Title: Asthma in School
1Asthma in School
- its more serious than you think!
- Karen P. Kain, MS, RRT-NPS, AE-C
- Pulmonary Education Specialist
- Asthma Initiative of Michigan
- 9/26/2007
2WHY TALK ABOUT ASTHMA?
- Asthma can be deadly.
- Most asthma episodes can be prevented.
- There are legal requirements that affect how
schools deal with students who have asthma. - Children with asthma account for almost 15
million missed school days a year, and miss more
days on average than their friends who dont have
asthma.1 - CDC. Asthma prevalence, health care use and
mortality, 2002. Hyattsville, MD U.S. Department
of Health and Human Services 2004.
3Could this happen in your district? Â
- Jury Awards 9 Million in Asthma Death at School
-
-
- A California jury that unanimously awarded a
mother 9 million in damages for her 11-year old
sons fatal asthma attack at school found the
school district guilty of negligence for failing
to inform parents of an unwritten school policy
that would have allowed the child to carry an
inhaler. -
- Gonzalez vs. Hanford Elementary School District,
Nos. F033659, F034555, (Super. Ct. Nos. 0031
1109). June 2002.
4What is Asthma?
- Chronic inflammatory disease of the
- airways characterized by
- Recurrent episodes of wheezing
- Shortness of breath
- Chest tightness/pain
- Coughing
- Airways are supersensitive and react to a
variety of stimuli or triggers
5Lung Changes During an Asthma Attack
- In response to a trigger (something that makes
asthma worse) - Airways swell and become narrowed
- Bronchial muscles tighten
- Mucus further obstructs airways
- Breathing becomes difficult
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7Normal Airway
8Asthma Airway Changes
9 Asthma Attack Airway Changes
10Triggers
- A variety of stimuli or triggers can cause
airway inflammation (swelling) and bring on an
asthma flare - Eliminating or reducing exposure to these
triggers will decrease the need for asthma
medications and reduce symptoms
11Asthma triggers in a classroom may include
- Stuffed animals
- Carpeting
- General dusty clutter
- Plants
- Pets
- Mold
- Perfume, candles, air fresheners
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13What is asthma control in children?
- No coughing
- No difficulty breathing, wheezing, or chest
tightness - No waking up at night because of asthma symptoms
- Normal activities, including play, sports,
exercise, or other school activities
14What is asthma control in children, contd
- No acute episodes of asthma that require a doctor
visit, emergency room visit, or urgent care - No absences from school or activities
- No missed days from work or other activities for
the parent or caregiver - Normal (or near normal) lung function
15What about those inhalers?
- Does your school allow students to possess and
self-administer prescribed medications at school?
16MDI Inhaler Law
17Do school facilities compromise student health
and achievement?
- Environmental triggers exacerbate asthma and
other respiratory ailments.1 - 50 of schools serving over 20 million children
have unsatisfactory environmental conditions such
as poor ventilation, heating and lighting.2 - Studies support the link between poor indoor air
quality and low student achievement.1,3 - 1Indoor Air Quality and Student Performance.
Environmental Protection Agency, March 2001,
Revised 2003. - 2U.S. General Accounting Office. School
Facilities The Condition of Americas Schools.
2000. - 3Schneider, M. Do School Facilities Affect
Academic Outcomes? National Clearinghouse for
Educational Facilities, November 2002.
18School Facilities and Achievement
- Students whose school facilities are in poor
condition have test scores about 5.5 percentage
points below students whose school facilities are
in fair condition, and about 11 percentage points
below students in excellent facilities.1 - 90 of U.S. schools were built before 1980, and
50 before 1960.2 - 1Indoor Air Quality and Student Performance.
Environmental Protection Agency, March 2001,
Revised 2003. - 2U.S. General Accounting Office. School
Facilities The Condition of Americas Schools.
2000.
19To think about
- Do you know your districts policy about the
self-possession and use of inhalers (and other
quick-relief medication) for students with
asthma? - How well does your district monitor indoor air
quality related to carpeting in classrooms? - What is your districts policy on keeping pets or
plants in the classroom?
20What can schools do?
