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Air Pollution, Asthma, Triggers & Health - Research and Remediation Strategies
 

Air Pollution, Asthma, Triggers & Health - Research and Remediation Strategies

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This content was created to help provide health care practitioners with more detailed information about air pollution, it's impact on health, and low-no-cost strategies for reducing exposure to asthma ...

This content was created to help provide health care practitioners with more detailed information about air pollution, it's impact on health, and low-no-cost strategies for reducing exposure to asthma triggers.

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  • -Introduce Clean Air Council and program areas -Introduce self/presenter -Describe how CAC approaches health and environmental issues from many angles (through various programs, advocacy, legislature, public health, community-level, and that this program takes yet another approach to improving health [through clinician education])
  • Program areas: indoor & outdoor air pollution, (clean air act, ports), transportation (public transit, trails, etc), energy, tobacco, climate change, public health and CEH, waste & recycling.
  • -Environmental assessments, respiratory triggers, and mitigation strategies are often missing from nursing and medical school education. -Not all patients receive comprehensive asthma education. Solution: 1)Provide information during brief clinical visits through care provider-patient communication. (Clinicians must be well versed in the types of air pollution and how to reduce exposure). 2)Clinicians must be able to offer materials on low-no cost mitigation strategies available to patient that they can use in their home
  • -Environmental assessments, respiratory triggers, and mitigation strategies are often missing from nursing and medical school education. -Not all patients receive comprehensive asthma education. Solution: 1)Provide information during brief clinical visits through care provider-patient communication. (Clinicians must be well versed in the types of air pollution and how to reduce exposure). 2)Clinicians must be able to offer materials on low-no cost mitigation strategies available to patient that they can use in their home
  • -Environmental assessments, respiratory triggers, and mitigation strategies are often missing from nursing and medical school education. -Not all patients receive comprehensive asthma education. Solution: 1)Provide information during brief clinical visits through care provider-patient communication. (Clinicians must be well versed in the types of air pollution and how to reduce exposure). 2)Clinicians must be able to offer materials on low-no cost mitigation strategies available to patient that they can use in their home
  • -Environmental assessments, respiratory triggers, and mitigation strategies are often missing from nursing and medical school education. -Not all patients receive comprehensive asthma education. Solution: 1)Provide information during brief clinical visits through care provider-patient communication. (Clinicians must be well versed in the types of air pollution and how to reduce exposure). 2)Clinicians must be able to offer materials on low-no cost mitigation strategies available to patient that they can use in their home
  • -Besides the EPA Criteria Pollutants -Small chunk of huge list.
  • Dendritic cells promote Th2 immune responses lead smelters; waste incinerators; utilities; lead-acid battery, plastics, rubber, manufacturing, dust (containing lead paint fragments).
  • PM 2.5 has been proven to be particiulary (no pun intended) dangerous becuase it is so small it is not filtered by the lungs and pollution that size can directly enter the bloodstream. PM 10 is larger and the particles are actually trapped in the lungs.
  • O2 is the normal oxygen we breath. Will discuss how O3 affects health later
  • Map of ozone concentrations.
  • MSR = metropolitan statistical region (common system for national statistics) U.S. Steel Clairton Plant is located approximately 20 miles south of Pittsburgh. In addition to our own state’s 38 coal-fired plants, Pennsylvanian’s are down-wind of dozens of coal-fired plants in Ohio and West Virginia.
  • Ranking takes into account all of those factors
  • -these are conservative rates. Some neighborhoods as high as 36% Average asthma hospitalization cost $20,483.
  • -Here it’s good to comment about how we always hear about how air pollution is bad for our health but where is the proof and why exactly is it bad? -The following section touches on some of the research of how air pollution is associated with negative outcomes and has a negative impact on physiology.
