&EPA
United States
Environmental Protection
Agency
Indoor Environments
Division (6609J)
Office of Air and Radiation
EPA 402-K-00-003
April 2000
Managing Asthma in the
School Environment
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10 Ways to Manage Asthma in the School Environment
1. Use the IAQ Tools for Schools Kit 7.
• Help people with asthma by
improving the school environment
with IAQ practices recommended
in this kit.
Z» Control Animal Allergens
• Remove classroom animals from
the school, if possible.
5.
• If not, locate animals away from
sensitive students and ventilation
systems.
Control Cockroach Allergens
• Use Integrated Pest Management
practices to prevent cockroach
and other pest problems (e.g.,
store food in tightly sealed con-
tainers and place dumpsters
away from the building).
8.
Develop an Asthma Management Plan in
Your School
• Include school policies on
inhaler and other medication
usage, and emergency proce-
dures for school staff for use
when a student has an asthma
attack.
• Obtain the National Asthma
Education and Prevention
Program's Managing Asthma: A
Guide for Schools.
Provide School-Based Asthma
Education Programs
• Contact your local American
Lung Association about Open
Airways For Schools, a school-
based asthma management pro-
gram for students with asthma.
4. Clean Up Mold and Control Moisture 9* File Student Asthma Action Catds
• Fix moisture problems and thor-
oughly dry wet areas within 24-48
hours to prevent mold growth.
• Clean up hard, moldy surfaces
with water and detergent, then
dry thoroughly.
Eliminate Secondhand Smoke Exposure
• Enforce no-smoking policies in
the school.
O» Reduce Dust Mite Exp(
osure
l Make sure the school is dusted
and vacuumed thoroughly
and regularly.
• Make sure students with asthma
obtain and turn in copies of their
Asthma and Allergy Foundation
of America action cards to
teachers, school nurse, etc.
• Encourage students to find out
and identify their asthma triggers.
1U» Gather Additional Asthma Information
and Resources
• Establish a complete file on
existing asthma and allergy-
related information sources
to reference throughout the
school year.
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The Asthma Epidemic
Asthma has reached epidemic propor-
tions in the United States affecting
about 20 million people of all ages and
races, particularly children. Nearly one
in 13 school-aged children has asthma,
and the percentage of children with
asthma is rising more rapidly in
preschool-aged children than in any
other age group. Asthma is the leading
cause of school absenteeism due to a
chronic illness, accounting for over 14
million missed school days per year.
Asthma also accounts for many nights
of interrupted sleep, limitation of activity,
and disruption of family and care-giver
routines. Asthma symptoms which are
not severe enough to require a visit to
an emergency room or to a physician
can still be serious enough to prevent a
child with asthma from living a fully
active life.
Asthma is a long-term, inflammatory
disease in which the airways of the lung
tighten and constrict causing wheezing,
breathlessness, chest tightness, and
coughing. These symptoms can be at
least partially reversed, either sponta-
neously or with treatment. The
inflammation also causes the airways of
the lung to become especially sensitive
to a variety of asthma triggers. In addi-
tion, the particular trigger or triggers and
the severity of symptoms can differ for
each person with asthma.
Since Americans spend up to 90% of
their time indoors, exposure to indoor
allergens and irritants may play a signifi-
cant role in triggering asthma episodes.
Some of the most common asthma
triggers found indoors include:
• animal dander
• cockroaches
• mold
• secondhand smoke
• dust mites
Other asthma triggers include: respira-
tory infections, pollens (trees, grasses,
weeds), outdoor air pollution, food aller-
" ^v ]l I
Hto
I
-------
Asthma in Schools
gies, exercise, and cold air exposure.
Each day, one in five Americans occu-
pies a school building and the majority
of these occupants are children.
