United States
         Environmental Protection
Office of Radiation
and Indoor Air
April 2000
EPA 402-F-00-QQ2
    National  Academy
     of Sciences Report
      Links Asthma to
  Indoor Environmental
 On January 19, the National Acad-
 emy of Sciences (NAS) released a
 report entitled, Clearing the Air:
 Asthma and Indoor Air Exposures.
 The U.S. EPA contracted with the
 National Academy of Sciences to
_.assesa the role of indoor air quality
-and asthma.- In the report, NAS
 characterized the state of the
 science on health impacts and
 prevention strategies, and provides
 recommendations on needed

 The Academy's conclusions and
 recommendations support EPA's
 initiative to increase awareness of
 the impact of indoor air pollutants on
 asthma exacerbation and develop-
 ment, and to increase the use of
 effective indoor environmental

 For example, the report finds strong,
 causal evidence linking common
 indoor substances to the develop-
 ment or worsening of asthma
 symptoms in susceptible people.
 The report finds sufficient evidence
 of a causal relationship or an
 association between indoor expo-
 sures and exacerbation of asthma
 for pet (cat and dog) dander,
 cockroaches, house dust mites,
 environmental tobacco smoke, fungi
 and molds, rhinovirus (the common
 cold), and nitrogen oxides.

 According to the Centers for Dis-
 ease Control and Prevention,
 asthma increased 75% from 1980 to
 1994.  Approximately 17 million
 Americans are now diagnosed with
 asthma, disproportionately affecting
 children and those of low income.

 Over 5 million  school-aged children
 have asthma or one in thirteen
 children.  School personnel can
 improve the indoor environments in
 schools by reducing air pollutants
 which may trigger asthma episodes.
 The IAQ Tools for Schools Kit
 provides step-by-step guidance on
 how to reduce exposures to these
 indoor environmental triggers.

 Copies of Clearing the Air: Asthma
 and Indoor Air Exposures is avail-
 able from the National Academy
 Press, or read a summary of the
 report on-line at their web site at:
   EPA and School
   Nurses  Team Up
   Against Asthma

The National Association of School
Nurses (NASN) and EPA have
recently begun working together to
improve indoor air quality and to
reduce asthma in schools.
    NASN currently has over 10,000
    school nurse members and 48
    state affiliate chapters.

    In the past decade, school nurses
    have expanded their role in school
    programs. In addition to delivering
    traditional health care, they are
    teaching a variety of health topics,
    providing parent health education,
    facilitating staff wellness programs,
    and participating in community
    health events.

    NASN is currently developing
    asthma training modules to
    educate school communities on
    the seriousness of asthma and the
    environmental triggers which may

               continued on page 2

School Nurses continued

increase the frequency and
severity of asthma episodes.
School nurses will deliver the
training modules at staff meet-
ings, PTA meetings and in
student health classes.

In June 1999, NASN hosted its
31st Annual National Conference
in Providence, Rhode Island.
Approximately 195 school nurses
attended EPA's session on IAQ
Toots for Schools and asthma.
As a result, many are now using
the Kit in their own schools.

For more information on EPA's
work with school nurses, contact
Kim Smith at (202) 564-9443.
 National  Education
  Association Makes
  Indoor Air Quality
        A Priority

   Submitted by Christine Luong,
   National Education Association

At the 1999 National Education
Association's (NEA) Annual
Meeting, held in Orlando in June,
indoor air quality in schools
emerged as a critical issue. In
response to the growing need for
help in addressing IAQ problems in
schools, delegates at the Annual
Meeting unanimously passed a
"new business" item on IAQ. The
new business item was adopted as

The NEA urges all state and local
affiliates to implement the Indoor Air
Quality Tools for Schools Action Kit in
their schools starting with the 1999-
2000 school year.

Page 2    	
The NEA Health Information
Network's existing IAQ in Schools
program is ready for the challenge
of implementing the Indoor Air
Quality Tools for Schools Kit in as
many public schools as possible.
The NEA's goal is to help EPA
reach its goal of implementing the
Kit in 16,000 public schools across
the country by 2005.

For additional information about
NEA's involvement with IAQ Tools
for Schools, contact Christine
Luong at the Health Information
Network of the National Education
Association at (202) 822-7799, or
via email at cluong@nea.org.
     American Lung
  Launches New  IAQ
    Tools for Schools
   Training Program

     Submitted by Katherine Pruitt
     American Lung Association

 The American Lung Association
 (ALA) has been a major promoter
 of IAQ Tools for Schools since its
 inception. The only health and
 environmental organization among
 the Kit's co-sponsors, ALA has
 served as a champion for the
 program in many communities
 around the country.

