Creating Clean AirSolutions for Preventing Childhood Asthma

June, 2010Amber Curry

TABLE OF CONTENTS

1

ASTHMA: the silent predator of America’s Youth...................................................... 2

What Exactly is Asthma ................................................................................................ 2

Asthma Through History ............................................................................................... 3

Children & Asthma ......................................................................................................... 3

Asthma and the Healthcare Reform: what will happen ............................................ 3

Why is Asthma on the Rise ............................................................................................ 4

Get Green Be Healthy ..................................................................................................... 6

Clean Air Legislation Over the Years .................................................................. 6

The Solution: Clean Air Zones ....................................................................................... 7

No-Idling Zones ...................................................................................................... 8

No-Smoking Zones ................................................................................................. 9

School Bus Zone Regulations ............................................................................ 10

Regulated Traffic Ways and Roads ................................................................... 11

Fighting to Breath: San Luis Obispo, CA ................................................................... 11

Call to Action ................................................................................................................ 12

Contacts ........................................................................................................................ 13

According to the EPA asthma is now considered a national epidemic and the rate of asthma in children less than 5 years of age has seen a 160% increase since 1995 (Raskin). Approximately 7,000 people die as a result of asthma each year, which equates to about 11-14 asthma-related deaths each day in America (U.S. Department of Health and Human Services Centers). More alarming is the increase in pediatric deaths caused by asthma. Between 1980 and 1993 deaths as a result of asthma for children 5 to 14 years of age has doubled (Raskin). Asthma is a respiratory condition that is marked by swelling and blockage of the bronchi, the airways to the lungs, which, is usually a result from allergic reaction and can cause extreme difficulty in breathing. The frightening increase in asthma and asthma related deaths and illness has led to a push to address reasons and find possible solutions. Most recently scientists have linked outdoor air pollution to the increase in asthma. Multiple types of air pollution can have an effect on and possibly even initiate asthma. The four major air pollutants that have been shown to have a relationship with an increase in asthma are ground level ozone, sulfur dioxide, particle matter, and nitrogen oxide (Asthma and Air Pollution). In 2002, a research study was published estimating that 30 percent of childhood asthma is

caused by environmental exposures, which leads to costing the nation $2 billion annually in healthcare costs (Asthma and Air Pollution). Having knowledge of the direct negative effect pollution has on the population, especially children; it that pollution needsshould be obvious that we as an educated community need to take action. What can be done about this obvious problem? We are all aware

to be decreased in both America and across the globe. But these have been major issues that activists, politicians and world leaders have been attempting to combat for years; so what can we as active members of society do?

Asthma is a disease that causes shortness of breath and the decreased ability to breathe due to the airways of the lungs becoming blocked and constricted (cdc). A healthy individual’s airways to the lungs are wide open with no b l o c k a ge m a k i n g s e d e n t a r y breathing an easy and effortless task. However, an asthma patient

has overly sensitive airways, which can easily become inflamed and obstructed causing a shortness of breath and a tight constricted feeling in the chest. When an asthma patients suffers from c o n s t r i c t e d a i r w a y s t h e y inflammation can become so severe medication and hospitalization are needed.

What Exactly Is Asthma?

ASTHMAThe Silent Predator of America’s Youth

2

Asthma Through History

• • •Asthma was initially

considered a psychosomatic disease. During the 1930s and 1950s, asthma was categorized as one of the holy seven psychosomatic illnesses (Opolski). At the time both doctors and the public believed the wheezing of asthma patients to be caused by the patient’s inner child’s suppressed cry for the mother. Therefore they thought that asthma could be controlled through psychoanalysis and other ‘talking cures’ (Opolski). It was not until the mid 1970s that the believed caused of asthma transferred from the psychosomatic view to an actual physiological condition. Nowadays, asthma is viewed as a disease of the respiratory system and wheezing is caused by the

blockage of breathing airways. When the medical consideration of asthma switched from being viewed as a psychosomatic problem to an actual physiological illness brought along with it the new problems of why people get asthma. Currently, we know asthma symptoms are caused by

two major factors: genetics and environmental factors. The environmental factors include indoor and outdoor allergens, physical activity and, what is now being considered the growing cause, outdoor air pollutants.