Environmental asthma triggers com-
monly found in school buildings are
cockroaches and other pests, mold
resulting from excess moisture in the
building, and dander from animals in
the classroom. Secondhand smoke
and dust mites are other known envi-
ronmental asthma triggers found in
schools. In addition, some literature
suggests children with asthma may be
affected by other pollutants found in
schools from such sources as unvented
stoves or heaters and common prod-
ucts such as cleaning agents,
perfumes, and sprays.
Effectively managing a child's asthma
can best be accomplished through a
comprehensive plan that addresses
both the medical management of the
disease and avoidance of environmen-
tal triggers. Since children spend most
of their time in schools, day care facili-
ties, or at home, it is important to
reduce their exposure to environmental
asthma triggers as much as possible in
each of these environments. This pub-
lication focuses on steps that schools
can take to help children breathe easier.
-------
Use the Indoor Air Quality
Tools for Schools Action Kit
Many indoor air quality problems in
schools can impact the health of stu-
dents and staff, including those with
asthma. Some of the indoor air quality
problems include: chemical pollutants
from building or building maintenance
materials; chemical pollutants from
science and art classes; improperly
maintained ventilation systems; and
allergens from classroom animals and
cockroaches or pests. Mold growth
may result from standing water in main-
tenance rooms and near piping, or from
excess moisture in ceiling tiles, carpets,
and other furnishings. Also, outdoor air
pollutants and pollens may enter the
school through ventilation systems
and/or open doors and windows.
In order to help improve indoor air
quality problems in school buildings, the
Environmental Protection Agency (EPA)
developed the Indoor Air Quality (IAQ)
Tools for Schools Action Kit. This kit
helps school personnel identify, solve,
and prevent indoor air quality problems
in the school environment. Through the
use of a 19-step management plan and
checklists for the entire building,
schools can also lower their students'
and staff's risk of exposure to asthma
triggers. The checklists cover the build-
ing's ventilation system, maintenance
procedures, classrooms (especially ani-
mals and mold), and food service areas.
Included in the kit is a Coordinator's
Guide, which explains the fundamentals
of indoor air quality in schools and pro-
cedures for improving the air inside the
schools. The kit also contains check-
lists, a background informational piece
for staff, a problem-solving wheel to
identify potential indoor air quality caus-
es and solutions, a guide for health
professionals, and a 30-minute, two-
part video covering the ventilation
checklist and a school's implementation
of IAQ Tools for Schools.
To use the IAQ Tools for Schools Kit,
most schools form an IAQ coordinating
team which implements the kit during
the school year. Because IAQ problems
can originate anywhere in the school
building, usually the entire staff is
informed and brought into the process
of improving the indoor air. In addition,
IAQ Tools for Schools
-------
students can be involved in the process.
Information about available curricula on
indoor air quality can be found on EPA's
web site (www.epa.gov/iaq/schools).
School districts across the United
States have adopted IAQ Tools for
Schools, thus improving the air quality in
all of the districts' buildings. The IAQ
Tools for Schools Kit can be used alone
or in conjunction with the American
Lung Association's Open Airways For
Schools asthma curriculum for eight to
11 -year old children (see information
included in this publication on Asthma
Management and Education).
EPA has developed additional tools
and programs to help schools and
school districts implement the IAQ
Tools for Schools Kit. This
includes a step-by-step guide to
successfully implementing the
IAQ Tools for Schools Kit. This
quick-start guide will help you
gain a valuable understanding
of the IAQ Tools for Schools
program and provide you
with a brief review of the kit,
helpful implementation
ideas, and case studies of
several schools that have
successfully implemented
the kit.
Schools (or school districts) and
non-profit groups may receive a
copy of the IAQ Tools for Schools Kit
at no cost simply by faxing a request on
school or company letterhead to IAQ
INFO at 703-356-5386. For more infor-
mation, please call IAQ INFO at
1 -800-438-4318. The entire IAQ Tools
for Schools Kit can be downloaded from
EPA's website (www.epa.gov/iaq/schools).
