United States
Environmental Protection
Agency
  Working Together
  So Everyone Can Breathe Belt
                      OUTREACH
     IMPROVING ASTHMA MANAGEMENT

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                            OUTREACH  AND EDUCATION
 PUBLIC AWARENESS
 CAMPAIGNS
To raise awareness about environmental asthma triggers
and promote community action to reduce exposure, EPA
sponsors comprehensive public awareness and media
campaigns.

>• In partnership with the Advertising Council
  (Ad Council), EPA supports a national media
inizations and other
B integration of outreach
crease awareness of
           manage
             Bailable
          TAKE ACTION and JOIN  the Communities

          in Action for Asthma-Friendly Environments network.

          Visit www.asthmacommunitynetwork.org.

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MAKING  A  DIFFERENCE TO  IMPROVE ASTHMA  MANAGEMENT
Asthma can be controlled through medical treatment and management of environmental triggers. The U.S.
Environmental Protection Agency (EPA) promotes scientific understanding of environmental asthma triggers and ways
to manage them by partnering with local, state and Federal agencies, universities and other research centers, the health
care community, nonprofit organizations, the media, and many other groups. EPA collaborates with partners to sup-
port scientific research and educate the public about asthma and ways to manage environmental asthma triggers.
EPA collaborates with partners to:
• Investigate the relationship between environmental factors and new cases of asthma, how exposure to environ-
  mental factors worsens existing asthma, and ways to manage environmental risk factors.
• Raise public awareness of environmental asthma triggers.
• Promote actions to reduce exposure to environmental triggers in and around homes, schools, and
  childcare settings.
• Integrate environmental management of asthma triggers into standard medical and health care asthma
  treatment practices and standards of care.

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ASTHMA    INITIATIVE    AT    EPA
The U.S. Environmental Protection Agency (EPA) is committed to safeguarding human health and the environment.
In response to the asthma problem, and with a special focus on children, EPA sponsors a national, multi-faceted
asthma research, education, and outreach program. This comprehensive program increases scientific knowledge
about environmental factors that contribute to asthma, and promotes asthma management through education
and outreach.
To improve the quality of life for the millions of Americans living with asthma, EPA:
• Monitors outdoor air quality and informs the public of health risks from outdoor air pollution.
• Helps children with asthma and their families manage environmental asthma triggers in and around their homes.
• Empowers school communities and childcare providers to protect children from environmental asthma triggers in
  and around places where children spend their time.
• Increases public awareness about asthma and managing environmental asthma triggers.
• Conducts and coordinates research to increase scientific knowledge about asthma and ways to manage environ-
  mental factors that cause asthma and trigger asthma attacks.
• Provides health care providers and plans with information, education, and resources to incorporate environmental
  management into clinical practices and standards of care for asthma patients.
• Supports community-based asthma initiatives to improve asthma health outcomes and help transfer knowledge
  across community programs.

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SUPPORTING  SCIENCE
EPA supports efforts to understand the links between
environmental factors and asthrr
developed the Asthma Research '
understanding of exposure, heal t     EPA  OFFICES  ADDRESSING
and risk managemen^fj^^^y    ASTHMA ISSUES
pollutants li' — L^^
EPAsu
ast
 The U.S. Environmental Protection Agency (EPA) knows
 that asthma is a complex illness and that identification
 and avoidance of environmental triggers are essential to
 comprehensively managing asthma. Therefore, many
 offices within EPA are working to combat asthma by
 building knowledge and awareness to help people with
 asthma identify and reduce environmental triggers and
 improve their qualjj

 Office.
Mis
                    LEARN  MORE about environmental asth-
                    ma triggers and the research, education,
                    and outreach conducted through EPA programs
                    at www.epa.gov/asthma.

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OUTREACH AND EDUCATION
„,
    works with national organizations and other
Federal agencies to encourage integration of outreach
and education designed to increase awareness of
environmental asthma triggers and ways to manage
them. EPA also develops tools and resources, available
at no cost, to assist implementation of comprehensive
      a care programs.
*EPA supports community-based asthma education for
 children, parents and caregivers, school officials, and
 childcare providers about comprehensive asthma
 management, including common environmental asthma
 triggers and ways to reduce children's exposure to those
 asthma triggers. For more information, visit www.asth-
 macommunitynetwork.org.

The Indoor Air Quality Tools for Schools (JAQ TfS)
 Program helps schools identify and reduce exposure to
 asthma triggers in and around school buildings. For
 more information, visit www.epa.gov/iaq/schools.

