5EPA
United States
Environmental Protection
Agency
ASTHMA
A PUBLICATION
OF THE OFFICE
OF RADIATION AND
INDOOR AIR
Welcome to the first issue of the Asthma Newsletter!
This newsletter—one of many new EPA publications aimed at increasing the national awareness of asthma—will provide
you with information on issues such as current and upcoming grants, partnerships and events related to the EPA asthma
initiative.
According to the U.S. Department of Health and Human Services, the incidence of asthma among school-age children
increased by an alarming 160 percent between 1980 and 1994. Studies have also recognized the disproportionate effect that
asthma has on children, especially those living in urban, low-income communities. In response, federal agencies formed an
interagency Task Force on Environmental Health and Safety Risks to Children. In 1998, this task force identified childhood
asthma as a priority area in need of immediate attention, including identification, assessment, and prevention of asthma
triggers.
As part of this effort, EPA launched numerous initiatives and developed programs to address indoor environmental triggers
and management of asthma. These initiatives include special events, media outreach, public education, grant, communica-
tions, and research programs.
World Asthma Day 2002
Asthma organizations, health agencies and state and
federal governments sponsored a variety of asthma-
related community outreach and educational activi-
ties throughout May in recognition of Asthma
Awareness Month. On World Asthma Day, May 7,
2002, EPA sponsored an event at George Mason
Elementary School in Alexandria, Virginia, to
educate children about asthma. At the event, EPA
honored Kim Gosselin, for authoring several
children's books on asthma including Taking Asthma
to School; WGBH Boston, for producing the
"Buster's Breathless" episode of the popular PBS
children's show, ARTHUR; and Robin Wallin, School
Nurse at George Mason Elementary School, for her
efforts to educate children on asthma triggers and
management. In addition, EPA generated over 200
state and local asthma events. Visit the web site at
www.epa.gov/iaq/asthma/wad2002.html for a recap
of the day's events. World Asthma Day 2003 is
May 6. To obtain an event planning kit to assist you
in planning World Asthma Day 2003 activities, visit
EPA's web site at www.epa.gov/asthma. For more
information on World Asthma Day, contact U.S.
EPA's Brenda Doroski at 202-564-9764.
EPA GOLDFISH Media Campaign:
A Huge Success
The Goldfish national media campaign produced by the EPA and the
Ad Council ranked in the top ten for donated media value in 2001,
according to a recent analysis by Media Marketplace. After one year
of circulation, the campaign received the value of some $72 million
in donations from television, radio, print and billboard media. Based
on a child's description of an asthma attack, the campaign was
launched with the message "I feel like a fish with no water" and the
image of a grounded goldfish as the icon. The campaign was pro-
duced in both English and Spanish which included Web banners and
alternative media like closed circuit programming. The campaign
was presented the Grain Award in honor of its outstanding success in
raising national awareness for children's asthma.
In This Issue:
EPA and the American Association of Health Plans (AAHP) Educate
Health Plans on Environmental Triggers
The Bureau of Primary Health Care (BPHC) and EPA Continue
Asthma Collaborative to Improve Clinical Care for Patients
The University of Michigan School of Public Health (UMSPH) Project
Will Evaluate Best Practices for Asthma Intervention
Feature Article: EPA Grants Support Fight Against Children's
Asthma
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ASTHMA BULLETIN
A web site, www.noattacks.org, and toll-free hotline,
1-866-NO-ATTACKS, are provided for the campaign to offer
technical support, advice to callers and address community
concerns of childhood asthma. Over 350,000 web site hits and
over 12,000 hotline calls have been generated by the campaign.
The next wave of the Goldfish campaign is expected to be
released in Spring 2003. For more information, contact U.S.
EPAs Kristy Miller at 202-564-9441.