IAQ Tools for Schools
-------
Classes may commonly adopt animals
as a classroom pet or science project.
School staff may not realize that any
warm-blooded animals including gerbils,
birds, cats, dogs, mice, and rats may
trigger asthma. Proteins which act as
allergens in the dander, urine, or saliva
of warm-blooded animals may sensitize
individuals and can cause allergic reac-
tions or trigger asthma episodes in
people sensitive to animal allergens.
The most common, obvious source of
animal allergen is having a pet in the
classroom or school. If an animal is pre-
sent in the school, there is a possibility
of direct, daily exposure to the animal's
dander and bodily fluids. It is important
to realize that, even after extensive
cleaning, pet allergen levels may stay in
the indoor environment
for several months after the animal
is removed.
The most effective
method to control-
ling exposure to
animal allergens
in schools is to
keep your school
free of feathered
or furred animals.
However, for some
individuals, isolation
measures may be suffi-
ciently effective. Isolation
measures include: keeping
animals in localized areas; keeping ani-
mals away from upholstered furniture,
carpets, and stuffed toys; and keeping
sensitive individuals away from animals
as much as possible.
For schools with animals, it is important
to make sure that classrooms contain-
ing animals are frequently and
thoroughly cleaned. In addition, animal
allergens can readily migrate to other
areas of the school environment through
the air and on children who handle pets.
Therefore, the entire building should be
cleaned thoroughly.
Schools are sometimes advised to use
air cleaners. Although properly used
and maintained air cleaners may be
effective for reducing animal dander in
small areas, they should only be consid-
ered as an addition to other control
methods. It is also important to careful-
ly review information on the type of air
cleaner used to make sure it is
suitably sized and has
high particle removal
efficiency. In addition,
some air-cleaning
devices marketed
as air purifiers
emit ozone,
which may be
harmful to people
with asthma.
-------
Remove animals from the school, if
possible.
If completely removing animals from the
school is not possible, then:
Keep animals in cages or localized
areas as much as possible; do not let
them roam.
Clean cages regularly. Consider using
disposable gloves when cleaning.
Locate animals away from ventilation
system vents to avoid circulating aller-
gens throughout the room or building.
Locate sensitive students as far away
from animals and habitats as possible.
Keep animals away from upholstered
furniture, carpets, and stuffed toys.
These action items are included on the IAQ
Tools for Schools Teachers Checklist.
Cockroach allergens may play a signifi-
cant role in asthma throughout
inner-city, suburban, and rural schools.
Certain proteins which act as allergens
in the waste products and saliva of
cockroaches can cause allergic reac-
tions or trigger asthma symptoms in
some individuals.
Pest allergens are a significant cause of
occupational asthma symptoms among
laboratory workers, such as scientists
who work with animals in scientific
investigations. These allergens may
also contribute to allergies and asthma
in the general population.
Cockroaches and other pests, such as
rats and mice, are often found in the
school setting. Allergens from these
pests may be significant asthma triggers
for students and staff in schools. Pest
problems in schools may be caused or
worsened by a variety of conditions
-------
such as plumbing leaks, moisture prob-
lems, and improper food handling and
storage practices. In order to manage a
pest problem, water and food sources
need to be controlled in the school envi-
ronment. Therefore, it is important to
avoid exposure to these allergens
through the use of common sense,
Integrated Pest Management (IPM)
practices throughout the entire school.
There are four key IPM methods for
reducing exposure to pests in the school
setting: 1) look for signs of pests; 2) do
not leave food, water, or garbage
exposed; 3) remove pest pathways and
shelters; and 4) use pest control prod-
ucts such as poison baits, traps, and
pesticide sprays, as needed.
Check food preparation, cooking, and stor-
age areas regularly for signs of cockroaches
and pests:
Look for dead cockroaches or pests.
Look for waste products
(e.g., pest droppings).
Look for greasy smears on walls,
which could indicate possible rat runs.
