Indoor Environments EPA 402-K-05-002
Division (6609J) August 2005
Office of Air and Radiation
IAQ Tools for Schools
Managing Asthma in the
School Environment
10 Ways to Manage Asthma in the School Environment
1. 7.
Use the IAQ Tools for Schools Kit Develop an Asthma Management Plan in
Your School
I Help people with asthma by
improving the school I Include school policies on
environment with IAQ practices inhaler and other medication
recommended in this kit. usage, and emergency
procedures for school staff for
2. use when a student has an
Control Animal Allergens
asthma attack.
I Remove classroom animals from
I Obtain the National Asthma
the school, if possible.
Education and Prevention
I If not, locate animals away from
Program鈥檚 Managing Asthma: A
sensitive students and ventilation
Guide for Schools.
systems.
8.
3. Provide School-Based Asthma
Control Cockroach Allergens
Education Programs
I Use Integrated Pest Management
I Contact your local American
practices to prevent cockroach
Lung Association about Open
and other pest problems (e.g.,
Airways For Schools, a school-
store food in tightly sealed
based asthma management
containers and place dumpsters
program for students with
away from the building).
asthma.
4. Clean Up Mold and Control Moisture
9. File Student Asthma Action Cards
I Fix moisture problems and
I Encourage students to work with
thoroughly dry wet areas within
their health care providers to
24-48 hours to prevent mold
identify their asthma triggers.
growth.
I Make sure students with asthma
I Clean up hard, moldy surfaces
obtain and turn in copies of their
with water and detergent, then
Asthma and Allergy Foundation
dry thoroughly.
of America action cards to
5. teachers, school nurse, etc.
Eliminate Secondhand Smoke Exposure
10. Gather Additional Asthma Information
I Enforce no-smoking policies in
the school.
and Resources
6. I Establish a complete file on
Reduce Dust Mite Exposure
existing asthma and allergy-
I Make sure the school is dusted
related information sources
and vacuumed thoroughly to reference throughout the
and regularly. school year.
Visit www.epa.gov/asthma for information on common asthma triggers and how to manage them,
asthma education programs available in your community, and no-cost resources that schools can use
to educate students and staff about asthma.
The Asthma Epidemic
Asthma has reached epidemic inflammation also causes the airways of
proportions in the United States the lungs to become especially sensitive
affecting millions of people of all ages to a variety of asthma triggers. The
and races. An average of one out of particular trigger or triggers and the
every 13 school-age children has severity of symptoms can differ for each
asthma, and the percentage of children person with asthma.
with asthma is rising more rapidly in
preschool-age children than in any other Since Americans spend up to 90% of
age group. Asthma is the leading cause their time indoors, exposure to indoor
of school absenteeism due to a chronic allergens and irritants may play a
condition, accounting for more than significant role in triggering asthma
14.7 million missed school days per episodes. Some of the most common
year. Asthma also accounts for many asthma triggers found indoors include:
nights of interrupted sleep, limitation of
activity, and disruption of family and I animal dander
care-giver routines. Asthma symptoms I cockroaches
that are not severe enough to require a I mold
visit to an emergency room or to a I secondhand smoke
physician can still be serious enough to I dust mites
prevent a child with asthma from living a
fully active life. Other asthma triggers include:
respiratory infections, pollens (trees,
Asthma is a long-term, inflammatory grasses, weeds), outdoor air pollution,
disease that causes the airways of the including ozone and particulate matter,
lungs to tighten and constrict, leading to food, allergies, exercise, and cold air
wheezing, breathlessness, chest exposure.
tightness, and coughing. The
1
Asthma in Schools
Each day, one in five Americans
occupies a school building; the majority
of these occupants are children.
Environmental asthma triggers
commonly found in school buildings
include 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
environmental asthma triggers found in
schools. In addition, some literature
suggests that children with asthma may
be affected by other pollutants from
sources found in schools, such as
unvented stoves or heaters and
common products (e.g., cleaning
agents, perfumes, and sprays).
Effectively managing a child鈥檚 asthma
can best be accomplished through a
comprehensive plan that addresses
both the medical management of
the disease and avoidance of
environmental triggers. Since children
spend most of their time in schools,
day care facilities, or at home, it is
important to reduce their exposure to
environmental asthma triggers as
much as possible in each of these
environments. This publication focuses
on steps that schools can take to help
children breathe easier.