  • Physiology As a result of short-term exposure, ozone causes injury to lung tissue cells followed by a cascade of other effects. These effects can be measured by a technique known as bronchoalveolar lavage (BAL), in which samples of fluid from lung cells are collected during bronchoscopy on volunteers experimentally exposed to ozone. Cells and biochemical markers in the lavage fluid can be analyzed to provide insight into the effects of exposure. Cellular injury is suggested by an increase in the concentration of lactate dehydrogenase (LDH), an enzyme released from injured lung cells,
  • FEV1 is the maximal amount of air you can forcefully exhale in one second. It is then converted to a percentage of normal. For example, your FEV1 may be 80% of predicted based on your height, weight, and race. FEV1 is a marker for the degree of obstruction with your asthma: FEV1 greater 80% of predicted= normal FEV1 60% to 79% of predicted = Mild obstruction FEV1 40% to 59% of predicted = Moderate obstruction FEV1 less than 40% of predicted = Severe obstruction
  • Physiology bronchoalveolar lavage (BAL),
  • Physiology
  • the annual direct medical expenditure attributable to asthma treatment is estimated at approximately $37.2 billion in 2007 U.S. dollars representing a significant portion of healthcare resource use in the U.S. Incremental Direct Expenditure of Treating Asthma in the United States  (2009) Shital Kamblea; Murtuza Bharmalb The University of North Carolina at Charlotte, Charlotte, North Carolina, USAb Quintiles Inc., Falls Church, Virginia, USA
  • Physiology
  • Physiology
  • Physiology
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc) - Connect with parent’s of friends, school nurses, coaches, physical education teachers, etc.
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • Outdoor solutions revolve around avoiding exposure. (with one exception: advocacy/large scale reductions in air pollution via legistlation, etc)
  • *Some reports suggest that indoor air is as much as 5 times more polluted than outdoor air.
  • -Some of the most common
  • -Some of the most common
  • -Some of the most common
  • -Some of the most common
  • -Also have patients fill out trigger checklist prior to clinical visits, allows for a more pointed discussion.
  • -Environmental assessments, respiratory triggers, and mitigation strategies are often missing from nursing and medical school education. -Not all patients receive comprehensive asthma education. Solution: 1)Provide information during brief clinical visits through care provider-patient communication. (Clinicians must be well versed in the types of air pollution and how to reduce exposure). 2)Clinicians must be able to offer materials on low-no cost mitigation strategies available to patient that they can use in their home
  • Administer feedback forms

Air Pollution, Asthma, Triggers & Health - Research and Remediation Strategies Air Pollution, Asthma, Triggers & Health - Research and Remediation Strategies Presentation Transcript

  • AIR POLLUTION & HEALTH A Workshop for Health Professionals Clean Air Council
  • Clean Air Council is a member-supported, non-profit environmental organization dedicated to protecting everyone's right to breathe clean air. The Council works through public education, community advocacy, and government oversight to ensure enforcement of environmental laws. Mission:
  • Environmental EducationEducation Avoiding environmental allergens and irritants is one of the primary goals of good asthma management. (American Academy of Pediatrics 2003) CLEAN AIR COUNCIL www.cleanair.org Integrate environmental education into clinical visits. Not all patients receive this level of comprehensive care. Comprehensive asthma interventions include in-home trigger inventories and environmental education.
  • CLEAN AIR COUNCIL www.cleanair.org Clinical Barriers Clinicians may lack knowledge of environmental triggers. Clinicians may be unaware of mitigation strategies. Clinics lack information/resources valuable to patients. Families leave without knowledge of triggers, how to reduce exposure or where to turn if they have questions. Time limitations.
  • CLEAN AIR COUNCIL www.cleanair.org Improve understanding of health issues associated with air pollution. Increase knowledge of mitigation strategies. Provide useful materials and resources. More effective and efficient care providers. Increase understanding of types and sources of air pollution. Workshop Objectives
  • CLEAN AIR COUNCIL www.cleanair.org Increase ability to individualize treatment plans. Increase capacity for building patient-provider relationships. Enhance quality of care and increase patient capacity for disease self management. Improve ability to communicate with patients about environmental exposures. Workshop Objectives
  • What is Air Pollution? CLEAN AIR COUNCIL www.cleanair.org Any particle or gas that harms your health, the environment, or causes property damage. Lead (Pb) Carbon Monoxide (CO) Particulate Matter (PM) Nitrogen Oxides (NOx) Sulfur Dioxides (SO2) Ozone (O3) EPA Regulated Air Pollutants
  • What is Air Pollution?What is Air Pollution? CLEAN AIR COUNCIL www.cleanair.org There are 1000s of unregulated compounds, pollutants and irritants that are equally or more dangerous.
  • Lead: A Toxic Metal CLEAN AIR COUNCIL www.cleanair.org * Gao, Modal & Lawrence, (2007) Lead effects on development and function of bone marrow-derived dendritic cells. Lead exposure can cause:  Brain damage  Nervous system disorders  Reproductive disorders  Kidney damage  Gastrointestinal distress  Low birth weight  Slowed neurological and behavioral development  Intensified allergic reactions *  Disruption in the development of certain immune system cells * Sources: Industrial processing. manufacturing, dust. 95% of lead that is inhaled is absorbed into the body.