Confirm that appropriate food preparation,
cooking, and storage practices are
implemented:
Review food handling and storage
practices. Containers should be well-
sealed, with no traces of food left on
outside surfaces of containers.
Make sure food is not kept in the
classroom overnight.
Animal food should be kept in sealed
containers.
Maintain general cleanliness:
Sweep and wet mop floors to remove
food.
Clean stoves and ovens after use.
Wipe counters clean with soap and
water or a disinfectant, according to
school policy.
Make sure trash is removed daily.
Fix plumbing leaks and other
moisture problems.
Do not let water stand in air condition-
ing or refrigerator drip pans.
Select waste containers by considering the
kind of waste that is placed in them:
Food waste or contaminated papers
and plastics should be disposed of
properly in secured, covered contain-
ers or tied off plastic bags to
discourage pests.
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Empty waste containers regularly and
frequently, and store them in an
appropriate location:
Follow a regular schedule of emptying
waste containers in order to minimize
odors and deprive pests of their food
sources.
Place dumpsters away from the build-
ing to minimize opportunities for pests
to enter the building.
Eliminate pest entryways, pathways,
and shelters:
Remove clutter (e.g., stacks of papers)
where cockroaches may hide.
Seal small spaces where cockroaches
may live (e.g., near where plumbing or
electrical wiring goes through walls,
and cracks or spaces in walls around
baseboards and window sills.)
Block possible entry points for rodents
and other pests.
Do not rely on widespread, indiscriminate
use of pesticides to control pests:
l Try using poison baits, boric acid, or
traps before using pesticide sprays.
Track cockroach populations by using
small sticky traps or monitoring traps
which contain no pesticide.
Rats and mice should be trapped
rather than baited.
Pesticide sprays should only be used
in classrooms as a last resort.
If pesticide sprays are used in the school:
Consider notifying school staff and
parents well in advance of pesticide
applications.
Schedule pesticide applications for
unoccupied periods so that the affect-
ed area can be well ventilated before
occupants return.
Use pest control chemicals in strict
accordance with regulations and the
instructions on the container.
These action items can be found on the
following checklists in the IAQ Tools for
Schools Action Kit:
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Molds can be found almost anywhere;
they can grow on virtually any sub-
stance, providing moisture is present.
Outdoors, many molds live in the soil
and play a key role in the breakdown of
leaves, wood, and other plant debris.
Without molds we would be struggling
with large amounts of dead plant matter.
Molds produce tiny spores to repro-
duce. Mold spores travel through the
indoor and outdoor air continually.
When mold spores land on a damp spot
indoors, they may begin growing and
digesting whatever they are growing on
in order to survive. There are molds that
can grow on wood, paper, carpet, and
foods. If excessive moisture or water
accumulates indoors, extensive mold
growth may occur, particularly if the
moisture problem remains undiscovered
or unaddressed. There is no practical
way to eliminate all mold and mold
spores in the indoor environment; the
way to control indoor mold growth is to
control moisture. If mold is a problem in
your school, you must clean up the
mold and eliminate sources of moisture.
When mold growth occurs in buildings,
it may be followed by reports of health
symptoms from some building occu-
pants, particularly those with allergies or
respiratory problems. Potential health
effects and symptoms associated with
mold exposures include allergic reac-
tions, asthma, and other respiratory
complaints.
Moisture problems in school buildings
can be caused by a variety of condi-
tions, including roof and plumbing leaks,
condensation, and excess humidity.
Some moisture problems in schools
have been linked to changes in building
construction practices during the past
twenty to thirty years. These changes
have resulted in more tightly sealed
buildings that may not allow moisture to
escape easily. Moisture problems in
schools are also associated with
delayed maintenance or insufficient
maintenance, due to budget and other
constraints. Temporary structures in
schools, such as trailers and portable
classrooms, have frequently been asso-
ciated with moisture and mold
problems.