2
IAQ Tools for Schools
Use the Indoor Air Quality
Tools for Schools Kit
Many indoor air quality problems in environment. Using an IAQ
schools can impact the health of management plan that includes
students and staff, including those with checklists for the entire building can
asthma. Some of the indoor air quality lower student and staff exposure to
problems include chemical pollutants asthma triggers. The checklists available
in the IAQ Tools for Schools Kit help
schools address ventilation systems,
maintenance procedures, renovations
and repairs, classroom policies鈥?
especially for animals and mold鈥?
administrative offices, health offices,
food service areas, pest management,
waste management, the role of school
officials, and a walkthrough of the entire
building.
Included in the Kit are several resources
to explain the fundamentals of indoor air
quality and guidance for improving air
inside schools:
from building or building maintenance
materials; chemical pollutants from I IAQ Coordinator鈥檚 Guide
science and art classes; improperly I IAQ Reference Guide
maintained ventilation systems; and I Checklists
allergens from classroom animals and I Background informational piece
cockroaches. Mold growth may result for staff
from standing water in maintenance I IAQ problem solving wheel
rooms and near piping, or from moisture I Road Map
in ceiling tiles, carpets, and other I Fact sheet on district-wide
furnishings. Also, outdoor air pollutants implementation
and pollens may enter the school I Summary of EPA鈥檚 Awards
through ventilation systems and open Program
doors and windows. I Video on how to conduct a
walkthrough
In order to help improve indoor air I Video covering the ventilation
quality problems in school buildings, the checklist and a case study on
Environmental Protection Agency (EPA) how one school implemented
developed the Indoor Air Quality (IAQ) IAQ Tools for Schools
Tools for Schools Kit. The IAQ Tools for
Schools Kit helps school personnel
identify, resolve, and prevent indoor air
quality problems in the school
3
IAQ Tools for Schools
Most schools form an IAQ coordinating For more information about EPA鈥檚 IAQ
team to implement the guidance in the Tools for Schools Program, visit the Web
IAQ Tools for Schools Kit. Because IAQ site at www.epa.gov/iaq/schools.
problems can originate anywhere in the
school building, the entire staff should The IAQ Tools for Schools Kit is
be informed about and participate in available at no cost. To receive the Kit,
improving IAQ. In addition, students can call IAQ INFO at 1-800-438-4318 or
be involved in the process. Information download it from EPA鈥檚 Web site at
about available curricula on indoor air www.epa.gov/iaq/schools.
quality can be found on EPA鈥檚 Web site,
www.epa.gov/iaq/schools.
School districts across the United
States have adopted IAQ Tools for
Schools. The IAQ Tools for Schools Kit
can be used alone or in conjunction with
the American Lung Association鈥檚
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 document,
Managing Asthma in the
School Environment, is one
of those tools. It is a
component of the IAQ Tools
for Schools Kit and is also
available as a stand alone
document.
4 IAQ Tools for Schools
Control Animal Allergens
Classrooms often adopt animals as effective. Isolation measures include
keeping animals in localized areas;
classroom pets or science projects. Any
keeping animals away from upholstered
warm-blooded animals, including
furniture, carpets, and stuffed toys; and
gerbils, birds, cats, dogs, mice, and
keeping sensitive individuals away from
rats, may trigger asthma. Proteins,
Asthma Triggers
Environmental
animals as much as possible.
which act as allergens in the dander,
urine, or saliva of warm-blooded
It is important to make sure that
animals, may sensitize individuals and
classrooms containing animals are
can cause allergic reactions or trigger
frequently and thoroughly cleaned. In
asthma episodes in people sensitive to
addition, animal allergens can readily
animal allergens. migrate to other areas of the school
environment through the air and on the
Common Sources Found in Schools clothing of staff and children who
handle pets. Therefore, the entire
The most common, obvious sources of
building should be cleaned thoroughly.
animal allergens in schools are in the air
and on the clothing of staff and children
Schools are sometimes advised to use
who handle pets. If an animal is present
air cleaners. Although properly used and
in the school, there is a possibility of
maintained air cleaners may be effective
direct, daily exposure to the animal鈥檚
for reducing animal dander in small
dander and bodily fluids. It is important
areas, they should only be considered
to realize that, even after extensive
as an addition to other control methods.
cleaning, pet allergens may stay in the
It is also important to carefully review
indoor environment for several months
information on the type of air
after the animal is removed.
cleaner used to make sure
it is suitably sized and has
The most effective
high particle removal
method to
efficiency. In addition,
control
some air-cleaning
exposure to
devices marketed as
animal
air purifiers emit
allergens in
ozone, which may
schools is to
be harmful to people
keep your school
with asthma.
free of feathered or
furred animals.