  • Carbon Monoxide CLEAN AIR COUNCIL www.cleanair.org Colorless, odorless, tasteless gas. Common sources: Vehicles, cigarette smoke, furnaces, stoves, gas or oil burning space heaters, etc. Formed when fuel is not completely burned. Attaches to hemoglobin, reducing the amount of oxygen carried in bloodstream. Dangerous to everyone, especially those with asthma.
  • Created by fuel combustion. Nitrous Oxides CLEAN AIR COUNCIL www.cleanair.org Highly reactive, chemistry is driven by sunshine, and temperature and depends on surrounding substances.
  • Created when fuel containing sulfur (ex. coal, oil) is burned. Sulfur Dioxides CLEAN AIR COUNCIL www.cleanair.org Reacts in air to form sulfate, a form of particulate matter.
  • Particulate Matter (PM) CLEAN AIR COUNCIL www.cleanair.org Mixture of solid particles and liquid droplets (acids, organic chemicals, metals, dust, soil.) Common sources of toxic PM: Fuel-burning engines, industry (i.e. power plants, incinerators), wood burning, cigarettes. PM 10: Airborne particles larger than 2.5 mm but smaller than 10 mm. PM 2.5: Fine airborne particles that are < 2.5 micrometers in diameter. Health threat is proportionate to size and composition.
  • Ozone (O3) CLEAN AIR COUNCIL www.cleanair.org NOx + Sunshine/Heat + VOCs Ozone “Good up high, bad nearby”
  • Ozone (O3) CLEAN AIR COUNCIL www.cleanair.org
  • Top 25 Most Ozone-Polluted Cities #16 Philadelphia (vs. 567 metropolitan statistical regions) 2009 “State of the Air” Report www.stateoftheair.org Air Pollution in PA CLEAN AIR COUNCIL www.cleanair.org Top 25 Cities with Worst Long-term PM #2 Pittsburgh/ New Castle, Pa. #20 York/Hanover/Gettysburg, PA #21 Lancaster, PA Top 25 Counties with the Worst Short-Term PM #1 Allegheny County (Pittsburgh) #21 Washington County (Pittsburgh metro area) #24 Philadelphia County
  • #1 Richmond, VA #8 Philadelphia (#12 2009) #14 Allentown #15 Scranton #19 Pittsburgh Most difficult places to live with asthma (out of 100 most-populated U.S. metro areas). -Asthma prevalence. -Death rate for asthma. -Annual pollen score. -Air quality. -Number of asthma specialists. -100% public smoke-free law. -Poverty rate. -Uninsured rate. -Use of rescue meds. -Use of controller meds. Asthma in PA CLEAN AIR COUNCIL www.cleanair.org 2010 Asthma & Allergy Foundation of America (AAFA) Annual “Asthma Capitals” Report
  • • 11% of Children (312,000) (9.4% nationally) • 8% of Adults (863,000) (7.3% nationally) • 15% of Children in Philadelphia • 40% of Children in the most burdened communities. -2007 PA Behavioral Risk Factor Surveillance System (PA BRFSS) -Pennsylvania Health Care Cost Containment Council (PA PHC4) -Bureau of Community Health Systems, Division of School Health -Department of Public Welfare, Commonwealth of Pennsylvania -CDC 2010 Data Sources: Asthma in PA CLEAN AIR COUNCIL www.cleanair.org • Over 22,862 in-patient hospitalizations were due to asthma. • Cost approx. $468,270,000 (not including physician charges). •Use of emergency services by children with asthma in Western Pennsylvania is 300 to 400 times the national average. Cost of Asthma in PA (2007)
  • Air Pollution Research CLEAN AIR COUNCIL www.cleanair.org Assumption: Air pollution has a negative impact on our health. What is the evidence? How does air pollution affect asthma related outcomes?
