Childcare Facilities Indoor Air Quality and Childhood Asthma

Childcare Facilities, Indoor Air Quality and Childhood Asthma Things You Need to Know

Childcare Centers and Indoor Air Quality • Asthma is a chronic illness that is controllable. • Some asthma triggers, such as environmental triggers and indoor air pollutants are preventable. • Childcare facilities frequently have problems with indoor air quality because there a lot of people in a small space.

What is Asthma? • Asthma is a respiratory illness that makes breathing difficult because of the narrowing of the bronchial tubes causing lung tissues to swell, spasms in the surrounding bronchial tubes, and the accumulation of mucus in the air passage. • These occurrences are triggered by allergens and lead to symptoms of tightness in the chest, wheezing, coughing and difficulty in breathing.

Key Points for Indoor Environments • Children should: – Avoid exposure to environmental tobacco smoke and other respiratory irritants, including smoke from wood-burning stoves and fireplaces and, if possible, substances with strong odors. – Avoid outdoor activities when levels of air pollution are high. • High ozone days. • High pollen and mold days.

Key Points for Indoor Environments • Use of humidifiers and evaporative coolers is not generally recommended. – Children sensitive to house-dust mites or mold.

Key Points for Indoor Environments • Children who have asthma at any level of severity should: – Reduce exposure to triggers known to affect them. – Childcare providers must recognize that trigger avoidance requires a comprehensive approach to protect a child with asthma. • So…. . what is included in a Comprehensive Approach to Asthma Management?

What is a Global Asthma Intervention Program? EDUCATION MEDICATION ENVIRONMENT

Indoor Air Pollutants and Asthma • Exposure to indoor air pollutants is an important contributor to the onset of respiratory system illnesses. • Environmental triggers contained in indoor air play a key role in aggravating pediatric asthma.

Let’s Work On Some Important Discussion Items!

Air Pollutants Associated with Respiratory Health • Particulate Matter: – PM 10 – PM 2. 5 – PM 1. 0 • • Carbon monoxide Carbon dioxide Ozone Volatile organic chemicals

Particulates Ø A complex mixture of extremely small particles and liquid droplets. Ø The size of particles is may be linked to their potential for causing health problems. Sources: ØChemicals ØFields ØSmokestacks/fires ØAutomobiles ØSOx ØNOx

Indoor Environmental Asthma Triggers • • Dust Mites Pet Dander ETS Mold/Fungi Cockroaches Combustion Residues Bacterial toxins

Dust Mites • Triggers: • Body Parts and droppings. • Where found: – Highest levels in mattresses and bedding. Also in carpeting, draperies, upholstered furniture, clothes and stuffed toys.

Cockroaches and Rodents • Triggers: – Cockroaches: Body parts, secretions and droppings. – Rodents: Hair, skin flakes, urine and saliva. • Where found: – Areas with available food and water (kitchens, bathrooms and basements).

Warm-Blooded Pets • Triggers: – Cat and dog skin flakes, urine and saliva. • Where found: – Entire house if allowed inside. – Also found in homes that do not have pets.

Mold • Triggers: – Mold and mold spores on damp or wet surfaces. – Fungal glucans, mycotoxins. • Where found: – Throughout the homes, especially in areas that are damp and temperate.

Environmental Tobacco Smoke • Trigger: – Children of all ages who live in homes with smokers are 63% more likely to have asthma. – Children of teenage mothers have a three fold to five-fold increased risk of developing childhood asthma. • Where found: – Cars or homes where allowed.

Other Sources of Irritants/Triggers Ø Aerosol products Ø Air fresheners Ø Building materials and home furnishings Ø Carpet/padding (new) Ø Cleaning agents Ø Detergent Ø Hair products Ø Moth repellents Ø Pesticides Ø Potpourri Ø Chalk dust

How Can We Make the Indoor Conditions Better?

Control Measures • Dust Mites: Recommended Actions – Cover all sleeping surfaces (pillows, mattresses and box springs) with an allergen-impermeable cover. – Wash all bedding weekly, including pillows, in hot water (130 o. F) for destroying mites. – Dry bedding at >130 o. F for 10 minutes to destroy mites.

Control Measures • Dust Mites: – Reduce indoor humidity to less than 60%, ideally between 30 -50%. – Remove carpets from the bedroom. – Avoid sleeping or lying on upholstered furniture. – Change air conditioner filter every month or keep filter clean. – Wash stuffed animals weekly at 130 o. F and dry for 10 minutes > 130 o. F.

Control Measures • Pests (Cockroaches/Rodents): – Maintain clean areas and limiting food consumption to only one area. – Caulk holes in walls, cupboards and cabinets. – Store food in closed containers. – Wash dishes promptly. – Keep flat surfaces clean and clear of clutter. – Dispose of garbage and food waste promptly. – Use poison baits or traps rather than insecticides or rodenticides to control pests. – Vacuuming and cleaning.

Control Measures • Animal Allergens/Dander: – Remove the animal from the home. – Keep pet out of patient’s bedroom, but keep outside is ideal. – Keep patient’s bedroom door closed. – Remove upholstered furniture and carpets from the home, or isolate the pet from these items to the extent possible. – Seal or put a filter on air ducts that lead to the bedroom. – Bathe animals regularly.

Control Measures • Molds: – Repair all water leaks and eliminate water sources associated with mold growth. – Clean all moldy surfaces. – Maintain relative humidity levels between 30 -50%. – Have air conditioner inspected yearly and keep coils inside the unit clean. – Ceiling tiles and carpets are difficult to clean once mold is growing on them.

Control Measures • Pollens and Outdoor Molds: – Stay indoors, if possible, during peak pollen times- particularly midday and afternoon. – Keep windows closed during allergy season(s). – Use air conditioners and keep filters clean. • Reduces indoor humidity.

Control Measures • Environmental Tobacco Smoke: – Stop smoking or do not become exposed to tobacco smoke if you have asthma. – No smoking in the house or car. – Other smoke sources: • Fireplaces • Heaters – Avoid exposure to gas stoves and appliances that are not vented to the outside, fumes from wood-burning appliances or fireplaces, sprays, or strong odors.

A Childcare Facility Response to Asthma: INDOOR AIR QUALITY INTERVENTIONS Ø Improving environmental living conditions. Ø Improve living conditions by improving behaviors (i. e. no smoking in the home). Ø “Evidence suggests that poor indoor air quality may be a more likely trigger of childhood asthma than outdoor pollution, ” said Dr. Ian Greaves, environmental medical specialist and consultant to the American Lung Association Health House program. Ø A healthy indoor environment lets us all live healthier lives.

Questions? Thank you for your participation!