2002 Symposium on Asthma and
the Environment
The 2002 Community Asthma Coalition Symposium,
entitled "Asthma and the Environment," was held during the
American College of Chest Physicians (ACCP)'s annual
meeting on November 6-7, 2002, in San Diego, CA. This
event was sponsored by ACCP and the National Asthma
Education and Prevention Program (NAEPP), with support
from EPA and the California Endowment Fund. Sessions
highlighted the importance of asthma management by
patients and families, and focused on identifying and eliminat-
ing allergens and asthma triggers from indoor and outdoor
environments. Attendees, including health professionals and
school personnel, shared experiences in managing asthma from
one community to another, discussed current trends, and
identified best practices for managing asthma by reducing
exposure to environmental triggers. In addition, the Sympo-
sium equipped attendees to better serve as local leaders in
asthma management through organized coalitions and
educational campaigns. For more information about the
Symposium, contact U.S. EPAs Kim Smith at 202-564-9443.
EPA and AAHP Educate Health
Plans on Environmental Triggers
In support of their Taking on Asthma Initiative, the American
Association of Health Plans (AAHP) was recently awarded
funding support from EPA. Through this initiative, a joint
effort with the American Association of Asthma, Allergy, and
Immunology (AAAAI), AAHP seeks to educate its members—
representatives from over 1,000 managed health plans—on the
importance of implementing a standard of care for asthma
management in clinics and ways to encourage environmental
management of asthma and indoor asthma triggers to reduce
health risks posed by poor indoor air. EPA funding will help
AAHP to develop products (including a best practices manual)
and offer services (including a grant program to provide seed
money for health plans to execute innovative patient educa-
tion programs). In addition, they will develop Web-based
training modules for health plan providers and case managers
to enhance chronic disease management programs in managed
care organizations, ultimately improving the quality, effective-
ness and value of clinical health care. For more information,
contact U.S. EPAs Katrin Krai at 202-564-9454.
BPHC and EPA Continue Asthma
Collaborative to Improve Clinical
Care for Patients
In March 2000, the Department of Health and Human
Services, Bureau of Primary Health Care (BPHC) and the
Environmental Protection Agency (EPA) joined together to
work on Action Against Asthma. This three-phased program is
integrating environmental asthma management into core
clinical asthma programs of community health centers.
Through this effort, EPA and BPHC provide funding,
technical assistance, and infrastructure support to participating
community health centers; track and report patient outcomes;
develop a network of health directors to provide technical
assistance to centers through onsite visits, conference calls and
a list-serv. BPHC's network of clinics serve more than 40
million children and families who are medically underserved.
More than 5,000 patients learned techniques to manage
environmental asthma triggers during the first two phases of
the program. Participating health centers successfully estab-
lished infrastructure support at national, state, local and
community levels to educate patients as well as other commu-
nity health centers. To evaluate the programs success, indica-
tors such as asthma severity, the number of symptom-free
days, the number of patients implementing environmental
management of asthma, and the number of school days missed
due to asthma episodes are measured. For more information,
contact U.S. EPAs Sheila Brown at 202-564-9439.
UMSPH Project Will Evaluate Best
Practices for Asthma Intervention
EPA recently funded The University of Michigan School of
Public Healths (UMSPH) Asthma Research Collaborative to
evaluate the results of asthma management programs and
identify best practices. Through this asthma health outcomes
project, UMSPH will convene an expert panel and establish
criteria for evaluating comprehensive federal, state, commu-
nity and local asthma intervention programs through an
Asthma Health Outcomes Project. Utilizing the University's
internal and community network of asthma researchers and
experts in the field of public health, pediatrics, internal
medicine, and pharmacy, the panel will evaluate programs in
terms of health outcomes and self management of asthma to
document best practices and program implementation
guidelines. In addition, program coordinators for EPAs
Children's Asthma Initiative will leverage the best practices
and guidelines to design and implementation of effective
asthma management programs of the federal and state levels.
For more information on the UMSPH Asthma Health
Outcomes Project, contact U.S. EPAs Tracey Mitchell at 202-
564-9446 or Alisa Smith at 202-564-9372.
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ASTHMA BULLETIN
EPA Grants Support Fight Against Children's Asthma
The U.S. Environmental Protection
Agency awarded In-Home Asthma
Environmental Education and Manage-
ment Grants this year to the Toledo
Children's Hospital in Ohio and the Mt.