CHILDREN & ASTHMA

Between 1980 and 1993 deaths as a result of asthma for children 5 to 14 years of age has doubled.

The rate of asthma in children less than 5 years of age has seen a 160% increase since 1995

• • • • •The healthcare reform has recently been on the forefront in American politics and in the front of every American citizen’s mind. Questions arise like how will the healthcare reform work, how much will physicians lose in pay, how much money will American citizens be paying. Regardless of the continual endless cycle of questions it is certain that by decreasing the persistent childhood asthma increases American tax payers along with insurance companies will be responsible for less medical dues. Childhood asthma accounts for two million emergency room visits yearly (Asthma and Air Pollution).

Asthma and the Healthcare Reform: what will happen?

3

“In 1998 this figure rose to an estimated $11.3 billion, with direct costs accounting for $7.5 billion and indirect costs accounting for $3.2 billion. Hospitalizations represented the single largest portion of this cost. The estimated annual cost of treating pediatric asthma (in children less than 18 years of age) is $3.2 billion”(Raskin). Asthma is solely responsible for 14 million ambulatory care visits each year along with one on six pediatric emergency visits. After reading these statistics it becomes clear how large of impact asthma has become on our community as well as the economy. By taking action as a community and endorsing easy to follow steps and guidelines to decrease children’s exposure to

outdoor pollutants healthcare will be greatly effected which can in turn make an impact in the American tax payer’s pockets.

NUMBERSYearly pediatric

asthma costs

$3.2 billion

ambulatory visits each year for childhood

asthma

14 millionChildren 18 and

younger diagnosed with asthma

9 million

How is the U.S.

health care

dollar Spent?

National Health Expenditures

2008 U.S.

Hospital Care 31%

Physician/clinical services 21%

RX Drugs 10%

Program Administration 7%

Investment 7%

Asthma is related to all top

healthcare expenditures

(Kimibuende)

4

WHY IS ASTHMA ON THE RISE?

• • •Asthma is considered to have

multifactorial causes such as: indoor and outdoor allergens, genetics,

physical activity, and outdoor air pollutants. Since the increase in

childhood asthma as raised dramatically over the past years so has the interest and research into why this is happening. The theory

that has received high positive correlation and seems to have an

obvious relationship is the increase in air pollution. The National

Institute of Environmental Health Sciences did a large research study published in Spring 2010 found that

children exposed to higher levels of traffic-

related air pollution at school and home are at an

increased risk of developing asthma.

This research groups concluded the exposure

to outdoor air pollution is an important public

health problem affecting large populations of

children (Weinmayr ). Children and infants are the most susceptible to many air

pollutants (Kim) and they also have an increased

respiratory rate compared to adults, therefore they are

breathing in up to 50% more air pollution.

DEFINITIONSBronchi: The large air tubes leading from the trachea to the lungs that convey air to and from the lungs.

Inflammation:The swelling of tissue. Asthma attacks cause the airways to swell and become greatly constricted causing it very hard to get air through the airways.

Mucus: a thick fluid produced by the lining of tissue. This thick fluid is a symptom of asthma and during an asthma attack mucus can become so thick the sufferer can barely breath.

Wheezing:A whistling noise in the chest during breathing when the airways are narrowed or compressed

Inhaler:A portable handheld devise that delivers medication, usually a steroid, in a form that the person breathes in directly to the lungs. There are two main kinds of inhalers asthma sufferers use, a preventive inhaler and a rescue inhaler. Preventive inhalers are used on a regular basis to help control asthma symptoms and prevent asthma attacks and rescue inhalers are used to decrease present symptoms

FACTORS OF ASTHMAAllergens: a substance that can cause an allergic reaction. Allergens are substances that, in some people, the immune system recognizes as "foreign" or "dangerous" but cause no response for most peopleGenetics: There are a number of genes that

contribute toward a person’s susceptibility to the disease. The relative roles of the genes in asthma predisposition are not completely clear, but research is continuing to find connections. Physical Activity: exercise induced asthma is

a type of asthma where the asthma symptoms are induced with the increase in physical activity. Exercising causes the sufferer to have increased troubles breathing.