However, for some
individuals, isolation
measures may be sufficiently
5
Environmental Asthma Triggers
Suggestions for Reducing Exposures in Schools
I Remove animals from the school, if I Place animals away from air vents to
avoid circulating allergens throughout
possible.
the room or building.
If completely removing animals from the
I Locate sensitive students as far away
school is not possible, then:
from animals and habitats as possible.
I Keep animals in cages or localized
areas as much as possible; do not let I Keep animals away from upholstered
them roam. furniture, carpets, and stuffed toys.
I Clean cages regularly. Consider using
These action items are included on the
disposable gloves when cleaning.
Teachers Checklist, available in the
IAQ Tools for Schools Kit.
Control Cockroach and Pest Allergens
Cockroach allergens play a significant contribute to allergies and asthma in the
role in triggering asthma throughout general population.
inner-city, suburban, and rural schools.
Certain proteins that act as allergens in
Common Sources Found in Schools
the waste products and saliva of
Cockroaches and other pests, such as
cockroaches can cause allergic
rats and mice, are often found in the
reactions or trigger asthma symptoms
school setting. Allergens from these
in some individuals.
pests may be significant asthma triggers
for students and staff in schools. Pest
Pest allergens, especially rats and mice,
problems in schools may be caused or
have been shown to cause occupational
worsened by a variety of conditions
asthma symptoms among laboratory
such as plumbing leaks, moisture
workers. These allergens may also
6 Environmental Asthma Triggers
problems, and improper food handling Confirm that appropriate food preparation,
cooking, and storage practices are
and storage practices. In order to
implemented:
manage a pest problem, control water
and food sources. It is important to I Review food handling and storage
avoid exposure to cockroach and pest practices. Containers should be well-
allergens by using common sense sealed, with no traces of food left on
integrated pest management (IPM) outside surfaces of containers.
practices throughout the entire school.
I Make sure food is not kept in the
classroom overnight.
There are four key IPM methods for
reducing exposure to pests in the school
I Keep animal food in sealed containers.
setting: 1) look for signs of pests; 2) do
not leave food, water, or garbage Maintain general cleanliness:
exposed; 3) remove pest pathways and
I Sweep and wet mop floors to
shelters; and 4) use pest control
remove food.
products such as poison baits, traps,
and pesticide sprays, as needed. I Clean stoves and ovens after use.
I Wipe counters clean with soap and
Integrated Pest Management Practices for water or a disinfectant, according to
Reducing Exposures in Schools school policy.
Check food preparation, cooking, and
I Remove trash daily.
storage areas regularly for signs of
cockroaches and pests:
I Fix plumbing leaks and other
moisture problems.
I Look for dead cockroaches or pests.
I Do not let water stand in air
I Look for waste products (e.g., pest
conditioning or refrigerator drip pans.
droppings).
Select waste containers by considering the
I Look for greasy smears on walls,
kind of waste that is placed in them:
which could indicate possible rat runs.
I Dispose of food waste or
contaminated papers and plastics in
secured, covered containers or tied off
plastic bags to discourage pests.
7
Environmental Asthma Triggers
Empty waste containers regularly and If pesticide sprays are used in the school:
frequently, and store them in an
I Use pest control chemicals in strict
appropriate location:
accordance with state and local
I Follow a regular schedule of emptying regulations and the instructions on the
waste containers in order to minimize container.
odors and deprive pests of their food
I Consider notifying school staff and
sources.
parents well in advance of pesticide
I Place dumpsters away from the applications.
building to minimize opportunities for
I Schedule pesticide applications for
pests to enter the building.
unoccupied periods so that the
Eliminate pest entryways, pathways, affected area can be well ventilated
and shelters: before occupants return.