Sinai School of Medicine in New York
City to help in the fight against childhood
asthma. These two programs complement
the efforts of the Children's Hospital of
Philadelphia, which in 2000 won an EPA
grant to expand its in-home visit and
intervention project. Taken together, the
three pilot projects provide models for the
types of local, innovative, community-
based health initiatives needed to tackle
childhood asthma head on.
These pilot projects will raise awareness
and reduce the impact of environmental
triggers on children with asthma. They
also strengthen the capacity of families to
eliminate or control asthma triggers in
the home, such as secondhand smoke,
dust mites, cockroaches, mold, and pet
dander. The ultimate goal is to enable
every child with asthma to lead a healthy
and active life with fewer emergency
room visits, asthma symptom days, and
days lost from school.
Mount Sinai School of
Medicine Addresses
Environmental Asthma Triggers
EPA's grant to the school's Healthy
Homes, Healthy Families Project serves to
ensure that asthma is managed compre-
hensively using both clinical care and
patient education approaches. In
collaboration with the East Harlem
Asthma Workgroup, the medical school
will coordinate the Healthy Homes,
Healthy Families Project to provide home
and group intervention to families living
in the culturally diverse, inner city
communities in East Harlem, NY, where
asthma rates are extremely high.
The grant will allow Mount Sinai to
provide environmental asthma educa-
tion, management and follow-up in
groups as well as one on one mediation
and education for 40 families. The
Healthy Homes project will demonstrate
the benefit of in-home asthma education
and management as a means of reducing
the frequency and intensity of asthma
attacks and the medical costs of hospital
visits. For more information, contact
U.S. EPA's Sheila Brown at 202-564-
9439.
Toledo Children's Hospital
Initiates In-Home Asthma
Education
EPA's grant supports asthma education
initiatives including the hospital's
Pediatric Pulmonary Center and asthma
intervention model. The Center serves
23 counties in northwest Ohio and
southeast Michigan, and receives more
than 2,540 visits each year from children
living with asthma—the second leading
cause for all admissions to the hospital.
This grant will help program directors to
expand the existing intervention model
to include a home environmental asthma
education initiative in which eighty
children and their families will partici-
pate. Home assessments will include
education sessions to help families
identify and reduce common asthma
triggers found in the home environ-
ment—secondhand smoke, cockroaches,
dust mites, mold, pet dander, more—
and ultimately improve family manage-
ment of children's asthma, reducing
emergency room visits, hospitalizations,
asthma attacks and the need for rescue
medication. For more information,
contact U.S. EPA's Tracey Mitchell at
202-564-9446.
Children's Hospital of
Philadelphia Expands Home
Visitor Program
In 2000, EPA provided a grant to the
hospital's Community Asthma Prevention
Program (CAPP) to expand the hospital's
home visit and intervention project for
children's asthma management. CAPP
provides community-based education,
training, and environmental intervention,
primarily in poor, urban communities.
Working with EPA, CAPP expanded their
innovative, randomized and controlled
study program that evaluates environmen-
tal triggers of asthma and methods of
mitigation in the home.
Eligible families received educational
materials, in-home visits, follow up
referrals, and general advice to clarify the
urgency of identifying and removing
environmental triggers to reduce the risk
of asthma attacks. CAPP purchased
materials, such as roach and mice bait,
dusters, mattress pads, etc., for families
participating in the study to help them
eliminate environmental triggers in their
homes. Though families were responsible
for implementing cleaning practices and
some infrastructure upgrades (e.g.,
replacing carpets with floor tiles), CAPP
provided the majority of the necessary
funding, materials and training to help
families make healthy changes to their
lifestyles and in-home environments.
Preliminary results indicate that families
have experienced a decline in emergency
room visits and hospitalizations. For more
information, contact U.S. EPA's Sheila
Brown at 202-564-9439.
For Further Information
For more information about EPA's
Asthma Education and Outreach Pro-
gram, visit EPA's web site at www.epa.gov/
asthma.
We hope you have found the first edition of the Asthma Bulletin informative and useful. We want to hear from you! If you
have ideas, projects, or events that you would like to highlight, please submit them to asthmabulletin@cadmusgroup.com.
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