Reduce Indoor Humidity:
Vent showers and other moisture-
generating sources to the outside.
Control humidity levels and damp-
ness by using air conditioners and
de-humidifiers.
Provide adequate ventilation to main-
tain indoor humidity levels between
30-60%.
Use exhaust fans whenever cooking,
dishwashing, and cleaning in food
service areas.
-------
Inspect the building
for signs of mold, mois-
ture, leaks, or spills:
Check for moldy odors.
Look for water stains or discoloration
on the ceiling, walls, floors, and win-
dow sills.
Look around and under sinks for
standing water, water stains, or mold.
Inspect bathrooms for standing water,
water stains, or mold.
Do not let water stand in air condition-
ing or refrigerator drip pans.
Respond promptly when you see signs of
moisture and/or mold, or when leaks or
spills occur:
Clean and dry any damp or wet build-
ing materials and furnishings within
24-48 hours of occurrence to prevent
mold growth.
Fix the source of the water problem or
leak to prevent mold growth.
Clean mold off hard surfaces with
water and detergent, and dry com-
pletely. Absorbent materials such as
ceiling tiles, that are moldy, may need
to be replaced.
Check the mechanical room and roof
for unsanitary conditions, leaks, or
spills.
Prevent moisture condensation:
Reduce the potential for con-
densation on cold surfaces (i.e.,
windows, piping, exterior walls, roof,
or floors) by adding insulation.
Floor and carpet cleaning:
Remove spots and stains immediately,
using the flooring manufacturer's rec-
ommended techniques. Use care to
prevent excess moisture or cleaning
residue accumulation and ensure that
cleaned areas are dried quickly.
In areas where there is a perpetual
moisture problem, do not install car-
peting (i.e., by drinking fountains, by
classroom sinks, or on concrete
floors with leaks or frequent conden-
sation).
These action items are included on the fol-
lowing checklists found in the IAQ Tools for
Schools Action Kit:
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Secondhand smoke is the smoke from
the burning end of a cigarette, pipe, or
cigar and the smoke breathed out by a
smoker. Secondhand smoke exposure
causes a number of serious health
effects in young children, such as
coughing and wheezing, bronchitis and
pneumonia, ear infections, reduced lung
function, and worsened asthma attacks.
Secondhand smoke is an irritant which
may trigger an asthma episode, and
increasing evidence suggests second-
hand smoke may cause asthma in
children. The Environmental Protection
Agency estimates that between 200,000
and 1,000,000 children with asthma
have their condition made worse by
exposure to secondhand smoke.
Secondhand smoke can also lead to
buildup of fluid in the middle ear, the
most common cause of children being
hospitalized for an operation.
The majority of schools in the United
States prohibit smoking on school
grounds. However, often times smoking
occurs in school bathrooms, lounges,
and on school grounds. This may cause
problems for students and staff who
have asthma.
It is important to enforce smoking bans
on school grounds in order to prevent
exposure from secondhand smoke. If
smoking occurs within the building, sec-
ondhand smoke can travel through the
ventilation system to the entire school.
Also, even when people smoke outside,
secondhand smoke may enter the
school through the ventilation system,
open windows, and doors.
Enforce smoking bans on school
property.
Refer to the IAQ Tools for Schools Health
Officer/School Nurse Checklist.
-------
Dust mite allergens play a significant
role in asthma. These allergens may
cause an allergic reaction or trigger an
asthma episode in sensitive individuals.
In addition, there is evidence that dust
mites cause new cases of asthma in
susceptible children.
Dust mites are too small to be seen but
are found in homes, schools, and other
buildings throughout the United States.
Dust mites live in mattresses, pillows,
carpets, fabric-covered furniture, bed-
covers, clothes, and stuffed toys. Their
food source is dead skin flakes.