 Nearly half of Lung Association
 offices nationwide are involved in
 activities to improve Indoor Air
 Quality in schools, and mariy^ are
—currently conducting outreach
 programs: training school
 personnel, involving students and
 their parents, and working  with
 coalitions and decision makers.

 In part because of the success of
 the program to date, the ALA
 Board of Directors voted in
 February 1999 to adopt IAQ Tools
 for Schools as a core program for
 the organization, making it one of
 a handful of programs that all local
 Lung Associations are expected to
 deliver in a consistent way.

 To help local Lung Associations
 develop effective promotional
 programs for IAQ Tools for
 Schools, the Indoor Air Programs
 staff at the ALA national office has
 launched a year-long series of
 regional trainings.  The one-day
 workshops are designed to give
 ALA staff and volunteers the
 background and skills they need to
 train school personnel and other
 community stakeholders to
 implement the guidance in IAQ
 Tools for Schools.

 Sessions include an overview of
 indoor air quality issues in schools;
 ideas for marketing the program to
 schools and other community
 stakeholders; strategies for
 training different audiences to
 implement the program in the
 schools; developing partnerships;
 and measuring program outcomes.

 The first training was held in San
 Jose, California in August, 1999.
 Seventeen staff and volunteers
 from 14 Lung Associations in
 California and Washington
 participated, bringing with them
 considerable expertise in lung
 health, indoor air quality,
 communications, development and
 strategic planning.

 Shelly Rosenblum from EPA
 Region 9 served as one of the
trainers, and was able to give
participants some technical
background for the program, along
 with the promise of guidance and
 support for their efforts when they
 got back home to their local
 associations. One of the highlights
 of the day was hearing
 presentations from teachers Adina
 Neal and Ruth Sweet. Ms. Neal,
 who is serving as the IAQ
 Coordinator for the Saugus school
 district, shared her difficult but
 ultimately rewarding experiences
 with an IAQ crisis situation. Ms
 Sweet talked about the benefits of
 working through the students to
 bring IAQ to the attention of the
 school population, as she did very
 successfully with a program she
 and her third graders call "Crabby

 The second workshop was held in
 Detroit, Michigan at the end of
 September 1999, with thirteen
 participants from across the
 midwestern states. Sheila Batka
 and Helen Tsiapas from EPA
 Region 5 served as co-presenters.
 Several of the participants who
 have been most involved with IAQ
 Tools for Schools also shared their
 experiences in informal
 presentations. One of the
 highlights from this training was
 hearing how local Lung
 Associations in Ohio have been
 able to leverage their efforts to a
 higher level of success by working
 through the very active State
 Indoor Air Coalition.

 ALA expects to hold two  more
 regional IAQ Tools for Schools
 trainings this winter and spring,
 reaching at least another 20 local
 Lung Association offices. Each
 participating Lung Association is
 asked, as part of the training, to
 make a commitment to taking
some action to promote IAQ Tools
 for Schools this year.  Individuals
and organizations working on IAQ
Tools for Schools outreach are
encouraged to contact their local
Lung Association as a potential
community partner at 1 -800-

  Low  Cost/No Cost
   An EPA Regional

     Submitted by Sheila Batka
          EPA, Region 5

Recently, EPA's Region 5 held an
Indoor Air Quality, "Train-the-
Trainers" workshop, organized by
the American Lung Association
(ALA) of Metropolitan Chicago for
its Americorps/Chicago Health
Corps staff.

The training was small (about
twelve participants) and informal,
making it easier to address
participants' needs.  Because the
participants had backgrounds in
health-related disciplines, they
were already familiar with indoor
air quality issues, so not as much
time was spent discussing IAQ
background information.  Instead,
the training focused on using IAQ
 Tools for Schools, including: doing
classroom activities that utilized
the checklists and problem-solving
wheel for mock IAQ  incidents in
schools; explaining the principles
of integrated pest management
 (IPM); and learning to use basic air
 monitoring equipment in a building

The training included a variety of
 resources such as slides and
 photographs of IAQ  problems,
 overheads explaining the process
 of implementing IAQ Tools for
 Schools, technical reference
 material and walkthrough ideas,
 audience notes of overheads, and
 activity sheets of mock IAQ school
 incidences. EPA's Region 5 also
 provided a list of resources that
 was co-developed by EPA and
 other IAQ and school experts in
the Region. This resource list
included Resources for Schools,
Tips for Schools, and Resources
for Homeowners. EPA Regional
IAQ staff may be able to provide
you with resources to further
enhance your own IAQ Tools for
Schools training.

