Academic journal article Journal of School Health

Environmental Allergens and Irritants in Schools: A Focus on Asthma. (Research Papers)

Academic journal article Journal of School Health

Environmental Allergens and Irritants in Schools: A Focus on Asthma. (Research Papers)

Article excerpt

Indoor allergens such as cat and rodent dander, cockroach, dust mites, and fungi/mold have all been implicated in exacerbating asthma symptoms among sensitized individuals. Exposure to dust mites also may cause development of asthma among susceptible children. (1-6) While some studies suggest that exposure to other agents, such as cockroach and fungi, also may increase the risk of developing asthma, the evidence is not conclusive. (1)

Although children spend seven or more hours in school each day, few environmental surveys have been conducted in the school environment, (7-10) and only the groups led by Dungy (7) and by Neuberger (9) characterize schools in the United States. Dungy (7) found mold concentrations in schools similar to those reported in homes, but dust mite concentrations considerably lower than reported home levels. In a case study of a Kansas City school, Neuberger (9) reported such indoor environmental problems as inadequate ventilation, odors, and poor temperature and humidity control. None of the studies provides comprehensive assessments of both air quality problems and other environmental triggers for children with asthma. Asthma management strategies have focused on suggesting methods to eliminate or avoid triggers in the home, but virtually ignored triggers in the school environment. (1,11-14)

The Partners in Asthma Management Study, a comprehensive school health promotion intervention, includes four components: casefinding, medical care liaison, self-management training, and environmental control. Because of their high risk for asthma and their high utilization of emergency room services to manage and treat asthma, the target population included inner-city children. This paper presents the study's baseline environmental results and describes the prevalence in elementary schools of environmental hazards that may act as triggers for asthma and that may place children with asthma at increased risk for exacerbation of symptoms.

METHODS

Study Sample

All 184 elementary schools in a large urban district in southeast Texas were sent announcements about the program and requests to participate; 70% responded positively. Based on the criterion of having more than two thirds of the student body enrolled in the free or reduced-cost school lunch program (an indicator of lower SES students), 60 schools were selected for the program. Environmental observations were performed in five to seven classrooms and in the libraries in each of the 60 schools (a total of 385 rooms). In addition, dust samples for allergen analyses were collected in two classrooms, the library, and the cafeteria at a randomly selected subgroup of 20 schools.

Instrumentation and Data Collection Procedures

The study was conducted in April and May 1997. Environmental data collection for each of the 60 schools was based on two measures: an Environmental Observation Checklist (EOC) to determine presence of conditions typically associated with common indoor allergens and irritants, including cleaning practices and policies, and Q-TRAK Indoor Air Quality Monitor measures as indicators of air exchange and ventilation. In the 20-school subgroup, dust samples were collected according to a standard protocol from hard floors, carpets, and area rugs.

The Environmental Observation Checklist. The EOC, adapted from an environmental checklist for schools developed by Dautel, (15) included a school and classroom survey for each school (Table 1). The EOC includes school wide information and observations such as age of building, condition of the exterior, odors, cleaning practices, and pest control. The EOC also was used to note structural problems, odors, cleanliness, signs of allergens and irritants, and heating, ventilation, and air conditioning (HVAC) systems in each classroom and in the library. Information on cleaning practices and pest control were obtained from the physical plant operator. …

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