I Remove clutter (e.g., stacks of papers)
These action items can be found on the
where cockroaches may hide.
following checklists in the IAQ Tools for
Schools Kit:
I Seal small spaces where cockroaches
may live (e.g., where plumbing or
Integrated Pest Management Checklist,
electrical wiring goes through walls,
Teachers Checklist, Administrative Staff
and cracks or spaces in walls around
Checklist, Waste Management Checklist,
baseboards and window sills.)
Food Service Checklist, Building & Grounds
Maintenance Checklist, Ventilation Checklist,
I Block possible entry points for rodents
Walkthrough Checklist
and other pests.
Do not rely on widespread, indiscriminate
use of pesticides to control pests:
I Try using poison baits, boric acid, or
traps before using pesticide sprays.
I Track cockroach populations by using
small sticky traps or monitoring traps
that contain no pesticide.
I Rather than using bait, trap rats
and mice.
I Use pesticide sprays in classrooms
only as a last resort.
8 Environmental Asthma Triggers
Clean Up Mold and Control Moisture
Molds can be found almost anywhere; Common Moisture Sources Found in Schools
they can grow on virtually any substance
Moisture problems in school buildings
if moiture is present. Outdoors, many
can be caused by a variety of problems,
molds live in the soil and play a key role
including roof and plumbing leaks,
in the breakdown of leaves, wood, and
condensation, and excess humidity.
other plant debris. Without molds we
Some moisture problems in schools
would be struggling with large amounts
have been linked to changes in building
of dead plant matter.
construction practices during the past
twenty to thirty years. These changes
Molds produce tiny spores to
have resulted in more tightly sealed
reproduce. Mold spores travel through
buildings that may not allow moisture to
the indoor and outdoor air continually.
escape easily. Moisture problems in
When mold spores land on a damp spot
schools are also associated with
indoors, they may begin digesting
delayed or insufficient maintenance due
whatever they are growing on to survive.
to budget constraints. Temporary
There are molds that can grow on wood,
structures in schools, such as trailers
paper, carpet, and foods. If excessive
and portable classrooms, have
moisture or water accumulates indoors,
frequently been associated with
mold growth may occur, particularly if
moisture and mold problems.
the moisture problem remains
undiscovered or unaddressed. There is
Suggestions for Reducing Mold
no practical way to eliminate all mold
and mold spores in the indoor Growth in Schools
environment; the way to control indoor
Reduce Indoor Humidity:
mold growth is to control moisture. If
I Provide adequate ventilation to
mold is a problem in your school, you
maintain indoor humidity levels
must clean up the mold and eliminate
between 30-60%.
sources of moisture.
I Control humidity levels and dampness
When mold growth occurs in buildings,
by using air conditioners and
it may be followed by reports of health
dehumidifiers.
symptoms from some building
occupants, particularly those with I Use exhaust fans whenever cooking,
allergies or respiratory problems. dishwashing, and cleaning in food
Potential health effects and symptoms service areas.
associated with mold exposures include
I Vent showers and other moisture-
allergic reactions, asthma, and other
generating sources to the outside.
respiratory complaints.
9
Environmental Asthma Triggers
Inspect the building for signs of
mold, moisture, leaks, or spills:
I Check for moldy odors.
Prevent moisture condensation:
I Look for water stains or discoloration
on the ceiling, walls, floors, and I Reduce the potential for condensation
window sills. on cold surfaces (i.e., windows, piping,
exterior walls, roof, or floors) by
I Look around and under sinks for
adding insulation.
standing water, water stains, or mold.
Floor and carpet cleaning:
I Inspect bathrooms for standing water,
I Remove spots and stains immediately,
water stains, or mold.
using the flooring manufacturer鈥檚
I Do not let water stand in air recommended techniques. Use care
conditioning or refrigerator drip pans. to prevent excess moisture or cleaning
residue accumulation and ensure that
Respond promptly when you see signs of
cleaned areas are dried quickly.
moisture and/or mold, or when leaks or
spills occur:
I Avoid installing carpeting in areas
I Clean and dry any damp or wet where there is a perpetual moisture
building materials and furnishings problem (i.e., by drinking fountains, by
within 24-48 hours of occurrence to classroom sinks, or on concrete floors
prevent mold growth. with leaks or frequent condensation).
