NH Partners for Healthy Schools

1
NH Partners for Healthy Schools

• Building Asthma Management
• Issues Training

2
Program Outline

• Orientation Meeting
• Building and Asthma Management Issues
• Evaluation and Walkthrough Training
• Building Walkthrough
• Review Results and Set Priorities

3
Building Asthma Management IssuesAgenda

• Asthma Triggers and Management Issues
• Building Issues
• Comfort Survey
• Homework

4

• Asthma Care for KidsCreating a safe
  supportive environment for children with asthma

The information provided is for reference only
and should not substitute for professional
medical care
5
Prevalence of Asthma

• Asthma affects over 20 million Americans
• The Center for Disease Control reported in 2005 -
  6.5 million children under the age of 18 were
  reported to currently have asthma.
• Asthma is the most common chronic disease of
  childhood, affecting 1 in 10 children.
• Asthma is the leading cause of school absenteeism
  14.7 million school days/year.
• Asthma is the 3 cause of hospitalization among
  children younger than 15 years of age.
• National Center for Health, National Health
  Interview survey (lifetime prevalence)
• CDC 2005, EPA 2005

6
Why do you need to know about asthma?

• Even a child with mild asthma can, at any time,
  have a life threatening episode.
• Knowing a childs triggers, warning signs
  and symptoms will make you more
  prepared for care.
• Be part of the partnership to help children
  manage their asthma by being aware
  of the issues surrounding asthma.

7
What is Asthma?

• A serious, chronic lung disease
• that can be controlled, not cured.
• It is an inflammatory condition of
  the bronchial airways, the lining of the airways
  are sensitive all the time.
• The airways go into spasm when exposed to certain
  things called flare factors or triggers.
• These spasms are called asthma attacks or
  episodes. They may be mild or severe.

8
Airways During an Asthma Episode
9
What does it feel likeAn asthma episode is like
breathing through a straw
10
How does asthma impact learning?

• You cant teach kids who are absent
• Its harder to teach kids who are not feeling
  well
• Classmates can be distracted by coughing
• It is difficult to teach kids who are sleep
  deprived
• Even with the best medical management, children
  with
• asthma will continue to be sick if they face
  triggers at
• school!
• Asthma-friendly schools create healthier
  environments for both living and learning!

11
(No Transcript)
12
What TRIGGERS Asthma?

• Triggers are irritants and allergens that set off
  an asthma episode.
• Triggers are different for each individual
  helping avoid these can prevent an episode from
  starting
• common asthma triggers
• Allergens Irritants Illness
• Changes in weather Strong emotions

13
Asthma Triggers

• Avoiding or controlling these will reduce
  symptoms.
• Some examples
• Allergens animal dander, dust mites, mold,
  pollen from trees, grasses weeds.
• Illness viral respiratory infections colds
• Weather changes cold air dry wind
• Strong odors irritants - cigarette smoke,
  perfume, cleaning products, air fresheners
• Exercise - too much activity with out resting
• Strong emotions - laughing, crying or stress.

14
Asthma Treatment Plan

• Tailored to each individual
• Standard part of asthma care
• Based on symptoms, triggers, medications, and
  peak expiratory flow (PEF).
• Provides detailed information on how to treat
  each episode.
• Keep on hand and in an accessible location in
  case of an emergency.
• Very Important to have!!

15
Goals of Asthma Management
Asthma is treatable. Episodes do not have
to be a crisis. No limits on activities, no
school or work missed.
16
Building IssuesTopics to be discussed!

• Backgrounder (TFS)
• Understanding IAQ
• Sources of Indoor Air Pollutants
• Six Basic Control Strategies
• Checklists
• How individuals affect their own environment
• Building Operations and Maintenance
• Building Occupant Behavior
• How to evaluate for a healthy indoor environment.
• Best Practices for IAQ Problems
• Energy efficiency
• Overall energy use in the building
• Long Term/Short Term Solutions

17
TFS Backgrounder
18
Sources of indoor pollutants

• Outdoor Sources
• Pollen, dust, mold spores
• Industrial emissions
• Vehicle and non-road engine emissions (cars,
  buses, trucks, lawn and garden equipment
• Loading docks
• Odors from dumpsters
• Unsanitary debris or building exhausts near
  outdoor air intakes
• Radon
• Pesticides
• Leakage from underground storage tanks