Dust mites may be found in schools in
carpeting, upholstered furniture, stuffed
animals or toys, and pillows. Stuffed
animals or toys, as well as pillows for
taking naps, are used mostly in the
primary grades.
Choose washable stuffed toys; wash
them often in hot water.
Cover pillows in dust-proof (allergen-
impermeable), zipped covers.
Remove dust from hard surfaces often
with a damp cloth, and vacuum car-
peting and fabric-covered furniture to
reduce dust buildup. Allergic people
should leave the area being vacu-
umed. Vacuums with high efficiency
filters or central vacuums may be
helpful.
Refer to IAQ Tools for Schools Teachers and
Building Maintenance Checklists.
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Asthma Management and Education
Experts convened by the National
Asthma Education and Prevention
Program (NAEPP) and coordinated by
the National Institutes of Health (NIH)
have reviewed the scientific literature
and produced guidelines which define
the best diagnosis and management
practices for asthma. These NAEPP
guidelines include recommendations for
medical diagnosis and treatment,
including the use of inhalation therapy
and specific recommendations for con-
trolling indoor environmental factors that
contribute to asthma severity.
Develop an Asthma Management
Plan in Your School
Schools can play an important role in
helping students manage their asthma
by providing support through the devel-
opment of an asthma management
plan. Each school should develop an
overall asthma management plan which
includes school policies on the use of
inhalers and medications, actions or
emergency procedures school staff
should take when a student has an
asthma attack, and student asthma
action cards. The student asthma
action card serves as an individual man-
agement plan for each student with
asthma. It provides pertinent informa-
tion to school officials on each student's
asthma condition.
The asthma action card should contain
the student's medical information, iden-
tified asthma triggers, emergency
procedures, and phone numbers. This
action card should be signed by a
physician and parent or care-giver and
kept on file at school. The Asthma and
Allergy Foundation of America's (AAFA)
asthma action card is provided in this
publication. AAFA encourages duplica-
tion and distribution of the asthma
action card in the school setting.
Provide School-Based Asthma
Education Programs
The school setting provides an opportu-
nity for directly educating children,
parents, and care-givers about asthma
management and indoor environmental
triggers. An example of a school-based
asthma education program is the
American Lung Association's (ALA)
Open Airways For Schools. This ele-
mentary school-based program
empowers children and their parents by
teaching them to take control of asthma.
Asthma Management and Education
-------
Through the ALA's Open Airways For
Schools program, children learn that
their asthma can be controlled and what
steps they can take to manage their
condition. Specifically, they learn to
prevent asthma episodes by reducing
their exposure to environmental asthma
triggers and using their asthma "control"
medication correctly. Children also
learn what to do when asthma symp-
toms develop, how to use "episodic"
medications correctly, and when to seek
help from adults.
Designed for eight to11 -year old chil-
dren with asthma, this curriculum
consists of six lessons and is designed
to be easy for trained volunteers or
school staff to present. Generally held
during the school day, each lesson
takes about 40 minutes and is flexible
enough to fit any school's schedule.
The program's hands-on teaching
approach utilizes group discussion, sto-
ries, games, and role-playing to promote
children's active involvement in the
learning process.
Children enrolled in this program have
demonstrated: increased school perfor-
mance; more confidence in their ability
to manage asthma; greater influence on
their parents' asthma manage-
ment decisions; fewer episodes of asth-
ma, as well as episodes of shorter
duration; and more active management
of their asthma. The program is
approved and recommended by the
National Association of School Nurses.
Although asthma affects children of all
backgrounds, minority groups are dis-
proportionately affected. To reach
children from all backgrounds, artwork
in the curriculum was designed with a
distinctive multi-cultural appeal with
specially designed cartoon illustrations
of children in urban, rural, and suburban
settings. To reach an even broader
audience, ALA's Open Airways For
Schools is now available with both
English and Spanish language text on
the handouts and posters.
