of control and action steps

44. Exercise • People with asthma should be able to exercise • Sometimes, taking inhaler medicine before exercising may help • Colds/flu/respiratory infections • Often these illnesses will trigger asthma symptoms or make them worse; consider getting a flu shot • Cold weather sometimes triggers asthma • Strong fragrances • Pollens Other asthma triggers

45. 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 Other asthma triggers

46. Create an Asthma Action Plan • There are two key ways to control asthma: Use of proper medications and reducing environmental triggers • Be aware of medicines used to treat asthma and have emergency contact numbers in case of asthma episodes • Control the environment to prevent common triggers: Secondhand smoke, dust mites, mold, pets, and pests Let’s reflect: ApplicationAction steps to control asthma

47. The U.S. Department of Housing and Urban Development: www. healthyhomes.hud.gov • The U.S. Environmental Protection Agency: www.epa.gov/asthma • The American Lung Association: http://www.lung.org/lung-disease/asthma/ • US Centers for Disease Control and Prevention: http://www.cdc.gov/asthma/ • Mold: Fire & 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 Resources for asthma and allergies