Region 5 frequently works with
non-profit partners, such as ALA to
provide course participants with
specific information enabling them
to be knowledgeable about IAQ
and to implement IAQ Tools for
Schools in their communities. The
benefits of small, focused training
workshops, like the EPA/ALA
training, is that information can be
fine tuned to meet the specific
needs of the class. Some IAQ
training courses are professionally
organized with national experts on
IAQ and offer continuing education
credits.- Othercourses are- avail.- ..
able that have been put together
on a shoestring budget.
 The following information was
 developed by Region 5 to assist
 you and your organization as you
 prepare to sponsor an IAQ Tools
 for Schools workshop in your area.
 Where do you get speakers/

 All ten Regional offices of EPA
 have experienced indoor air staff
 who actively train school personnel
 and local partners about IAQ in
 schools. They may be able to
 assist in the training or provide
 suggestions for other speakers in
 your area.

 Some speakers may be able to
 provide gratis training, especially if
 they are collaborating with EPA or
 its partners.  Make sure that your
 speaker's expertise relates to your
,..audjence'.s needs.,,Te.achers and_
 parents may need general IAQ
 background information and an
 introduction to IAQ Tools for
 Schools, whereas school facility or
 health personnel may need a
 different level of expertise.

 Sources of potential speakers may
 be found through the following
 organizations: local affiliates of
 EPA's national partners, such as
 the American Lung Association
 chapters, National Education
 Association, American School
 Board Officials, or the National
 Parent/Teachers Association.

 Speakers may also be available
 through local or state health,
 environmental or education
 agencies; local or state IAQ
 offices; asthma or school coalition
 members; and university/training
 center instructors involved in IAQ
 Page 4

 How do you determine the size
 of a training and find a location ?

 Depending on the size of a pro-
 posed training, local partners may
 be able to provide free space in
 their offices or obtain space in a
 public building. Smaller trainings
 may be held in  a school during off-
 hours, where it might be possible
 to do a building walk-through.
 With larger audiences, a typical
 auditorium setting will be appropri-

 Smaller groups (less than 35) may
 benefit if the training is set up to
 include more individualized,
 roundtable discussions. Informal
 discussions between the
 instructorand class participants
 can  occur with a smaller group,
 allowing the instructor to gauge the
 audience's knowledge and spend
 more time on specific issues of    :

 What resources are needed for
 IAQ Tool for Schools training?

 IAQ Tools for Schools Kits - You
 may wish to ask participants to
 bring their own Kits if they already
 have them, or charge a nominal
 fee to order the Kits yourself.
 Trainers may be able to provide
 free  Kits, if they have ordered
 them from EPA in  advance, but
 they may require certain criteria to
 be met.  Otherwise, all of the
 printed material  (except for the
 IAQ Problem-Solving Wheel and
videos) is found on EPA's web
 IAQ Tools for Schools Presenta-
 tion materials -The IAQ Tools for
 Schools Training Modules (see
 page 13) are available on CD-
 ROM. They contain overhead
 slides for training school staff and
 a Train-the-Trainers module.  In
 addition, Regional offices and
 state/local partners may have
 developed overheads on risk
 communication, technical issues,
 school walk-throughs and imple-
 mentation ideas. As an additional
 resource, trainers/presenters
 should provide copies of
 overheads to participants so they
 may take notes on each slide.

 Local Resources Lists - Some of
 the Regional offices, partners and
 state and local agencies have
 compiled resources in your area/
 Region that supplement the
 information provided within the
 IAQ Tools for Schools Coordin-
 ator's Guide. Suggestions on
 other environmental issues that
 affect schools, or contact names,
 numbers and web sites of state
 and  local agencies and local
 partners are always  helpful for the

 Participants - Allow time within
training for networking, either
through extended breaks or
activities which require participants
to interact with each other. Small
group activities, where participants
use the checklists and problem-
solving wheel for a mock IAQ
incident, allow the participants to
learn from each other, as well as
keep the training interesting.
Many resources are available to
assist you as you organize IAQ
Tools for Schools training events.
Contact your Regional office for
more information. To locate the
EPA Regional office in your area,
see the map on page 14 or visit
the EPA Home Page at:
Iocate2.htm. Click on Regions.

Please let us know how your event
works out. Email Paula Selzer at
selzer.paula@epa.gov with your
story for this Bulletin.
                                   ming module on CD-ROM,
               |Jiop °$paSf 13-  To find a Partner in your community,
         £our BpA^regional office.
                                                                                          Page 5

                                           raining IMews
        EPA Trains
  School Personnel to
 Address Presidential

In response to a call by President
Clinton, EPA recently undertook
an Urban Schools Initiative. This
demonstration project improved
the indoor air quality in a Washing-
ton, D.C. public school.