  • Devlin et al. (1997) • Exposed healthy individuals to ozone (in lab). BAL results: • Temporary increases in inflammation. • Long-term increases in lactate dehydrogenase (enzyme released from injured epithelial cell walls). * Variable and complex immune response. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Devlin et al. (1997) • 2 hours of exposure to typical concentrations of ozone. • 1 hour of heavy exercise during exposure. Results: • Least-responsive individuals may experience no symptoms or lung function changes. • Most-responsive individuals experienced up to a 50% decrease in FEV1 (lung function) and have severe coughing, shortness of breath, or pain on deep inspiration. * Response to ozone can vary greatly by individual. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Kerhl et al. (2009) • Pre and post-ozone exposure dust mite challenge. • 8-hour ozone challenge. BAL Results: • Increases in inflammation 24 hours post ozone exposure (in comparison to pre-exposure inflammation). *Ozone increases airway reactivity/intensity of allergic response. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Morishita et al. (2004) • Induced an allergic airway disease in a group of rats (oval- bumin exposure). • Exposed allergic and non-allergic to air from urban Detroit air (mobile lab). BAL Results: • Exposure to particulate matter induced inflammation (eosinophils, proteins) most in rats with the allergic disease. * Non-specific allergic response is triggered by particulates found in urban air. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Rossi et al. (1993) • Measured air pollution levels and emergency room visits in an industrial town (population 100,000). • 1 year = 232 emergency room visits for asthma. Results: • Significant correlation between air pollution levels and emergency room visits for asthma. * Air pollution linked to asthma exacerbations and health care usage. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Burnett et al. (1994) • Tracked air pollution levels, health care usage, and absenteeism. • 16 cities • 10 years • 720,519 asthma-related admissions. Results: • Days with higher ozone levels were associated with higher rates of absenteeism, and more visits to doctors, hospitals and emergency rooms. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Jerrett et al. (2009) • Paired air pollution data in 96 cities with cause of death data for almost 500,000 people (118,777). Results: • Significant increase in the risk of death from respiratory causes associated with increases in ozone concentration. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Gordon et al. (2000) (Review article) “Cardiovascular Toxicity of Inhaled Ambient Particulate Matter” • PM exposure increases: -Blood pressure -Heart rate -Heart rate variability -Changes in blood plasma and blood coagulation -Risk of heart attack, stroke, etc. Exposure Research CLEAN AIR COUNCIL www.cleanair.org
  • Most at risk? CLEAN AIR COUNCIL www.cleanair.org Individuals with existing health conditions. People engaging in work or heavy exercise outdoors. Children Elderly
  • Outdoors • Urban environments (ie. industrial, manufacturing, transportation and goods movement-related activities, etc). • Neighborhood/community level (ie. motor traffic, autobody shops, dry- cleaners, nail salons, etc). • Rural environments (ie. pollen). Indoors • Home • Homes of friends, family, etc • School • Work Environmental Asthma Triggers CLEAN AIR COUNCIL www.cleanair.org
  • • Ozone • Particulate Matter • Industrial Processing (metal dust, toxic fumes, etc) • Vehicle exhaust • Road dust • Pollen • Mold spores • Cold weather • Auto-body practices (paint, engine work, etc) • Dry-cleaning emissions • Construction • Chlorine • BBQ/Grill • Fires, Burn barrels • Fireworks Outdoor Asthma Triggers & Sources CLEAN AIR COUNCIL www.cleanair.org
  • Reducing Exposure to Outdoor Asthma Triggers Tools for Minimizing Exposure: -Air Quality Data (pollution, weather, pollen) -Advocacy (patient, community, political) Reduce time spent outdoors on days with higher concentrations of air pollution & pollen. Reduce intensity and duration of outdoor activity during times that pollution is highest. CLEAN AIR COUNCIL www.cleanair.org
  • Reducing Exposure to Outdoor Asthma Triggers Seasons and weather conditions - Pollution is more severe in Summer. - High pollution days are typically sunny, hot, humid with light winds. - Winter “inversions” can trap pollution at ground-level. Time of day -In morning, the sun comes out, and temperature rises, creating the conditions in which ozone is formed. -Ozone levels increase throughout the day, peaking in the afternoon. -Plan activities for early in the day or late evening. CLEAN AIR COUNCIL www.cleanair.org