»-EPA works with various sectors of the healthcare
 community, including health plans and providers. EPA
 has developed tools and resources to promote the
 integration of environmental controls into clinical
 practices and standards of care for asthma management.
 For more information on these tools, visit
 www.epa.gov/asthma.

> "Ozone and Your Patients' Health" is a short, evidence
 based, technical training course for family practice
 doctors, pediatricians, and other primary care providers.
 This online course provides information about the
 effects of exposure  to ground-level ozone which can
 cause uncomfortable and damaging
 respiratory symptoms. With this information physicians
 can help their patients understand how ozone can
 trigger their symptoms and  advise them about how to
 avoid exposure. Visit www.epa.gov/O3healthtraining.

*The Smoke-free Homes Program raises awareness about
 the health effects of exposure to secondhand smoke and
 promotes smoke-free indoor environments.  For more
 information, or to take the Smoke-free Home Pledge to
 commit to protecting children from secondhand smoke,
 visit www.epa.gov/smokefree.

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AWARDS AND  RECOGNITION
PROGRAMS
Every year EPA honors public and private organizations
for their outstanding dedication and leadership in
addressing environmental health issues as they relate to
the continued support of asthma mafiagement. The
following is a list of programs that recognize
asthma management organizations for their efforts:
^-National Environmental Leadership Aivard in Asthma
 Management—This award recognizes community
 stakeholders, including health care providers and health
 care plans for leadership in addressing management of
 environmental triggers as part of a comprehensive asthma
 management program. For more information and to
 submit an online application visit www.epa.gov/asthma
^Communities in Action for Asthma-Friendhj
 Environments Network—This initiative recognizes
 community-based programs dedicated to achieving
 positive health outcomes through outstanding asthma
 management. These exemplary community programs
 proactively share information and tools within the
 network and serve as mentors for other community
 programs and models for the nation. For more informa-
 tion, visit www.asthmacommunitynetwork.org.
+Indoor Air Quality Tools for Schools Awards Program—
 This awards program recognizes schools and school
 districts that are implementing comprehensive,
 sustainable indoor air quality (IAQ) management plans.
 Eligible schools are those that have       Indoor Air Quality
 demonstrated a strong commitment to
 improving children's health, and
 communicating the importance of a
 healthier indoor environment. For
 more information visit
 www.epa.gov/iaq/schools.
                                       Tools for Schools

                                                 (over)
^Children's Environmental Health Excellence and
 Recognition Aivards—This awards program is designed
 to recognize ongoing and sustainable dedication to, and
 notable leadership in, protecting children from
 environmental health risks at the local, regional, national,
 and international level. EPA wants to honor projects that
 significantly impact children's environmental health issues
 through research; indicators; capacity building; regulatory
 and policy innovations; education and outreach; and
 interventions. For more information about this recognition
 opportunity visit www.epa.gov/children.

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PUBLIC AWARENESS
CAMPAIGNS
I To raise awareness about environmental asthma triggers
and promote community action to reduce exposure, EPA
sponsors comprehensive public awareness and media
campaigns.
* In partnership with the Advertising Council
  (Ad Council), EPA supports a national media
  campaign to educate parents about managing
  children's asthma to prevent serious attacks. The
  call to action encourages parents and caregivers of chil-
  dren with asthma to learn more by calling the
  hotline (1-866-NO-ATTACKS) or by visiting www.noat-
  tacks.org. The cam-
  paign (available in
  English and Spanish)
  includes television,
  radio, newspaper,
  public service
  announcements
  (PSA), posters, and
  brochures that
  describe how to
  manage the indoor
  environment as
  part of an overall
  asthma management
  plan.
Visit www.epapsa.com to view and order EPA's public
service announcement (PSA) materials.
                       oEPA
United States
Environmental Protection
Agency
                           EPA has also developed comprehensive Web-based
                           resources dedicated to informing the public about the
                           effects of poor outdoor air.

                           * The Air Quality Index (AQI) is an air quality scale that is
                            produced by EPA in coordination with state, local, and
                            tribal agencies. The AQI correlates local air quality con-
                            ditions with an associated color category that describes
                            health threats from air pollution and outlines actions
                            people can take. Local television, radio stations, and
                            newspaper outlets use the AQI to raise awareness about
                            asthma and to announce community action, such as an
                            Ozone Action Day. People with asthma should check the
                            AQI daily, and follow its recommendations to reduce
                            exposure to air pollution.