Checklists (i.e. Building Mainte-
nance, Ventilation, Teachers)
published in the IAQ Tools for
Schools Kit, served as a starting
point in identifying IAQ problems in
the school. Using the checklists,
staff collected information during a
school walk-through and devel-
oped an action plan to address
priority needs. Ultimately, consid-
erable capital improvements were
made in the school as a result of
the action plan.

The total project cost was about $3
million dollars, split between the
D.C. Public Schools and EPA.
The majority of the cost incurred
was associated with deferred-
maintenance items, such as the
HVAC system and damage
caused by excess moisture.
Over $1 million dollars of the
cost went to repair damages
attributable to poor maintenance
of the ventilation system. (An
EPA economic analysis of the
repairs performed showed that if
$370 per year over 22 years (a total
of $8,140) had been spent on
preventive maintenance, $1.5
million in repairs could have been
 Gene Kilby, Director of Facilities
 and Maintenance Staff, DCPS
 addresses training participants
 D.C. School personnel register
 and receive Kits

 As a result of the renovation,
 school facilities personnel have
 developed and are implementing a
 preventive maintenance program
 to reduce future costs associated
 with IAQ problems at the school.
 The building is now in much better
 condition. The principal, Dr.
 Johnetta Smith, stated, "...When
 the children returned to school,
 they were in awe. Excited, happy,
 and pleased to see a whole new
 school. The kids have a lot of
 pride in the school."

 In an effort to promote better air
 quality in schools, the District of
 Columbia Public Schools, EPA,
 and Environmental Health and
 Engineering, Inc. teamed up to
School personnel and EPA staff discuss
IAQ Tools for Schools

  train over 200 D.C. Public School
  employees and officials on indoor
  air quality. In July of 1999, two
  training sessions were conducted
  at the elementary school.  All of
  the participants received IAQ Tools
  for Schools Kits and heard presen-
  tations on school air quality,
  ventilation, and the improvements
  made in the school.

  As a follow-up to the training,
  Cheryl Eason and Keith Keemer
  from the District of Columbia's
  Radon Office will assist a number
  of D.C. public schools as they
  implement a pilot program using
  IAQ Tools for Schools Kit. It is
  hoped that the Charles Young
  demonstration project will provide
  valuable information not only for
  the DC Public Schools, but for
  other schools nationwide.

   For more information on the D.C.
   Schools pilot program contact Ms.
   Eason or Mr. Keemer at (202) 442-
 Page 6

   EPA and Partners
       Continue the
  Training Tradition

 EPA continues to partner with
 national non-profit organizations to
 train school personnel to use the
 IAQ Tools for Schools Kit.

 In the fall of 1999, EPA teamed
 with the American Association of
 School Administrators, the National
 Association of School Nurses, the
 National Education Association,
 the National Association of County
 Officials, the American Association
 of School Administrators, and the
 American Lung Association in
 separate training events. These
 workshops were designed to train
 their members to develop plans for
 using the Kit in their own communi-

 Although the Kit was designed to
 be implemented without any formal
 training, the workshops provided a
 forum for increasing IAQ aware-
 ness, an opportunity for action
 planning and networking, and a
 chance to hear success stories
 about schools across the country
 who are successfully using the  Kit.
 Many of the workshops also
 featured a school walk-through
 aimed at giving participants an
 opportunity to visit a school  and
 become familiar with the process
 of doing a checklist, the first step
 in developing an IAQ management

 Feedback from IAQ Tools for
 Schools trainings is always
 positive, but there is still room for
 improvement. EPA is now plan-
 ning to  expand and combine these
workshops in a more holistic
approach.  By including adminis-
trators, school board members,
 teachers, nurses, and facilities staff
 in the same workshop, IAQ Tools
 for Schools training may be even
 more effective.

 To find out about upcoming
 training opportunities in your area,
 visit the IAQ Tools for Schools web
 site at: www.epa.gov/iaq/schools/
 html. If you are sponsoring an
 upcoming training, or know of one
 in your area, and would like it
 announced on the web site,
 contact Kim Smith at (202) 564-
      IAQ Tools for
  Schools Incentives

 EPA is expanding its efforts to
 create healthier indoor environ-
 ments for children in our nations
 schools by launching an incentives
 program to spur the use of the IAQ
 Tools for Schools in school
 districts across the country.

 EPA has developed a six-compo-
 nent marketing, technical support,
 and awards program to make it
 easier and more rewarding for
 schools to improve their indoor air
 quality through the use of IAQ
 Tools for Schools. The program
 was developed based on feedback
 obtained in focus  groups, a
 national stakeholders' meeting
 held in April 1999, and from
 anecdotal information collected at
various IAQ Tools for Schools
training workshops. The six
components are described below:

An Outreach Campaign will focus
on the importance of good IAQ in
schools and its connection to
student performance.
 A Recruitment Campaign will
 identify and distribute IAQ Tools
 for Schools to schools and school
 districts most likely to read and/or
 use the Kit.