  • • 0 - 50: Good. Air quality poses little/no risk. • 51 - 100: Moderate. Some risk for unusually sensitive individuals. • 101 - 150: Unhealthy for sensitive groups. Sensitive groups include children, adults active outdoors, and lung disease patients. • 151 - 200: Unhealthy. Risk for anyone active outdoors. • 201- 300: Very Unhealthy. Risks for general population. • 301 – 500: Hazardous. Emergency conditions. http://airnow.gov www.cleanair.org Reducing Exposure to Outdoor Asthma Triggers • E-mail or text message notification. CLEAN AIR COUNCIL www.cleanair.org
  • Filing Air Pollution Complaints Air Management Services (AMS) City of Philadelphia Department of Public Health Call (215)685-7580 (or 311) • Dust • Odor • Noise • Idling • Smoke • Vibration CLEAN AIR COUNCIL www.cleanair.org -Time of day, duration -Wind direction -See, smell, taste -Irritation
  • Reducing Exposure to Outdoor Asthma Triggers Pollen.com -Create a pollen diary. -E-mail notifications. -Pollen-type specific. - Spend less time outdoors on day with high pollen counts. CLEAN AIR COUNCIL www.cleanair.org
  • Reducing Exposure Through Advocacy CLEAN AIR COUNCIL www.cleanair.org Encourage families to be advocates for their own health. Parents should make connections with other who have a stake in their child’s health. -Relatives -Parents of friends -School nurses -Physical education teachers -Coaches
  • Reducing Exposure Through Environmental Action • Use less-polluting forms of transportation. • Conserve energy. • Consider alternative energy sources. • Stay abreast of environmental news, contact legislators, submit letters to the editor, join advocacy organizations, attend environmental rallies. CLEAN AIR COUNCIL www.cleanair.org
  • Advocacy Solutions for Community-level Pollutants • Reduce vehicle emissions - IdleFreePhilly.org • Approach polluting businesses - Auto-body shops - Nail salons - Dry cleaners *Non or less toxic solutions may be available. CLEAN AIR COUNCIL www.cleanair.org
  • Indoor Air Pollution According to the EPA people spend nearly 90% of their time indoors. CLEAN AIR COUNCIL www.cleanair.org
  • Pets (furry or feathered) -Remove pet from home. -Brush/comb pet outside and more often. -Bath pet more often. -Wash hands after touching pet. -Vacuum and clean often areas where pets frequent. -Keep pet out of patient’s bedroom. -Have someone besides the patient clean litter boxes, or cages. Dust -Dust carries dust mites. Wipe surfaces with damp cloth. -Dust all surfaces more frequently and clean only when the patient is out of the room or house. Pests (mice, rats, insects) -Eliminate standing food and water. -Fill holes in walls and around fixtures with steel wool. -Integrated Pest Management for professional help. paipm.cas.psu.edu/ Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • Carpets and Rugs -Remove if possible. Wood flooring is easier to keep clean. -Use small area rugs that can be washed easily. -Use vacuums with HEPA bags and filters. Steam clean. -Vacuum when patient is out of the house Upholstered Furniture and Drapes -If possible, wash furniture covers and drapes. -Vacuum with HEPA bags and filters. -Steam cleaning can help eliminate the harmful effects of pet dander, dust and pollen. Bedding -Wash in hot water frequently. -Use dust mite/allergy proof covers for pillows and mattress. -Avoid feather stuffed products. Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • Stuffed Animals -Limit the number in the bedroom. -Wash more frequently, drying completely. Arts and Crafts Supplies (markers, paints, glue, etc) -Use non-toxic supplies. -Use with extra ventilation. -Keep well contained. Clutter, Stacks of Papers, Magazines, etc -They attract dust and create safe havens for insects and rodents. -Organize, store in boxes, etc. Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • Cooking -Cook with fans and vents running. -Keep patient out of room. Fragrance & Personal Care Products -Perfume, air fresheners, hair spray, nail polish, etc. -Discontinue use. -Use only away from patient. Cleaning Products (with Ammonium, Phthalates, etc). -Check ingredients. -Replace with cleaners that are made of organic ingredients such as plant derivatives and essential oils. -Keep patients out of room when using irritating products. Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • Tobacco Smoke -Help smoker quit (provide materials, support, meds, etc). 1-800-QuitNow www.quitnow.net -Have smoker smoke outside in a smoking jacket. Vehicles in Garage -Do not idle vehicles. -Keep garage door open to allow emissions to completely clear. Mold and Mildew -Clean with water and light bleach. -Remove and replace materials with mold. -If renting, exercise tenant rights to have mold removed. Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • Old Housing Stock -Replace crumbling materials. Contact the landlord for improvements. -May contain asbestos and formaldehyde which must be removed professionally. Humidifiers and De-humidifiers Use de-humidifiers to keep basements dry (avoid mold and mildew). Clean water basins frequently. Air purifiers, Ion and Ozone Generators -Clean filters as recommended. -Look into specific product information and owners manuals, some emit unsafe amounts of ozone. -Discontinue use, especially if the product is an old model. Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • Nitrogen dioxide – Comes from fuel and kerosene burning stoves, space heaters, etc. -Discontinue use. -Use ventilation that leads outside. Radon -A natural, radioactive, colorless, odorless gas -Increases risk of lung cancer. -More common in lower levels. -Enters homes through dirt floor, cracks in concrete walls and floor, floor drains, and sometimes well water. -Radon test kits are commercially available. Indoor Triggers & Solutions CLEAN AIR COUNCIL www.cleanair.org
  • • Discuss with patients how environmental triggers impact health, and how avoiding exposure is a crucial part of asthma management. • Environmental Checklists: Have patient fill out at home. Use during visit. • Discuss environmental issues specific to the patient. • Provide environmental resources with other materials given to patients (e.g. prescription slip). • Discuss approaches to addressing community-level triggers. • Include environmental trigger profiles in EMRs. Clinical Solutions CLEAN AIR COUNCIL www.cleanair.org
  • • Clean Air Council www.cleanair.org (215) 567-4004 • Environmental Protection Agency. http://www.epa.gov • IdleFreePhilly.org www.idlefreephilly.org or (877)853-1552 CLEAN AIR COUNCIL www.cleanair.org Environmental Health Resources
  • • Asthma Community Network: Communities in Action http://www.asthmacommunitynetwork.org/ - New website! CLEAN AIR COUNCIL www.cleanair.org Asthma Resources
  • • 1-800-QuitNow • Smoke Free Philly http://www.smokefreephilly.com/ CLEAN AIR COUNCIL www.cleanair.org Tobacco Cessation Resources
  • Lead Prevention and Inspection  Pennsylvania Department of Health Lead Information Line - (717) 782-2884  Philadelphia Health Department Lead Poisoning Prevention Program - (215) 685-2797  "Get the Lead Out!" Hotline: (215) 685-2797 (24-hour; English, Spanish, and Vietnamese) CLEAN AIR COUNCIL www.cleanair.org Housing Resources
  • • Integrated Pest Management (814) 863-0604 • www.allergysolution.com CLEAN AIR COUNCIL www.cleanair.org Housing Resources
  • • American Council for an Energy-Efficient Economy www.aceee.org/ • Alliance to Save Energy http://ase.org/ • Clean Air Council cleanair.org CLEAN AIR COUNCIL www.cleanair.org Energy Resources
  • • Department of Housing and Urban Development (PA) http://www.hud.gov/local/pa/renting/tenantrights.cfm • City of Philadelphia Fair Housing Commission • City of Philadelphia Department of Licenses and Inspections (L&I) • Tenant Union Representative Network (TURN) • Community Legal Services of Philadelphia • Philadelphia Legal Assistance CLEAN AIR COUNCIL www.cleanair.org Tenants Resources
  • The Children's Advocacy Project – This site provides names and contact information of social service agencies in over 20 categories. Also provides information about the Pennsylvania Children's Health Insurance Program (CHIP) expansion, Cover All Kids. •After School Programs/Camps •Child Abuse •Childcare •Domestic Violence •Early Intervention Services •Education •Employment •Food and Nutrition •Health Insurance •Housing •Immigration/Refugee Services •Legal Services •Literacy •Mental Health •Parenting Resources •Physical Health •Pregnancy Resources and Infants •Safety •Shelters •Special Needs •Teen Resources Resources: www.cap4kids.org CLEAN AIR COUNCIL www.cleanair.org Human Services Resources
  • • Air pollution is a major risk factor, especially for the young, the old and those with pre-existing conditions. • Everyone reacts differently to air pollution. • Summer is the worst time for air pollution. • Exposure to many of the most common triggers can be avoided. CLEAN AIR COUNCIL www.cleanair.org Conclusions
  • CLEAN AIR COUNCIL www.cleanair.org Discussing environmental factors can: -Serve as opportunities to build patient-provider relationships. Enhance quality of care, increase patient capacity for disease self management & IMPROVED OUTCOMES! HCPs with a more specific knowledge of environmental asthma triggers and the available resources can provide more comprehensive care. Conclusions -Increases patient’s awareness. -Empower patients to create and ask for change in their homes and their communities.
  • Questions? Comments? Feedback? CLEAN AIR COUNCIL www.cleanair.org
  • Thank you! CLEAN AIR COUNCIL www.cleanair.org