21Be Proactive
- Create local policies that support
asthma-friendly schools. - Provide school health services for students with
asthma. - Offer asthma-management education to students,
staff, and families. - Provide a safe and healthy environment by
reducing asthma triggers in the school
environment. - Coordinate school, family, and community
resources to better manage asthma symptoms and
reduce school absences.
22Asthma Management Plan (AMP)
23State Board of Education Model Asthma Policy
24Resources for School Leaders from AASA
- AASAs Indoor Air Quality Asthma initiatives.
- School Governance and Leadership (Spring 2003).
- Schoolhouse in the Red (2004 Edition).
- Frequently Asked Asthma Questions document.
- Powerful Practices A Checklist for School
Districts Addressing the Needs of Students with
Asthma.
25Schoolhouse in the Red
26School Governance Leadership
27Completing HSAT
- Process Driven by Coordinated School Health Teams
- Identify Strengths
- Identify Challenges
- Develop an Action Plan
- Make Policy and Environmental Changes
28The HSAT Homepage
www.mihealthtools.org/hsat
29What is the Healthy School Action Tool (HSAT) ?
- Assessment
- Action Plan
- Implementation
- Expected Results
- Partnerships
- Policy Change
- Environmental Improvement(s)
- www.mihealthtools.org/hsat
- Â
30The HSAT Process
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32Asthma Strategic Plan for MI
- Goal 5
- Reduce Barriers to Self-Management In People With
Asthma - Objective 1
- Promote development and implementation of
asthma-friendly policies in schools. - Strategy A Develop a statewide partnership to
address asthma in schools. - Strategy B Facilitate implementation of asthma
inhaler law and State Board of Education Asthma
management Policy and other asthma-friendly
policies in all Michigan schools.
33Additional Resources
- Strategies for Addressing Asthma Within a
Coordinated School Health Program Centers for
Disease Control and Prevention -
http//www.cdc.gov/healthyyouth/asthma/strategies.
htm - Managing Asthma A Guide for Schools National
Asthma Education and Prevention Program (NAEPP)
http//www.nhlbi.nih.gov/health/prof/lung/asthma/a
sth_sch.htm - Fit, Healthy, and Read to Learn National
Association of State Boards of Education -
http//www.nasbe.org/HealthySchools/fithealthy.htm
l - Quest for the Code Asthma CD Rom Game Starlight
Starbright Childrens Foundation
-http//www.starlight.org/site/c.fuLQK6MMIpG/b.135
2333/k.2867/Asthma_CD_ROM_Quest_for_the_Code.htm - Schooled in Asthma American Academy of
Pediatrics - http//www.aap.org/schooledinasthma/ - Tools for Schools Environmental Protection
Agency - http//www.epa.gov/iaq/schools/toolkit.ht
ml - Open Airways for Schools Asthma 101 (for
Elementary School children) - http//www.lungusa.o
rg/ - Power Breathing (for Teens) - http//www.aafa.org
/display.cfm?id4sub79cont436
34For More Information
- For more information on AASAs efforts to address
asthma in schools please visit www.aasa.org/focus.
- For more information on AIM school initiatives
visit www.GetAsthmaHelp.org -
35Asthma Contacts
- Karen P. Kain, MS, RRT-NPS, AE-C
- President, Asthma Coalition of NW MI
- (231) 935-6736
- Asthma School Coordinator
- Shawn Cannarile, MAEd
- Michigan Public Health Institute
- 517-324-7385 or scannari_at_mphi.org
- Asthma Initiative of Michigan
- www.GetAsthmahelp.org
36References
- CDC. Asthma prevalence, health care use and
mortality, 2002. Hyattsville, Maryland US
Department of Health and Human Services, CDC,
National Center for Health Statistics, 2004. - Gonzalez vs. Hanford Elementary School District,
Nos. F033659, F034555, - (Super.Ct. Nos. 0031 1109). June 2002
- Indoor Air Quality and Student Performance. EPA,
March 2001, Revised 2003. - School Facilities The Condition of Americas
Schools. US General Accounting Office 2000. - Schneider, M. Do School Facilities Affect
Academic Outcomes? National Clearinghouse for
Educational Facilities, November 2002.
37HSAT Expansion
- New Topic Areas
- Asthma Management
- Violence and Injury Prevention
- New Format a la carte design allows schools to
choose topics to assess - More resources!
- Better tools!