 A Mentoring Program will provide
 an open line of communication
 among front-line school personnel,
 to network and share experiences
 and successes.

 Technical Tools will provide
 innovative materials to support the
 use of the Kit to achieve good
 indoor air programs in schools.

 An Awards and Recognition
 Program will publicly recognize
 leaders promoting school environ-
 mental issues.

 Private Sector Partnering will
 facilitate the partnership of schools
 with corporations and businesses
 who wish to display their environ-
 mental and civic leadership by
 providing technical assistance to
 schools and school systems who
 are implementing the Kit.

This summer, EPA will launch the
 incentives  program nationwide.
See page 13 for details about the
upcoming National Symposium in
August, 2000.
                                                                                       Page 7

    New Book from
   Architect's Group
   Examines  State of
   School Buildings

The American Institute of Archi-
tects (AIA) released a new booklet
this fall on the state of the nation's
school buildings. The booklet,
Good Enough for Congress? A
Pictorial Representation of Why
Americans Deserve Better School
Buildings, challenges Congress to
focus its attention on the dire need
for school construction and

The booklet contains photographs
of the former high school buildings
of various members of the House
Ways and Means and Senate
Finance Committees. It includes
photographs, statistics, and facts
about each  school and other
education facilities in each
member's respective state and
encourages members of Congress
to take immediate action to provide
a quality learning environment for
our nation's children.

The AIA believes the United States
must upgrade and modernize its
education facilities to equip
America's students with the
necessary resources to meet the
global challenges of the 21st

The U.S. General Accounting
Office reports that one-third of the
country's public schools, which
house more than 15 million
children, are in need of "extensive
repair or replacement." The
average public school is 42 years
old, and with record  enrollments of
53.2 million children this year,
enrollment is expected to continue
to climb.
Several legislative
proposals, including,
H.R. 1660, Public
School Modernization
Act of 1999,
introduced by Rep.
Charles Rangel (D-
N.Y.); H.R. 1760,
America's Better
Classrooms Act of
1999, introduced by
Rep. Nancy Johnson (R-Conn.);
and S. 1454, Public School
Modernization and Overcrowding
Relief Act of 1999, introduced by
Sen. Charles Robb (D-Va.), would
boost the incentive for school
construction  by providing tax
credits, generating an estimated
$25 billion in  school construction

These bills can be viewed by
searching the Thomas Legislative
Information web site from the
Library of Congress.  The web site
is http://thomas.loc.gov/. A copy of
the booklet can be viewed on the
AIA web site  at:
   Our Web Site Has
       A New Look

If you have visited the IAQ Tools
for Schools web site lately, you
may have noticed that we have a
new look. The site has been
redesigned and the information
and content substantially in-

In addition to updating and revising
some of the existing information on
the site, we have added informa-
tion on the IAQ Tools for Schools
Incentives Program and an outline
of the Tools for New Schools
initiative. A What's New Page
features this Bulletin, and previous
copies of the IAQ Tools for Schools
Bulletin, in PDF format. We will
soon have the recently published
IAQ Tools for Schools: Actions to
Improve Indoor Air Quality on the
site in PDF and HTML formats, so
visit frequently.

We encourage you to take a look
at the revised site and provide us
with comments.  Please send any
comments or suggestions directly
to the webmaster at:
                                                                                       Page 9

Asthma is a growing problem in our
nation's schools. Many asthma
episodes are associated with
environmental triggers caused by
poor indoor air quality. The following
articles are meant to help parents
and teachers become more aware
of the problems associated with
asthma in schools.
   Does Your Child's
   Trigger  Allergies?

     Submited by Colleen Horn
  Asthma and Allergy Foundation of

You can work hard to minimize the
allergens to which your child is
exposed at home, but you have
much less control over his/her
school setting. Still, if your child is
experiencing allergic reactions at
school, you should visit the school
and classroom, look for potential
problems and ask the principal and
teachers to cooperate by making
the educational environment as
allergen-free and irritant-free as
possible. As you review the list
below, place a check mark beside
those steps that may be appropri-
ate at your child's school.