I Fix the source of the water problem or These action items are included on the
leak to prevent mold growth. following checklists found in the IAQ Tools
for Schools Kit:
I Clean mold off hard surfaces with
water and detergent, and dry Ventilation Checklist, Building & Grounds
completely. Absorbent materials such Maintenance Checklist, Administrative Staff
as ceiling tiles, that are moldy, may Checklist,Teachers Checklist, Food Service
need to be replaced. Checklist, Renovation and Repair Checklist,
Walkthrough Checklist.
I Check the mechanical room and
roof for unsanitary conditions, leaks, or
spills.
10 Environmental Asthma Triggers
Eliminate Secondhand Smoke Exposure
Secondhand smoke can originate from Common Sources Found in Schools
burning cigarettes, pipes, or cigars or
The majority of schools in the United
exhaled smoke. Secondhand smoke
States prohibit smoking on school
exposure causes a number of serious
grounds. However, oftentimes smoking
health effects in young children, such as
occurs in school bathrooms, lounges,
coughing and wheezing, bronchitis and
and on school grounds, especially near
pneumonia, ear infections, reduced lung
entrances. This may cause problems for
function, and worsened asthma attacks.
students and staff who have asthma.
Secondhand smoke is an irritant that
may trigger an asthma episode, and
It is important to enforce smoking bans
evidence suggests that secondhand
on school grounds in order to prevent
smoke may cause asthma in children.
exposure to secondhand smoke. If
EPA estimates that exposure to
smoking occurs within the building,
secondhand smoke exacerbates
secondhand smoke can travel through
asthma symptoms in 200,000 to
the ventilation system to the entire
1,000,000 children. Secondhand smoke
school. Even when people smoke
can also lead to buildup of fluid in the
outside, secondhand smoke may enter
middle ear, the most common cause of
the school through the ventilation
children being hospitalized for an
system, open windows, and doors.
operation.
Suggestion for Reducing Exposure in Schools
I Develop no smoking policies on
school grounds.
I Enforce smoking bans on school
property.
I Educate staff and students on the
effects of secondhand smoke.
I Learn more about EPA鈥檚 Smoke-
free Homes Program at
www.epa.gov/smokefree
These action items are included on the
Health Officer/School Nurse Checklist,
available in the IAQ Tools for Schools Kit.
11
Environmental Asthma Triggers
Reduce Exposure to Dust Mites
Dust mite allergens play a significant Suggestions for Reducing
role in triggering asthma. They may Exposure in Schools
cause an allergic reaction or trigger an
I Choose washable stuffed toys; wash
asthma episode in sensitive individuals.
them often in hot water.
In addition, there is evidence that dust
mites cause new cases of asthma in I Cover pillows in dust-proof (allergen-
susceptible children. impermeable), zipped covers.
I Remove dust from hard surfaces often
Dust mites are too small to be seen but
with a damp cloth, and vacuum
are found in homes, schools, and other
carpeting and fabric-covered furniture
buildings throughout the United States.
to reduce dust buildup. Allergic people
Their food source is dead skin flakes.
should leave the area being
vacuumed. Vacuums with high
Common Sources Found in Schools efficiency filters or central vacuums
Dust mites may be found in schools in may be helpful.
carpeting, upholstered furniture, stuffed
I Maintain clean classrooms.
animals or toys, and pillows. Stuffed
animals or toys, as well as pillows for
Refer to the Teachers and Building &
taking naps, are used mostly in the
Grounds Maintenance Checklists, available
primary grades. It is important to keep
in the IAQ Tools for Schools Kit.
classrooms free of clutter, to dust
regularly, and to wash items frequently
that attract dust.
12 Environmental Asthma Triggers
Asthma Management and Education
Experts convened by the National The asthma action card should contain
Asthma Education and Prevention the student鈥檚 medical information,
Program (NAEPP) and coordinated by identified asthma triggers, emergency
the National Institutes of Health (NIH) procedures, and phone numbers. This
have reviewed the scientific literature action card should be signed by a
and produced guidelines that define the physician and parent or care-giver and
best diagnosis and management kept on file at school. The Asthma and
practices for asthma. These guidelines Allergy Foundation of America鈥檚 (AAFA)
include recommendations for medical asthma action card is provided in this
diagnosis and treatment, including the publication. AAFA encourages
use of inhalation therapy and specific duplication and distribution of the
recommendations for controlling indoor asthma action card in the school setting.
environmental factors that contribute to
asthma severity.