Air Pollution: The increased pollutants in the air causes breathing to become difficult and induces asthma symptoms such as shortness of breath, tightened chest and wheezing

5

Get Green Be Healthy

• • •

The Clean Air Act of 1970 brought major change both politically and mentally with regard to air pollution. Up until 1970 the government had no control or regulation over air pollution. The Clean Air Act made it so that the government could legally regulate air pollution through the limiting of emissions from both stationary (industrial) sources and mobile sources. This legislation brought with it a huge change in the view of the environment and the responsibility that we as humans have to regulate and protect the Earth. From the enactment of the law there have been multiple amendments including the 1990 amendment to the Clean Air Act, which expanded and modified provisions concerning the attainment of the National Ambient Air Quality Standards, modified the enforcement policies and authorized

numerous programs to control toxic pollutants (epa.gov). To learn more on the history of the Clean Air Act please visit http://www.epa.gov/air/caa/caa_history.html.

Even with the Clean Air Act in effect, which regulates emissions and

pollutants, we as a community need to do more. Living green is not just a fad or decade theme, this is a way of life that we as Americans need to accept in order to continue to live successfully in America.

CLEAN AIR LEGISLATION OVER THE YEARS

Major Milestones

Air Pollution Control Act 1955

Clean Air Act of 1963

Air Quality Act 1967

Clean Air Act of 1970

Clean Air Act Amendments 1977

Clean Air Act Amendments 1990

GOING GREENCreating Clean Air for Future Lives

6

The Solution: Clean Air Zones

by Leo PraesenSophomore

• • •

One easy solution to help combat childhood asthma is the enactment and use of Clean Air Zones, which are created to decrease the amount of pollution near schools and recreational areas. Childhood asthma, as an epidemic, can be reversed; and we as a community have the power to enact the change. Clean air zones are an easy and very effective way to dramatically decrease a child’s exposure to outdoor pollutants on an everyday basis. Enacting clean air zones throughout school properties and recreational parks is an easy to accomplish way for the every-day parent, teacher, mentor, and active and concerned community member to do their part in creating a healthy and clean green earth for the next

generation to grow up in. Clean Air Zones will decrease a child’s contact with large amounts of unnecessary outdoor pollutants and therefore can lead to the decrease in childhood asthma. Clean Air Zones consist of No Idling and No Smoking Zones,

regulated bus areas, and the regulation of the construction and maintenance of traffic ways.

Established Clean Air Zones will lead to a decreased amount of outdoor air pollution that children will be breathing in on an every-day basis.

CLEAN AIR ZONES1. No-Idling Zones

2 . S c h o o l B u s Z o n e

Regulations

3. No Smoking Zones4. R e g u l a t i o n o f R o a d

Construction

PLAYING AROUND

The majority of a child’s life is spent at school, play areas and recreational parks and home. When air is clean in these places asthma will decrease.

30% of childhood asthma is caused by environmental exposures, and much of the air pollutants children are exposed to are preventable

7

• • •

These zones are set up in front and around school zones. When children hear the school bell ring and run out to meet their parents to go home they are running into a pollution war zone. According to the Environmental defense Fund, in New York idling buses, tucks, and cars on school property leads to roughly 130,000 tons of carbon dioxide, 940 tons nitrogen oxide, 24 tons of soot particles, and 6,400 tons of carbon monoxide each year (Isreal). This equates to the average school child inhaling toxic pollution every morning and night around 180 days per year. By simply turning off your engine while picking your child up from school can help decrease childhood asthma greatly. There are also financial incentives for non-

idling zones. Every ten minutes spent idling leads to the use of about 0.026 gallons of gasoline, which costs about five cents and produces 9.5 ounces of carbon dioxide. This does not sound like a lot but this easily adds up, if idling every morning and afternoon (Idling). Enacting and enforcing no-idling zones in school districts will expose every child at that school to a significant decreased amount of pollutants that would potentially lead to asthma.