•  Remove pets (for example,
   guinea pigs, gerbils, mice) from
   the classroom.
•  Avoid keeping piles of newspa-
   pers in the classroom since they
   may attract mold.
•  Check books and bookshelves
   frequently for mold growth, and
   to prevent dust accumulation.
•  Keep room closets free of dust-
   accumulating items, old clothes
   and moisture sources.
  Avoid conducting physical
  education or other activities in
  open areas or fields during high
  pollen and mold count days.
  Remove plants from classroom.
  Provide pillows with allergen-
  proof casings for preschoolers
  who take naps at school.
  Provide adequate fresh air
  through ventilation in the class-
  room; ask that trees, shrubs and
  flowers be trimmed back from
  classroom windows.
  If food allergies are present,
  educate staff and children. Have
  an emergency plan and make
  sure it is understood by every-
  one. Keep a supply of allergy-
  free treats at school for unex-
  pected celebrations.
  Prohibit smoking on school
  premises (indoors and out-
  Vacuuming and cleaning with
  chemical solutions should be
  done after school hours.
  Areas where chemicals are used
  should be aired out.
  Check that the school is well-
  ventilated and that these ventila-
  tion systems and filters are
  cleaned or replaced
Managing Asthma in

The teachers and other staff at
your child's school need to know
how to handle both everyday
situations and emergencies related
to your child's asthma. Share with
them the following information,
provided by the Asthma and
Allergy Foundation of America.
     What To Look For:

  Anxious look
  Stooped body posture
  Rapid respirations (greater than
  25-30 per minute at rest)
  Painful breathing
  Retractions (a concave appear-
  ance of the chest as the child
  struggles to breathe)
  Nasal flaring
  Decreased peak flow value (if a
  peak flow meter is used at
  school to monitor your child's
  hat's the Relationship between Schools and Asthma?
   .use an estimated 5 rnjHjpn children under 18 years of Age have
   _ima, ancTit is the leading cause of absenteeism due to a chronic
   Tdition, asthma is a serious public heaM IssueTn schools. Children
 spend up to eight hours a day in the school building; thus a healthy
   aor environment is crucial in the management of asthma. By
Implementing the \AQ Tools for Schools Kit, schools can improve
     r air quality for all students, and most especially for those with
                    eir exposure to pollutants that may trigger
Page 10

    What To Listen For:

   Complaints of chest tightness
   Persistent coughing
   Irregular breathing
   Abnormal sounds (decreased or
   absent breathing sounds;
   wheezing; rattling sounds while
   Prolonged expiration
    What To Do For An
 Asthma Crisis At School:

• Review the student's current
  medication and emergency
  medications and asthma
  management plan.
• Have the student sit upright and
  check his breathing with a peak
  flow meter if possible.
• Administer prescribed medica-
  tion by inhaler. (Medication
  should be inhaled slowly and
• Administer medication by
  nebulizer if prescribed.
• Reassure the student and
  attempt to keep him/her calm
  and breathing slowly and
• Student should respond to
  treatment within 15-20 minutes.
• Recheck with a peak flow
• If there is no change, or if the
  student's breathing becomes
  worse, contact the parent
  immediately and call for emer-
  gency help.

 Seek Medical Emergency
  Care If The Student Has
  Any Of The Following:

• Coughs constantly
• Is unable to speak in complete
  sentences without taking a
         •  Has lips, nails and mucous
            membranes that are gray or
         •  Demonstrates severe retrac-
            tions and/or nasal flaring
         •  Is vomiting persistently
         •  Has 50 percent reduced peak
            flow reading
         •  Has a pulse greater that 120
            per minute
         •  Has respirations greater than 30
            per minute
         •  Is severely restless
         •  Shows no improvement after
            15-20 minutes

           Can Children With
          Asthma Participate
              in  Gym  Class?

         Children with asthma can and
         should participate in a full range of
         activities at school, including gym.
         By following these simple points,
         you can help ensure your child's

         •  Be sure your child is under a
            doctor's care.
         •  Help your child to understand
            his/her asthma plan and take
            their medicines as prescribed.
         •  Make sure the gym teacher
            understands that your child has
            asthma and how he/she can be
            part of your child's asthma
            management plan.
         •  Be sure your child uses his/her
            inhaler right before gym class
            (and after if needed) to prevent
            exercise-induced asthma (EIA),
            especially if the class is held
            outside during cold weather or
            pollen season.
         •  Help your child feel comfortable
            telling the gym teacher if
            breathing becomes rapid and
            difficult. Understanding that the
            child needs to use an inhaler at
            this time is important.
•  Make sure your child under-
   stands that he/she must tell an
   adult whenever their medication
   is not working.

With a proper treatment plan,
children with asthma should be
able to fully participate in gym
class and team sports. Contact
school personnel, teachers and
coaches to let them know about
your child's asthma management
plan. Ask your doctor to complete
a Student Asthma Action Card,
available free through the Asthma
and Allergy Foundation of
America, to help share your child's
asthma management plan with the
school. Together you can create a
winning combination for health.