Provide School-Based Asthma
Education Programs
Asthma Management
Develop an Asthma Management
The school setting provides an
and Education
Plan in Your School opportunity for directly educating
Schools can play an important role in children, parents, care-givers, teachers,
helping students manage their asthma and other school staff about asthma
by providing support through the management and indoor environmental
development of an asthma management triggers. An example of a school-based
plan. Each school should develop an asthma education program is the
overall asthma management plan that
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 management plan for
each student with asthma. The action
card also provides pertinent information
to school officials on each student鈥檚
asthma condition.
13
Asthma Management and Education
American Lung Association鈥檚 (ALA) Children enrolled in this program
Open Airways For Schools. This have demonstrated: increased school
elementary school-based program performance; more confidence in their
empowers children and their parents by ability to manage asthma; greater
teaching them to take control of asthma. influence on their parents鈥? asthma
management decisions; fewer episodes
Through ALA鈥檚 Open Airways For of asthma, as well as episodes of
Schools program, children learn specific shorter duration; and more active
steps they can take to manage asthma. management of their asthma. The
Specifically, they learn to prevent program is approved and recommended
asthma episodes by reducing their by the National Association of
exposure to environmental asthma School Nurses.
triggers and using their asthma
medication correctly. Children also learn Although asthma affects children of
what to do when asthma symptoms all backgrounds, minority groups are
develop, how to use medications disproportionately affected. To reach
correctly, and when to seek help children from all backgrounds, artwork
from adults. in the curriculum was designed with a
distinctive multi-cultural appeal with
Designed for eight to 11-year old specially designed cartoon illustrations
children with asthma, this curriculum of children in urban, rural, and suburban
consists of six lessons and is designed settings. To reach an even broader
to be easy for trained volunteers or audience, ALA鈥檚 Open Airways For
school staff to present. Generally held Schools is now available in English
during the school day, each lesson and Spanish.
takes about 40 minutes and is flexible
For more information about the American
enough to fit any school鈥檚 schedule. The
Lung Association鈥檚 Open Airways For
program鈥檚 hands-on teaching approach
Schools program, contact your local Lung
utilizes group discussion, stories,
Association at 1-800-LUNG-USA (1-800-
games, and role-playing to promote
586-4872) or visit the ALA Web site
children鈥檚 active involvement in the
(http://www.lungusa.org.)
learning process.
14 Asthma Management and Education
Reviewed by
Asthma Action Card Asthma and Allergy
Foundation of America
National Asthma Education and
Prevention Program
Name: __________________________________________ Grade: ________Age: ________________
Homeroom Teacher: ______________________________ Room: ______________________________
Parent/Guardian Name: ______________________________________Ph: (H) ____________________
Address: __________________________________________________Ph: (W) ____________________
Parent/Guardian Name: ______________________________________Ph: (H) ____________________
Address: __________________________________________________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 ______________________
Asthma Action Card
Hard time breathing with:
鈥? Chest and neck pulled in with breathing
鈥? Stooped body posture
ID Photo
鈥? Struggling or gasping
Trouble walking or talking
Stops playing and can鈥檛 start activity again
Lips or fingernails are grey or blue
Emergency Asthma Medications
Name Amount When to Use
1. ____________________________________________________________________________________
2. ____________________________________________________________________________________
3. ____________________________________________________________________________________
4. ____________________________________________________________________________________
15
Asthma Action Card
Daily Asthma Management Plan
(Identify the things which start an asthma episode. Check each that applies to the student.)
J Exercise J Strong odors or fumes J Other ______________________
J Respiratory infections J Chalk dust /dust J Change in temperature
J Carpets in the room J Animals J Pollens
J Food _______________________ J 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
J I have instructed ________________________________ in the proper way to use his/her medications.
It is my professional opinion that ________________________________ should be allowed to carry and
use that medication by him/herself.
J It is my professional opinion that ________________________________ should not carry his/her inhaled
medication by him/herself.