                           ^EnviroFlash is an e-mail and pager notification system
                            that alerts people when their local air quality reaches lev-
                            els that they are concerned about. This reliable,
                            forecast information allows them to make an  informed
                            decision about outdoor  activities on a given day.
                            EnviroFlash is especially helpful for people who are at
                            greater risk from air pollution including children, older
                            adults, and people with heart or lung diseases.

                           *The AIRNow Web site provides the public easy access to
                            air quality information. The AIRNow Web site reports
                            conditions for ozone and particle pollution for over 300
                            major U.S. cities, and provides nationwide and regional
                            real-time ozone and particle pollution air quality maps
                            covering all 50 U.S. States and 6 Provinces of Canada.
                            People living with asthma and their caregivers can access
                            the AIRNow Web site or look for the AQI in their local
                            media to see if they need to manage their exposure to
                            outdoor triggers in order to minimize their chances of
                            having an asthma attack.

                           For more information on or to access any of the tools
                           above, visit the AirNow Web site at www.airnow.gov.

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SUPPORTING  SCIENCE
                          INDOOR EXPOSURES
EPA supports efforts to understand the links between
environmental factors and asthma. In 2002, EPA scientists
developed the Asthma Research Strategy to further scientific
understanding of exposure, health effects, risk assessment,
and risk management of indoor and outdoor environmental
pollutants linked to asthma.

EPA supports studies to address three high-priority areas in
asthma research:

••The role air pollutants may play in induction and
 exacerbation of asthma.

••Susceptibility, or factors that increase risk for subgroups of
 Americans. Because where a person lives determines in
 part what is in the air he or she breathes, residence history
 is a priority for research in the susceptibility area. Genetic
 factors, which may interact with environmental
 exposures, are also a primary focus.

^Interventions for reducing the risks from environmental
 factors (e.g., controlling cockroaches and other types of
 allergens, improving indoor air quality, and providing
 educational opportunities to affected communities).

In addition to collaborations with universities, Federal
Agencies, nonprofit organizations, and others, EPA pro-
vides grants to increase scientific understanding of topics of
asthma and the environment. For more information about
          potential funding opportunities, visit
           www.epa.gov/epahome/finance.htnn.

                     Visit www.epa.gov/ord/htm/
                      researchstrategies.htm#rs02 to
                      learn more about the Asthma
                     Research Strategy.
                       SEPA
United States
Environmental Protection
Agency
                          EPA commissioned a National Academy of Sciences
                          Institute of Medicine expert panel review of the scientific
                          evidence on the relationship between indoor air pollution
                          and asthma. The landmark report. Clearing the Air.
                          Asthma and Indoor Exposures, released in 2000, guides
                          much of the national effort to improve environments
                          through various EPA programs. Several key findings
                          include:
                          ••Indoor environment plays an important role in the
                           increasing asthma problem.

                          ••Exposure to secondhand smoke, nitrogen dioxide,
                           and indoor allergens—dust mites, animal dander,
                           cockroaches, and mold—can make asthma
                           symptoms worse.
                          ••Exposure to dust mite's can cause asthma in susceptible
                           individuals.
                          ^Exposure of pre-school aged children to environmental
                           tobacco smoke can cause asthma.

                          OUTDOOR AIR POLLUTION

                          Extensive  research on the relationship between outdoor
                          air pollution and asthma has determined that exposure to
                          ozone and particle pollution can trigger asthma attacks,
                          especially in people who are active outdoors.

                          EMERGING  SCIENCE

                          Some evidence  suggests that in utero exposure to tobacco
                          smoke can increase the risk of developing asthma.

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EPA  OFFICES  ADDRESSING
ASTHMA  ISSUES
The U.S. Environmental Protection Agency (EPA) knows
that asthma is a complex illness and that identification
and avoidance of environmental triggers are essential to
comprehensively managing asthma. Therefore, many
offices within EPA are working to combat asthma by
building knowledge and awareness to help people with
asthma identify and reduce environmental triggers and
improve their quality of life.

Office of Research and Development (ORD)
Mission: Perform research and development to identify,
understand, and solve current and future environmental
problems, provide responsive technical support to EPA's
mission, integrate the work of ORD's scientific partners
(other agencies, nations, private sector organizations,
and academia) and provide leadership in addressing
emerging environmental issues and in advancing the
science and technology of risk assessment and risk
management. To learn more about ORD's research
agenda, including the Asthma Research Program, visit
www.epa.gov/ord.