For more information, contact
Colleen Horn at the Asthma and
Allergy Foundation of America
(202) 466-7643. Or visit their web
site at: www.aafa.org/
                                                                                     Page 11

ew  wt
                                      tf h  fAQToofs
 EPA Publishes Two
    New  Brochures

IAQ Tools for Schools: Actions
to Improve Indoor Air Quality

EPA's Indoor Environments
Division recently designed and
released a colorful new brochure to
promote IAQ Tools for Schools.
The brochure was designed to
promote the Kit to K-12 schools
and other interested stakeholders.

The promotional brochure provides
information on IAQ Tools for
Schools including unique insert
cards with guidance and action
items for facility managers, teach-
ers, administrators, and health
officers. The brochure offers tips
on community sponsorship of IAQ
programs in schools and includes a
postcard to order the Kit.

The text includes quotations from
enthusiastic Kit users and nation-
ally recognized education leaders.
National Education Association
President Bob Chase states, "NEA
members and the children they
serve are already benefitting
hugely from the Indoor Air Quality
Tools for Schools Kit. In support
of the Kit, delegates at NEA's July
1999 national convention voted to
urge all of our state and local
affiliates to implement the program
in every school."

The brochure measures 9" x 11"
when folded, but actually opens to
a poster-sized 20" x 24", illustrating
key indoor air quality concepts that
the IAQ Coordinator can post on a
door or bulletin board for reference.
The key concepts are:
    "All schools should implement the IAQ Tools for Schools Kit. It's
    great to have so many people involved in the health and safety of
           Jim Stefanik, Director of Facilities, Chicopee County Schools, Chicopee, MA
    • Why IAQ is important in schools
    • What actions school personnel
      can take to improve the IAQ in
      their schools
    • Who should use the IAQ Tools
      for Schools checklists.

    To order a copy of the brochure,
    call the IAQ Clearinghouse at
    (800) 438-4318 or FAX (703) 356-
    Managing Asthma
    in the School Environment

    Another brochure is being pub-
    lished as a companion piece to the
    IAQ Tools for Schools Kit. The
    purpose of the publication is to
    better link indoor air quality to
IAQ Tools for Schools: Managing
Asthma in the School Environment
is a full-color, 18-page booklet that
focuses on steps that schools can
take to help students and staff
breathe easier. The brochure is
designed to provide:

• General asthma information
• Information on indoor environ-
   mental asthma triggers found in
• Suggested action items from
   IAQ Tools for Schools to help
   reduce or eliminate these
   asthma triggers in the school

The publication also includes an
Asthma Action Card designed by
the Asthma and Allergy Founda-
tion of America. The card is
designed for the families of
students with asthma to complete
and return to the school nurse or
other school official.

Students with asthma are encour-
aged to identify their asthma
triggers on the card, and include
medical and emergency contact
information. A parent or caregiver
and a physician should also sign
the card.

The booklet will be available this
spring. Check EPA's web site for
more information.
Page 12

                                            f/VOToofs -f
      IAQ TooJs for
  National Symposium

EPA is sponsoring a National
Indoor Air Quality Tools for
Schools Symposium to be held
August 3rd - 5th, 2000 in Baltimore,
Maryland at the Renaissance
Baltimore Harbor Place Hotel. Two
to three hundred attendees are
expected to participate in this event
and will include stakeholders from
major school based not-for-profit
organizations, health-based
organizations, and state, county,
and city officials.

This Symposium will highlight
sure-fire ways to adopt EPA's
                             Indoor Air Quality Tools for
                             Schools Program in a school/
                             school district.

                             The Symposium will host concur-
                             rent break-out sessions that will
                             focus on the specific challenges
                             school/school districts face every
                             day while trying to implement a
                             strategic indoor air quality man-
                             agement plan in their schools.
                             The sessions will offer recommen-
                             dations and provide a forum for
                             school personnel to network with
                             their peers and share successes.

                             EPA will also launch the IAQ Tools
                             for Schools Incentives Program
                             which includes a mentoring
                             program, and will present national
                             awards to schools in recognition of
environmental leadership in the
indoor air quality arena.

For more information about the
Symposium, contact the national
office of the American Association
of School Administrations, National
Education Association, National
Association of School Nurses,
American Lung Association,
International City/County Manage-
ment Association, National Asso-
ciation of County/City Health
Officials, or the National Associa-
tion of Counties.