Physician Signature Date
Parent/Guardian Signature Date
AAFA 鈥? 1233 20th Street, N.W., Suite 402 , Washington, DC 20036 鈥? www.aafa.org 鈥? 1-800-7-ASTHMA
16 Asthma Action Card
Additional Resources
For more information on asthma contact:
U.S. Environmental Protection Agency Asthma and Allergy Foundation of America
www.epa.gov/iaq/schools (800) 7-ASTHMA
Download the IAQ Tools for Schools Kit www.aafa.org
from EPA鈥檚 Web site. Ask about AAFA鈥檚 Asthma Management
at School presentation for parents and
www.epa.gov/asthma
school personnel. Also available are
Find more asthma resources on EPA鈥檚
additional school-based child and teen
Web site.
education materials.
www.epa.gov/cleanschoolbus
Learn about EPA鈥檚 clean school bus
Center for Disease Control and Prevention
initiative on EPA鈥檚 Web site.
(888) 232-6789
U.S. EPA Indoor Air Quality Information www.cdc.gov/asthma
Find out more information on the
Clearinghouse (IAQ INFO)
Asthma Prevention Program by visiting
(800) 438-4318 this Web site.
(703) 356-5386 Fax
Call to request the IAQ Tools for Schools 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 and the Asthma-
Friendly Schools Toolkit.
Additional Resources
17
Additional Resources
Integrated Pest Management
Names, phone numbers, and e-mail addresses are
in Schools Web site
provided for informational purposes only. EPA
schoolipm.ifas.ufl.edu does not endorse products, services, or general policies
Find out more IPM information by of any organization. The organizations mentioned in this
visiting this Web site. publication are not the only sources of information on
asthma in schools. Additional information may be
National Association of School Nurses obtained from your physician or other health care
provider, insurance carrier, school system, or state or
(207) 883-2117
local public health agency as appropriate.
www.nasn.org
Ask about obtaining Asthma Modules to
present to school staff.
National Asthma Education and
Prevention Program
(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 this Web site for IAQ in
schools information.
18 Additional Resources
EPA REGIONAL OFFICES
US EPA/Region 1 (CAP) US EPA/Region 6 (6PD-T)
(CT, ME, MA, NH, RI, VT) (AR, LA, NM, OK, TX)
1 Congress Street 1445 Ross Avenue, Suite 1200
Suite 1100 Dallas, TX 75202-2733
Boston, MA 02114-2023 (214) 665-7547
(617) 918-1639 (214) 665-6762 fax
(617) 918-1505 fax
US EPA/Region 7 (ARTD/RALI)
US EPA/Region 2 (R2DEPDIV) (IA, KS, MO, NE)
(NJ, NY, PR, VI)
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290 Broadway Kansas City, KS 66101
28th Floor (913) 551-7020
New York, NY 10007-1866 (913) 551-7065 fax
(212) 637-4013
(212) 637-4942 fax
US EPA/Region 8 (8P-AR)
(CO, MT, ND, SD, UT, WY)
US EPA/Region 3 (3PM52)
999 18th Street
(DC, DE, MD, PA, VA, WV)
Suite 300
1650 Arch Street Denver, CO 80202-2466
Philadelphia, PA 19103-2029 (303) 312-6031
(215) 814-2086 (303) 312-6044 fax
(215) 814-2101 fax
US EPA/Region 9 (Air-6)
US EPA/Region 4
(AZ, CA, HI, NV, AS, GU)
(AL, FL, GA, KY, MS, NC, SC, TN)
75 Hawthorn Street
61 Forsyth Street, SW
San Francisco, CA 94105
Atlanta, GA 30303-3104
(415) 947-4192
(404) 562-9143
(415) 947-3583 fax
(404) 562-9095 fax
US EPA/Region 10 (OAQ-107)
US EPA/Region 5 (AE-17J) (AK, ID, OR, WA)
(IL, IN, MI, MN, OH, WI)
1200 Sixth Avenue
77 West Jackson Boulevard Seattle, WA 98101-9797
Chicago, IL 60604-3590 (206) 553-4273
(312) 353-6053 (206) 553-0110 fax
(312) 886-0617 fax
19
Additional Resources
Remember...
10 Ways to
Manage Asthma in
the School Environment
1. Use the IAQ Tools for Schools Kit
2. Control Animal Allergens
3. Control Cockroach Allergens
4. Clean Up Mold and Control Moisture
5. Eliminate Secondhand Smoke Exposure
6. Reduce Dust Mite Exposure
7. Develop an Asthma Management
Plan in Your School
8. Provide School-Based
Asthma Education Programs
9. File Student Asthma Action Cards
10. Gather Additional Asthma
Information and Resources
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