IDLING FACTS

2. 10 seconds of idling uses more fuel than restarting your engine

3. Cumulatively idling wastes more than 10 billion gallons of gasoline per year

4. Newer vehicles need no more than 30 seconds of idling time in cold temperatures to warm it up

5. A single vehicle dropping off and picking up kids at one school puts 3 lbs of pollution in to the air per month

(Idling)

CHILDREN: the most susceptible population

Children are especially vulnerable to the effects of vehicle emissions because their

lungs and airways are immature. Also, their breathing zone is lower than adults

so they are more exposed to vehicle exhausts and heavier pollutants that concentrate at lower levels in the air.

No-Idling Zones

8

No Smoking Zones: Many cities and states in the U.S. have put some restrictions on smoking, most of which include where smokers can light up. However, bans on smoking vary dramatically across the nation. For instance, Wyoming has virtually no restrictions on smoking, while other locations, such as San Luis Obispo, CA has completely banned smoking in all public outdoor areas. Whether or not a state’s law prohibits smoking, it is necessary to set in place regulations around all school properties and recreation parks, which would ban smoking. By prohibiting smoking in both school areas and recreation parks children will be exposed to much less second-hand smoke. This is an easy way to severely decrease a child’s contact with outdoor pollutants and decrease the incidence of childhood asthma.

Between 70% and 90% of non-smokers in the American population, children and

adults, are regularly exposed to secondhand smoke. It is estimated that only 15% of cigarette smoke gets inhaled

by the smoker. The remaining 85% lingers in the air for everyone to breathe. If a

person spends more than two hours in a room where someone is smoking, the nonsmoker inhales the equivalent of four

cigarettes. Secondhand smoke is the third leading preventable cause of disability and

early death (after active smoking and alcohol) in the United States. For every eight smokers who die from smoking, one

innocent bystander dies from secondhand smoke.Secondhand smoke contains over

4000 chemicals including more than 40 cancer causing agents and 200 known poisons. (Dusenberry)

Secondhand Smoke Facts

NO SMOKING ZONES

9

School Bus Zone Regulations

Idling regulations for school buses both on school properties and at stops need to be enacted in order to decrease children’s exposure to

outdoor pollutants. School Buses use diesel fuel, which has been identified to contain multiple types of carcinogens as well as being a combination of very fine particles of carbon dioxide and toxic gases. In the United States 600,00 school buses transport 24 million students to school daily (Children’s Exposure to Diesel Exhaust ). If

the average school bus ride is thirty minutes, then on average students spend 180 hours on a school bus yearly, and is exposed to toxic diesel exhaust while riding and even more so when exiting the bus. Even when children do no ride buses themselves, they are many times exposed to the same pollutants buses produce because

buses idle for long periods of time in front of schools during pick up and drop off. By not allowing school buses to idle in front of schools and at bus stops will decrease the amount of diesel exhaust children are exposed to and in turn will greatly decrease the amount of pollutants being breathed in.

10

Regulated Traffic Ways

and Roads• • •

Another very easy way to greatly minimize the pollution children are presented with is to disallow new roadways to be constructed near recreation parks and schools. Nearly ten percent of public schools in California are located within 150 meters of roadways with more than 25,000 vehicles daily (Weinmayr). Children are already exposed to numerous pollutants from traffic; therefore, there is no need to increase this exposure by increasing contact with traffic by building new roadways. There are currently many protests happening throughout America in regards to this very subject. San Luis Obispo, CA is having protests and debates concerning this very issue. The city wants to construct a road, which

would connect to major parallel roads in the city. The problem that has arisen is that the potential road will be built right next to a recreation park. Compared with adults children are more affected by air pollution because they have

an increased breathing rate while sedentary and active. When a child is playing a sport and breathing in polluted air from a nearby roadway their respiration of toxic pollutants increase dramatically as well as their risk for asthma.

FIGHTING TO BREATH: SAN LUIS OBISPO, CA

KIDS JUST WANT TO HAVE FUN

San Luis Obispo, CA is one of many cities caught up in a battle over clean air for children and creating convenience for fast pace lifestyles. The City of San Luis Obispo is trying to construct a new roadway that will connect major roads and allow more convenience for drivers. The problem arises

when the location of where this proposed road will be built is taken into consideration. The road the city is wanting to build will run within feet of a large children’s sports park. The Damon Garcia Sports Fields were initially built as a safe, beautiful and friendly environment for children and families. Bill Wilson is one of the head activists fighting the construction of the new road. Wilson says, “ Do we value our children or do we value the road, what we are saying is don’t put the road above our children! Let’s protect and preserve for future generations.”