19
Sources of indoor pollutants

• Building HVAC
• Mold growth in drip pans, ductwork, coils, and
  humidifiers
• Improper venting of combustion products (Boiler)
• Dust or debris in ductwork
• Non-HVAC Equipment
• Emissions from office equipment (volatile organic
  compounds (VOCs) and ozone), particulate
• Emissions from shop, lab, and cleaning
  supplies/equipment

20
Sources of indoor pollutants

• Building Components
• Mold growth on or in soiled or water-damaged
  materials
• Dry drain traps that allow the passage of sewer
  gas
• Materials containing VOCs, inorganic compounds,
  or damaged asbestos
• Materials that produce particles (dust)
• Building Furnishings
• Emissions from new furnishings and floorings
• Mold growth on or in soiled or water-damaged
  furnishings

21
Pollutant Control Strategies

• Source Management
• Removal
• Substitution
• Isolation
• Local Exhaust removes stale air
• Ventilation provides fresh air
• Exposure Control control pathways
• Air Cleaning reducing particulate load
• Education using best practices/provide training

22
Interaction of SourcesHVAC Systems, Pathways,
and Occupants

• If independently evaluated, a minor roof leak and
  a
• dirty classroom carpet might not cause much
• concern.
• But if the water from the roof leak
• reaches the carpet, the water can wet the dirt in
• the carpet and the mold that has been dormant in
• the carpet.
• The mold can grow and become a
• pollutant source that releases spores into the
• classroom air.
• The HVAC system may act as a
• pathway that disperses the spores to other parts
  of
• the school, where occupants may experience
• allergic reactions.

23
HVAC System Design Operation

• Properly designed HVAC equipment in a school
  helps to
• Control temperature and relative humidity
• Distribute adequate amounts of fresh air
• Isolate and remove odors and other contaminants
• Some buildings rely only on natural ventilation
• Others lack mechanical cooling equipment
• Many function with little or no humidity control

24
(No Transcript)
25
Best Practices for Indoor Air Quality (IAQ)
Problems

• Fight Moisture
• Send Chemicals Home
• Control Pollutants
• Improve Shop/Art Exhaust
• Efficient Effective Cleaning
• Communicate
• Take credit
• Accept accountability

26
Fight Moisture
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
Reduce and Control Chemicals
31
(No Transcript)
32
(No Transcript)
33
Control Pollutants

• Walk-Off Mats/Stomp Days
• Reduce/Regularly Clean Fabrics etc
• Damp Dusting/HEPA Vacuuming
• Microfiber Cleaning Equipment
• Improved Cleaning Techniques
• Clutter/Paper Reduction

34
Energy Efficiency

• Types of Energy Consumed by Schools
• Electricity
• Large Building Components
• Boilers, Air Handling Units, Radiators, Water
  Pumps, Lighting, Kitchen/Voc Tech Equipment
• Other appliances
• Microwaves, Toasters, Small Refrigerators,
  Computers, Fish Tanks, Grow Lights.
• Fuel
• Gas
• Oil

35
Impact of Poor Indoor Environment on Energy
Efficiency

• High Particulate Load
• Requires more frequent air filter changes ()
• Makes the system work harder ()
• May require the radiators to be cleaned more
  frequently (Labor).
• Blocked radiators and Unit Ventilators
• Require the systems to work harder () and
  increase the amount of pollutants in the indoor
  air.

36
Short Term Solutions

• Begin to reduce particulate TOMORROW
• Micro-Fiber/damp dusting methods
• Stomp Days
• Reduce Clutter, unblock HVAC delivery
• Shut lights, Computers, and appliances off when
  not in use, at night and over weekends/vacations
• Monitor and regulate heat (68-72 Deg.)
• Have policies regarding open windows/doors.

37
Long Term Solutions

• Create standards for workplace cleanliness.
• Provide Education to staff
• Build budget for more walk-off mats to reduce the
  amount of material entering the building.
• Include CHPS in all new building
  construction/Renovation

38
Homework

• Fill out the appropriate Tools for Schools check
  lists based on your observations in your work
  area.
• Continue to collect data (i.e. students with
  Asthma, of Absences, of Students with
  Medication, Action Plans, and Health Office
  Visits
• Continue work on Comfort Survey (as needed)

39
Conclusion

• Dates for remaining meeting(s)
• Meeting 3
• Evaluation and Walkthrough Training
• Review homework.
• What and how to spot issues.
• Evaluation and walkthrough of a room.
• Homework.
• Meeting 4
• Building Walkthrough