This document outlines Project Asthma in Retreat (AIR), a collaborative effort between several local organizations in Holyoke, MA to address high asthma rates in the community and public schools. The project aims to (1) increase awareness of indoor and outdoor asthma triggers, (2) provide asthma education to teachers, students, and staff, and (3) conduct indoor air quality assessments in schools. Over three years, the project worked with the Holyoke Public School system and custodial staff to improve HVAC systems, implement green cleaning practices, and provide asthma training. Challenges included securing funds and compliance from the school system. Next steps involve continuing to work with schools and the community to evaluate indoor environments and educate parents and residents about

1. Project Asthma in Retreat
(AIR)
Public Health 102
Michaela Veillette

2. Background
• $30,000 a year for 3 schools
• Primarily identified as an environmental risk for Holyoke residents
through an EPA CARE grant to Nuestras Raices (a politically moved urban
agriculture organization based in Holyoke MA)
• A combined effort between many local organizations in and around
Holyoke, MA
• Holyoke Board of Health
• Holyoke Food and Fitness Policy Council
• Holyoke Public Schools
• Nuestras Raices
• Pioneer Valley Asthma Coalition
• HCC
• Address the asthma issues with a focus on public schools and community
education
• Increase the community’s awareness of: indoor/ outdoor asthma triggers
and effective strategies for management of asthma
• Includes asthma education for teachers, students and school staff;
conduct indoor air quality (IAQ)

3. Asthma
Asthma is a disease of the lungs in
which the airways become blocked
or narrowed causing breathing
difficulty (AAFA).
• Affects 25.9 million Americans.
• Two types: allergic and non-
allergic
• Causes: dust mites, pollens,
molds, pet dander, and
cockroach droppings, cigarette
smoke, wood/charcoal fires,
household sprays, paint,
gasoline, perfumes, and scented
soaps
• Weather such as dry wind, cold
air, or humidity
Holyoke MA
• The current asthma occurrence rate was higher
in the Northeast (8.8%) than in the South (7.6%)
or in the West (8.0%) CDC
• In 2008, an estimated 136,267 children in
Massachusetts had asthma CDC
• Pediatric asthma rates are extremely high in both
Holyoke (19%) and Springfield (17%), both close
to double the statewide prevalence of (9.5%)
PVAC
• 1272 students with asthma in HPS or 23% of
student PVAC
• Kelly School has 34%! That’s almost 2x Holyoke
and 3x MA

5. Target Strategy Steps
Holyoke Public Schools
• Get them on board
• Approval
• Compliance
• Need the superintendent to
support and help
coordinate
• Identify chain of demand
• Schedule inspections
• Evaluate current systems
• Identify problems
• Provide stats
Maintenance Workers
• Educate on proper
maintenance
• Identify roles and
responsibilities
• Custodial evaluation
• Evaluate current day to day
clean up
• Provide staff with proper
training

6. Target Strategy Steps
School Nurses
• Provide better training
• Track student cases
better
• Pass out packet info
• Coordinate with
community outreach
workers
• Raise asthma awareness
Parents
• Educate
• Get them involved
• Parent education meetings
• Find a parent
representative
• Asthma info packets
• Coordinate efforts with
home health workers and
landlords

7. 2012-2015
• 1st meeting with Facility Manager, Lenny 7/30/12
• HVAC?
• Training manuals
• Try to get rid of carpet
• 1st meeting with Custodians 2/12/13
• Seniors to train juniors
• Order environmentally safe supplies
• Meeting with Brian, head custodian 10/6/14
• Principals are direct supervisors
• New floor products
• HPS meeting with Brian 10/24/14
• Added extra cleaning work
• Switched to green cleaning products
• Train for asbestos
• Try to replace cafeteria fan, Kelly
• Peck has a pest problem (mice and cockroaches)
• Seek training for IAQ equipment

8. 2012-2015
• Meeting with Matt Lustig, Healthy Holyoke Coordinator 10/24/14
• Talked to Patty Alfred, nurse director for walk through
• 10-14 families signed up for home visits
• Improve ER response to asthma visits
• Meeting with Brian 11/3/14
• Review bathroom checklist
• Expand training and ass items
• Need new vacuums
• Phone meeting with Lenny
12/1/14
• School dept. isn’t allowed to do capital repairs
• Need copy of grant with commitments
• Phone meeting with Sarita, PVAC 1/26/15
• Carpet request to mayor
• Call into CT DPH IAQ
• HPS shampoo once a year
• Set priorities
• Window replacement, only 30% work
• 2 floods, were they handled correctly?

9. Completed
• Hired a new electrician for the district
• Kelly:
• $10,500 for HVAC system
• Fixed both thermostats and damper actuators in gyms
• Installed exhaust and supply fans in the dome
• Removed and replaced kitchen exhaust ventilations
• Dean Tech:
• New HVAC systems for 6 rooms
• New chemical storage room with detected ventilation
• 3 new exhaust ventilation systems in auto repair shops
• New ceiling lightening and sprinkler system
• Replaced garage door seals to prevent pest entry and control air flow

10. Challenges and Next Steps
• Compliance with the
school system
• Setting up meetings
• Getting work done
while school’s in
session
• Funds
• Need more data for
grant
• Use the states take
over to our
advantage
• Work with other
corporations (OAS,
PVAC, ALA, Elms)
• Find and evaluate
more data and
statistics
• May is asthma
awareness month

11. Target Group Strategy Action Steps Who will do it? What resources are
needed?
Timeline
From 1st meeting
Assessment of
strategy
Holyoke Public
Schools
 Get them on board/ their
approval/ compliance
 Need superintendent to
support and help
coordinate
 Identify current chain
of command
 Schedule inspections
 Evaluate current
systems
 Identify problems
 Provide statistics
 Katie Gallagher  Stats on asthma in
public schools
 Information on mold,
VOCs, lead, asbestos,
HVAC systems
 IAQ tools:
humidity/temp,
moisture, sound, CO
meter, light
1 month
3 years to completely
integrate our
systems
Number of school
IAQ assessments
completed, asthma
curriculum
improved
Maintenance
Workers
 Educate on proper
maintenance
 Identify roles and
responsibilities
 Do custodial
evaluation
 Evaluate current day
to day clean up
 Provide staff with
training manuals
 Katie Gallagher
 Lenny, Facilities
and Maintenance
Director
 Custodial manual
 IAQ tools and
directions
 Basic IAQ regulations
and standards for
public buildings
4 months (3 schools,
1 month per school)
1 year to train on
equipment and
procedures
Number of staff
trained/
participating,
equipment
modified
School Nurses  Get better training
 Track student cases better
 Pass out packet info
 Coordinate with
community outreach
workers
 Raise asthma
awareness
 Open Airways for
Schools (OAS)
 Pioneer Valley
Asthma Coalition
(PVAC)
 Elms College/
Students
 American Lung
Association (ALA)
 Asthma training
 School asthma stats
 Inhalers/ medications
1 month to train Number of training
sessions held
Parents  Educate
 Get them involved
 Parent education
meetings
 Find a parent
representative
 Asthma info packets
 Coordinate efforts
with home health
workers and
landlords
 Katie Gallagher
 School Nurses
 PVAC?
 Landlords?
 Location for meetings
 Informative handouts
 Incentives?
1 year, 2 meetings
per year
3 years to impact
homes
Number of
educational
meetings held,
house evaluations