For more information about the American
Lung Association's Open Airways For
Schools program, contact your local Lung
Association at 1-800-LUNG-USA (1-800-
586-4872) or visit the ALA website
(http://www. lungusa. org.)
Asthma Management and Education
-------
i^ Reviewed by
/ I y) /• '.) V/7 s) ^l/)/'//^'/l / s) \) iI iitL'j.1 Asthma and Allergy JWl A ^na
•JO//////C/ / -\ljllOll U'll (I ^f^ Foundation of America ^|^ «EPA
Name:
Homeroom Teacher:
Parent/Guardian Name:
Address:
Parent/Guardian Name:
Address:
Grade: Age:
Room:
Ph: (H)
Ph:(W)
Ph: (H)
Ph:(W)
Emergency Phone Contact #1:
Name Relationship Phone
Emergency Phone Contact #2:
Name Relationship Phone
Physician Treating Student for Asthma: Ph:
Other Physician: Ph:
Emergency Plan
Emergency action is necessary when the student has symptoms such as
_, or has a peak flow reading of
Steps to take during an asthma episode:
1. Check peak flow.
2. Give medications as listed below. Student should respond to treatment in 15-20 minutes.
3. Contact parent/guardian if:
4. Re-check peak flow.
5. Seek emergency medical care if the student has any of the following:
/ Coughs constantly
/ No improvement 15-20 minutes after initial treatment with medication and a relative cannot
be reached
/ Peak flow of
/ Hard time breathing with:
• Chest and neck pulled in with breathing
• Stooped body posture
• Struggling or gasping '" rhoto
/ Trouble walking or talking
/ Stops playing and can't start activity again
/ Lips or fingernails are grey or blue
Emergency Asthma Medications
Name Amount When to Use
1.
2.
3.
4.
-------
Daily Asthma Management Plan
(Identify the things which start an asthma episode. Check each that applies to the student.)
a Exercise
a Respiratory infections
a Carpets in the room
a Food
a Strong odors or fumes
a Chalk dust/dust
a Animals
a Other
a Change in temperature
a Pollens
a Molds
Comments
Control of School Environment
(List any environmental control measures, pre-medications, and/or dietary restrictions that the student needs to prevent an
asthma episode.)
Peak Flow Monitoring
Personal Best Peak Flow Number:
Monitoring Times:
Daily Medication Plan
Name
Amount
When to Use
1.
2.
3.
4.
Comments/Special Instructions
For Inhaled Medications
a I have instructed
It is my professional opinion that
use that medication by him/herself.
a It is my professional opinion that
medication by him/herself.
in the proper way to use his/her medications.
should be allowed to carry and
should not carry his/her inhaled
Physician Signature
Date
Parent/Guardian Signature
Date
AAFA • 1233 20th Street, N.W., Suite 402 , Washington, DC 20036 • www.aafa.org • 1-800-7-ASTHMA
Asthma Action Card
-------
Additional Resources
For more information on asthma contact:
U.S. Environmental Protection Agency
http://www.epa.gov/iaq
Download the IAQ Tools for Schools
Action Kit from EPA's website.
U.S. EPA Indoor Air Quality Information
Clearinghouse (IAQ INFO)
(800)438-4318
(703)356-5386 Fax
Call and request the IAQ Tools for
Schools Action Kit.
Allergy and Asthma Network/Mothers of
Asthmatics, Inc.
(800)878-4403
www.aanma.org
Ask about obtaining their School
Information Packet.
American Lung Association
(800)LUNG-USA
www.lungusa.org
Ask about the Open Airways For
Schools program.
Asthma and Allergy Foundation of America
(800)7-ASTHMA
www.aafa.org
Ask about AAFA's Asthma Management
at School presentation for parents and
school personnel. Also available are
additional school-based child and teen
education materials.
Center for Disease Control and Prevention
(770)488-7320
www.cdc.gov
Find out more information on the
Asthma Prevention Program by visiting
this website.
