Background Asthma is a chronic disease of the airways that causes recurrent and distressing episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Exacerbations can be triggered by exposure to allergens or irritants, respiratory infections and exercise. The environment, both indoor and outdoor, plays an important role in the exacerbation of asthma symptoms in people who already have asthma. One in 14 Minnesota children (an estimated 85,000) currently have asthma. 1 Among Minnesota children with asthma, more than half had an asthma attack in the past year. 2 Children in the U.S. miss about 14 million school days each year due to asthma. 3 While exposure to allergens and irritants found inside of schools can trigger asthma symptoms in sensitive individuals, the U.S. Environmental Protection Agency (EPA) emphasizes these five: Animals Dust mites Mold/moisture Pests Secondhand smoke Minnesota School Walkthroughs The Minnesota Department of Health (MDH) Asthma Program has developed a school asthma walkthough checklist that focuses on low to no cost solutions for addressing environmental asthma triggers. MDH staff has conducted 32 walkthroughs in urban and rural school buildings, and in a variety of K-12 classrooms. The most common problems seen in the school environmental asthma walkthroughs can be grouped into two categories. Common Building Related Problems Carpet next to moisture sources such as sinks, drinking fountains & water coolers Ceiling stains: evidence of moisture problem Entrances without walk-off mats No school bus idling policy Common pests: ants, mice, silverfish Reduction in custodial staff Common Occupant Related Problems Plants: too many; no water trays; over watering; dead leaves/plants/insect infestations Refrigerators on carpet Personal appliances such as microwave oven or coffee makers placed on or near carpet Upholstered furniture brought from homes of staff Consumer products such as air fresheners (plug-in, solid, spray can) and cleaning products Animals in classroom: seen more frequently in elementary grade classrooms 1
Sample School Walkthrough Report Excessive clutter: seen more frequently in elementary grade classrooms MDH Recommendations The MDH recommendations for addressing these problems are: Building Related Problems and Recommendations Carpet near sinks o Recommendation: As carpet is replaced, place hard flooring around the sink area and other sources of water Ceiling stains o Recommendation: Replace tiles; look for source of the moisture Walk-off mats o Recommendation: All entrances need walk-off mats Pests / bus idling o Recommendation: Develop and implement integrated pest management & no bus idling policies o Recommendation: Remind staff about Integrated Pest Management policy including the following steps Clean dirty dishes before leaving school for the day Promptly clean up food spills Clean the inside of appliances such as microwave ovens and popcorn poppers after each use Place covers on food storage containers Store food and cooking ingredients in plastic containers Occupant Related Problems and Recommendations Plants o Recommendation: limit number of plants, require watering trays and encourage regular maintenance (such as discarding dead leaves) of plants Small refrigerators (on carpet) o Recommendation: Prohibit personal refrigerators or require an impervious surface such as rubber tray Upholstered furniture / stuffed toys o Recommendation: District-purchased items only or suggest small items that are washable in hot water o Wash items in hot water on a regular basis Consumer products from home o Remove products that emit strong odors or particles o Encourage the use of environmentally preferable cleaning products ( green products) Animals in classrooms o Recommendation: Remove animals from school, if possible; if not, keep animals in cages or localized areas and away from upholstered furniture and carpets Clutter (dust collector) o Recommendation: Remind staff that papers & general clutter is difficult to clean, collects dust and can worsen existing breathing problems such as asthma 2
On (insert date), Laura Oatman accompanied (insert walkthrough participants names and titles) on a walkthrough of (insert school name). The school district has an Indoor Air Quality Management Plan and all of the buildings were well maintained. The building specific observations and recommendations are provided on pages (insert page numbers). For additional information contact: Laura Oatman P.O. Box 64882 St. Paul, MN 55164-0882 651-201-5914 laura.oatman@state.mn.us The school walkthrough checklists and sample walkthrough report are available at http://www.health.state.mn.us/asthma/schools.html References 1. Minnesota Behavioral Risk Factor Surveillance System, 2006 2. National Survey of Children s Health, 2003 http://nschdata.org/content/default.aspx 3. Mannino DM, Homa DM, Akinbami LJ, Moorman JE, Gwynn C, Redd S. Surveillance for Asthma-United States, 1980-1999. MMWR March 29, 2002; 51 (No.SS-1):1-13. 3
School (insert school name) Address (insert address) Date (insert date of walkthrough) Participants (insert names of walkthrough participants) General Observations Plants o A few classrooms had too many plants (proper maintenance is difficult) o Water trays were not always used (excess water can drip on carpet causing mold growth) o A few plants had standing water in the water tray (promotes growth of biological agents) o Insect infestations were observed on several plants o Dead leaves (mold and cleaning issues) Carpet is located near water sources such as sinks (mold growth occurs if carpet becomes wet) Upholstered furniture and pillows were seen in classrooms (can be a source of dust mites) Excess clutter was noticed in a few classrooms (excess clutter can be a dust collector and is difficult to clean) and dust was observed on light fixtures & window blinds Personal appliances such as small refrigerators were seen in several classrooms; the appliances were placed directly on carpeting Air fresheners were found in several classrooms; the odors & particles released by these products could trigger an asthma episode in sensitive students and staff. Stained ceiling tiles were observed in 15 rooms The ventilation system was partially blocked in a few classrooms (limits air circulation) Evidence of pests (droppings) were observed in two classrooms and teachers lounge, and open containers of food were seen in a few rooms Recommendations Plants o Recommendation: limit number of plants, require watering trays and encourage regular maintenance (such as tossing dead leaves) of plants Carpet near sinks o Recommendation: when carpet is replaced, use hard flooring around the sink area Upholstered furniture / stuffed toys o Recommendation: District-purchased items only or suggest small items that are washable in hot water o Wash small items in hot water on a regular basis Clutter (dust collector) and dust on fixtures o Recommendation: Remind staff that papers & general clutter is difficult to clean, collects dust and can worsen existing breathing problems such as asthma o Light fixtures and other surfaces should be cleaned (dusted) at least once a year 4
Personal appliances such as refrigerators, microwaves and coffee makers o Recommendation: Only allow district-purchased appliances or require the use of an impervious surface such as rubber tray under the appliance Consumer products such as cleaning agents, wipes and air fresheners o Recommendation: Remove consumer products that release strong odors or particles o Recommendation: Purchase environmentally preferable cleaning products ( green products) Stained ceiling tiles o Recommendation: Ask school staff to report problems to the appropriate person Blocked ventilation system o Recommendation: Remind staff that to maintain good air quality inside their classrooms, it is important that objects not be placed in front of ventilation system Mice and other pests o Recommendation: Clean up mouse droppings in the teachers lounge and classrooms o Recommendation: Remind staff about district s Integrated Pest Management policy including the following steps Clean dirty dishes before leaving school for the day Promptly clean up food spills Clean the inside of appliances such as microwave ovens and popcorn poppers after each use Place covers on food storage containers including cooking grease Store food and cooking ingredients in plastic containers 5