                           ^                               ,         . .
                        ools for Schools Training Btodules Are Here!
                 S*^ip~!^Wj₯' •*>$» * i^*""!  ?    j                       <      V*-            »     ^    *   *   3.
                 3d the MQ Tools for Schools Training Modules to assist with training people to use the
   •fCf foolsjjor ^^oofe'Mt^ThejTipdules are now available on CD-ROM.  In fact, there are three modules;
      i one Sesignerfto meTtlSe'needs'of diverse audiences using the Kit
      ^^^Ig,  ,.,  .^t^^,  „                           /            ,              •      ,  *
                         _^   for decision makers and general audiences. For example, it might be
        __       arclsland Administrators who may decide to Implement IAQ Tools for Schools in
      nd districts." """7""*™""
 ,-,^^^^J?'^^::^i\r\  "'  .v    '-'  "          -                -  '•'-'-'   '-*1
jjule/j is designed to raise audience*awareness about the importance of indoor air quality and motivate
          sgtrQ|i.m)t»is ii^^fTo.u.r, presentation.

  filel2 is designed fotrain IAQ Coordinators. It provides more in-depth technical knowledge and skills*
 djifSTmplement an fAQ program in a school or school district It is a day-long presentation.
 t^^^gfKS^gi.j.^^.f^fyliirinjyn, ^_                                        *    5» ~      -.   ,

     5ajy|PA's rlationy*Service Center for Environmental Publications at (800) 490-9198 or visit their
     5 atw^^egl^ovTncepihom/ to order a copy. Requests for mulitple copies wiHbe considered on a
     '-case basis.     """""
       ^rg.also PDF versions of each of the modules posted on EPA's website at www.epa.gov/faq/schools.

                 rfflftjoil about the Training Modules, contact John Gueyin at (202) 564-9055 or
    |wn John @ epa.gov*.
    • - ~                 *fe
                                                                                     Page 13

                        Regional Contact Information
The following Is a list of EPA indoor air quality contacts.
Mary Beth Smuts
Eugene Benoit
US EPA/Region 1
1 Congress Street Suite 1100
Boston, MA 02114-2023

Larainne Koehler
Matthew Hiester, Rachel Chaput,
 Jean Feola
US EPA/Region 2
290 Broadway 28th Floor
New York, NY 10007-1866

Christina Schulingkamp
Fran Dougherty
US EPA/Region 3
1650 Arch Street
Philadelphia, PA 19103-2029

Henry Slack
Marion Hopkins, Linda Thomas,
Cindy Gibson
US EPA/Region 4
61 Forsyth Street, SW
Atlanta, GA 30303-3104

Sheila Batka
Helen Tsiapas, Daniel O'Riordan,
Darice Ellis
US EPA/Region 5 (AE-17J)
77 West Jackson Boulevard
Chicago, IL 60604

Michael Miller
Traci Fambrough, Paul Scoggins
US EPA/Region 6 (6PD-T)
1445 Ross Avenue
Dallas, TX 75202-2733
Michael Marshall
Vickie Pastorino
901 North 5th Street
Kansas City, KS 66101

Megan Williams
US EPA/Region 8 (8P-AR)
999 18th St. Suite 500
Denver, CO 80202-2466
Barbara Spark
Shelly Rosenblum, Louise Hill
US EPA/Region 9 (Air-6)
75 Hawthorn Street
San Francisco, CA94105

Brook Madrone
US EPA/Region 10 (OAQ-107)
1200 Sixth Avenue, 10th Floor
Seattle, WA 98101
     • Regional
     "go to;. .www,£ga;|^^
Page 14

                  Thank You  For
              Your Contributions!

Thanks to everyone who has contributed articles for this and the
previous edition of the IAQ Tools for Schools Bulletin. Please
keep them coming!

Our main concern is protecting children's health and the environ-
ment from harmful indoor air pollutants. EPA works cooperatively
with people who share our concern about health and environmental
issues pertaining to indoor air quality.

In future editions of the IAQ Tools for Schools Bulletin, we would
like to share some of your perspectives on issues, successes,
and challenges you  have experienced.  Whether you use the
guidance in EPA's Kit, or another indoor air quality management
plan, we would like to hear from you.
While supplies last, school districts, schools, EPA Partners and
their affiliates may receive a free copy of the Indoor Air Quality
Tools for Schools Kit by sending a request on official school
letterhead to:
       EPA Kit
       PO Box 37133
       Washington, D.C. 20013-7133

       Or, by FAXing the request to:

       (703) 356-5386

The entire text of the Kit can be downloaded for free from EPA's
web site at: www.epa.gov/iaq/schools. Other information on
indoor air quality is also available from EPA's web site, through
your EPA Regional office, or by calling EPA's Indoor Air Quality
Clearing House at: (800) 438-4318.
                                                                                    Page 15

          P.O. BOX 42419
      CINCINNATI, OHIO 45242