Integrated Pest Management
in Schools Website
www.ifas.ufl.edu/~schoolipm/
Find out more IPM information by
visiting this website.
Additional Resources
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National Association of School Nurses
(207)883-2117
www.nasn.org
Ask about obtaining Asthma Modules to pre-
sent to school staff.
National Asthma Education and
(301)592-8573
www.nhlbi.nih.gov
Ask about obtaining four publications:
Managing Asthma: A Guide for Schools,
Asthma and Physical Activity in School, How
Asthma Friendly is your School?, and the
Asthma Awareness Curriculum.
National Education Association Health Information
Network
(800)718-8387
www.neahin.org
Call to request information on a variety
of health issues in schools, including
asthma. Check website for IAQ in
schools information.
National Parent Teacher Association
(800)307-4PTA
www.pta.org
Ask about obtaining an Asthma Module
to present at PTA meetings.
School Asthma Website
www.schoolasthma.com
An educational website designed
for school nurses.
EPA lias included the names, phone numbers, and
E-mail addresses of these non-profit organizations in
this publication for informational purposes only. This
does not imply Agency endorsement of the products,
services or general policies of any of these organiza-
tions. Further, the organizations mentioned in this
publication are not the only sources of information
on asthma in schools. Additional information may
be obtained from your physician or other health care
provider, insurance carrier, school system, or state
or local public health agency as appropriate.
Additional Resources
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EPA REGIONAL OFFICES
US EPA/Region 1
(CT, ME, MA, NH, Rl, VT)
1 Congress Street
Suite 1100
Boston, MA 02114-2023
(617)918-1639
(617)918-1505 fax
US EPA/Region 2
(NJ, NY, PR, VI)
290 Broadway
28th Floor
New York, NY 10007-1866
(212)637-4010
(212)637-4942 fax
US EPA/Region 3
(PC, OE, MO, PA, VA, WV)
1650 Arch Street
Philadelphia, PA 19103-2029
(215)814-2704
(215)814-2101 fax
US EPA/Region 4
(AL,FL,GA,KY,MS,NC,SC,TN)
61 Forsyth Street, SW
Atlanta, GA 30303-3104
(404)562-9136
(404)562-9095 fax
US EPA/Region 5 (AE-17J)
(IL, IN, Ml, MN, OH, Wl)
77 West Jackson Boulevard
Chicago, IL 60604
(312)353-2205
(312)886-0617 fax
US EPA/Region 6 (6PD-T)
(AR, LA, NM, OK, TX)
1445 Ross Avenue
Dallas, TX 75202-2733
(214)665-7547
(214)665-6762 fax
US EPA/Region 7 (ARTD/RALI)
(IA, KS, MO, NE)
901 North 5th Street
Kansas City, KS66101
(913)551-7020
(913)551-7065 fax
US EPA/Region 8 (8P-AR)
(CO, MT, ND, $0, UT, WY)
999 18th Street
Suite 500
Denver, CO 80202-2466
(303)312-6144
(303)312-6044 fax
US EPA/Region 9 (Air-6)
(AZ,CA,HI,NV,AS,GU)
75 Hawthorn Street
San Francisco, CA 94105
(415)744-1046
(415)744-1073 fax
US EPA/Region 10 (OAQ-107)
(AK, 10, OR, WA)
1200 Sixth Avenue
10th Floor
Seattle, WA 98101
(206)553-2589
(206)553-0110 fax
Additional Resources
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Remember...
10 V/y/s it
MiM<3 jWhm-i hi
Use the IAQ Tools for Schools Kit
Control Animal Allergens
Control Cockroach Allergens
Clean Up Mold and Control Moisture
Eliminate Secondhand Smoke Exposure
Q Reduce Oust Mite Exposure
7 Develop an Asthma Management
Plan in Your School
Provide School-Based
Asthma Education Programs
File Student Asthma Action Cards
Gather Additional Asthma
Information and Resources
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