Office of Children's Health Protection and
Environmental Education (OCHPEE)
Mission: Promote environmental health protection for
children and older adults in the United States and
around the world. For more information about
OCHPEE's programs including the Children's
Environmental Health Excellence and Recognition
Awards visit www.epa.gov/children.
                    r
                       &EPA
United States
Environmental Protection
Agency
Office of Prevention, Pesticides, and Toxic Substances
(OPPTS)
Mission: Promotes safer chemicals through a combination
of regulatory and voluntary efforts; promotes risk
reduction so as to minimize exposure to existing
substances such as lead, asbestos, dioxin, and
polychlorinated biphenyls; and promotes public
understanding of risks by providing understandable,
accessible, and complete information on chemical risks to
the broadest audience possible. OPPTS manages programs
such as Integrated Pest Management in school and
housing; Strategic Agricultural Initiative; Pesticide
Environmental Stewardship Program; Pesticide Program;
Consumer Labeling Initiative; Buy Clean Program for
schools; Chemical Right-To-Know Initiative; and the
Design for the Environment. For more information on
OPPTS' programs, visit www.epa.gov/oppts.

Office of Air and Radiation (OAR)
Mission: Leads the United States and the world in
protecting human health and the environment by
preventing air pollution and exposure to radiation through
effective management of public and  private resources.
OAR develops national programs, technical policies, and
regulations  for controlling air pollution and radiation
exposure. OAR is concerned with energy conservation and
pollution prevention, indoor and outdoor air quality,
industrial air pollution, pollution from vehicles and
engines, radon, acid rain, stratospheric ozone depletion,
and radiation protection.

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Within OAR there are several offices working on asthma:
Office of Radiation and Indoor Air (ORIA), Office of Air
Quality Planning and Standards (OAQPS), and the Offici
of Transportation and Air Quality (OTAQ).
:
Office of Radiation and Indoor Air (ORIA)
Mission: Safeguard human health from indoor
environmental health threats. Within OAR, the Indoor
Environments Division (IED) is committed to educating
the public, schools and daycares, the healthcare
community, and national and Federal partners about the
links between indoor environmental asthma triggers and
asthma. To learn more about lED's programs including
community-based initiatives, the National Environmental
Leadership Award in Asthma Management for health plans
and healthcare providers, and educational resources for
patients and healthcare professionals, visit
www.epa.gov/asthma.

Office of Air Quality Planning and Standards (OAQPS)
Mission:  Preserve and improve air quality by setting
national air quality standards that protect public health
and the environment. OAQPS also monitors and reports
on air quality, air toxics, and emissions and monitors
visibility issues as they relate to air pollution. Part of
OAQPS' responsibility is to inform the public about air
pollution, related health risks, and risk management
techniques. To learn more about OAQPS programs,
including AIRNow and the Enviroflash service, visit
www.airnow.gov.

Office of Transportation and Air Quality (OTAQ)
Mission: Protect public health and the environment by
controlling air pollution from motor vehicles, engines and
the fuels used to operate them, and by encouraging  travel
choices that minimize emissions. To learn more about
OTAQ's successful programs including National Clean
Diesel Campaign such as the Clean School Bus USA
initiative and the SmartWay Transport partnership, visit
www.epa.gov/otaq.
Contact EPA Regions for more information on
state and local efforts.

EPA REGIONAL CONTACTS
Region 1—CT, ME, MA, NH, RI, VT
www.epa.gov/region I

Region 2—NJ, NY, PR, VI
www.epa.gov/region2

Region 3—DE, DC, MD, PA, VA, WV
www.epa.gov/region3

Region 4—AL, FL, GA, KY, MS, NC, SC, TN
www.epa.gov/region4

Region 5—IL, IN, MI, MN, OH, WI
www.epa.gov/region5

Region 6—AR, LA, NM, OK, TX
www.epa.gov/region6

Region 7—IA, KS, MO, NE,
www.epa.gov/region7

Region 8—CO, MT, ND, SD, UT, WY
www.epa.gov/region8

Region 9—AS, AZ, CA, GU, HI, NV
www.epa.gov/region9

Region 10—AK, ID, OR, WA
www.epa.gov/region 10

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ORDER ASTHMA  MATERIALS  TODAY!
Contact the National Service Cen

For phone orders: (800) 490-9198
For fax orders: (513) 489-8693
jlace an order:
                                                                                       Office of Air and Radiation
                                                                                       (6609J)
                                                                                       EPA 402-K-05-007
                                                                                       September 2006

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