11

• • •

Enacting Clean Air Zones is a simple and extremely effective method of drastically decreasing children’s exposure to outdoor air pollution, which has been proven to have a significant relationship with the increase in childhood asthma. Clean Air Zones are easy to enact by active community members and will have a great outcome and lead to the decrease in childhood asthma, which has hit an all time high and is seen as an epidemic in America.

STAND UP AND MAKE CHANGE

We as active members in our communities need to look within for change. We do have the power to make change and to

transform the world we are currently living in and the lives of our children. Air pollution has been increasing and a national problem for years. This has lead to in devastating increase in childhood asthma, which continues to be on the rise. We have the responsibility to enact change and see our children breathing in clean fresh air, rather than polluted toxic air that we produce with driving, smoking and idling cars.

What Can I DO?

1. Take the idea of clean air zones to your local school board or principal and begin to get other community members involved.

2. Make notes of the number of idling cars and buses on any given school day along w i t h t h e n u m b e r o f smokers at schools and parks. Take these statistics to board members and principles.

3. Get involved with your communities planning board and stand up to new roads and construction that might potentially cause an increase in pollution and a decrease

in children’s health.

FOR MORE INFORMATION Please Contact:

AMBER CURRYemail: amberbcurry7@gmail.com

Website: calpoly.edu/~abcurry/

BILL WILSONemail: biwilson100@gmail.com

Call to Action

12

REFERENCE LISTAir Pollutants and Asthma. (April 2009). Children’s Environmental Heath Centers: U.S.

Environmental Protection Agency. Retrieved from http://epa.gov/ncer/childrenscenters/asthma.html#questions4

Asthma and Air Pollution (1995). Natural Resources Defense Council. Retrieved from http://www.nrdc.org/health/effects/fasthma.asp

Asthma Fact and Figures. Asthma and Allergy Foundation of America. Retrieved from http://www.aafa.org/display.cfm?id=8&sub=42

Children’s Exposure to Diesel Exhaust on School Buses. Environment and Human Health, INC. retrieved from: http://www.ehhi.org/reports/diesel/

Cowen, M. (March 2010). Air Pollution Link to Childhood Asthma Supported. Medwire News, 110, 294-301. Retrieved from http://www.medwire-news.md/48/86968/Respiratory/Air_pollution_link_to_childhood_asthma_supported.html

Dusenberry, M. B., (August 2007). Butts Out. The Council of State Government. Retrieved from http://trendsinamerica.com/knowledgecenter/docs/sn0708ButtsOut.pdf

History of the Clean Air Act. (2008). Environmental Protection Agency. Retrieved from: http://www.epa.gov/air/caa/caa_history.html.

Idling: frequenty asked questions. Hamilton County Environmental Services. Retrieved from http://www.hcdoes.org/airquality/anti-idling/idlefaq.htm

Isreal, B.(October 2009). Idle Moments Turn into Tons of Air Pollutants at Schools. Scientific American. Retrieved from: http://www.scientificamerican.com/article.cfm?id=idle-moments-turn-into-to

Kim, J. J. (December 2004). Ambient Air Pollution: health hazards to children. [Abstract]. Pediatrics, 114(6), 1699-1707

Kimibuende, E., Ranji U., Laundy J., Salganicoff A. (March 2010). U.S. Health Care Costs:

background brief. Retrieved from http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358

Niclai, T. (1999) Air Pollution and Respiratory Disease in Children: what is the clinically relevant impact? [Abstract]. PubMed.gov, 18, 9-13.

Opolski, M., Wilson, A. (2005). Asthma and depression: a pragmatic review of the literature and recommendations for future research. Clinal Practive and Epidemiology in Mental Health, v.1. doi: 10.1186/1745-0179-1-18.

REFERENCE LISTRaskin, L. (February 2000). Breathing Easy: solutions in pediatric asthma. The Maternal

and Child Health Library at Georgetown University. Retrieved from http://www.mchlibrary.info/documents/asthma.html#Table%202

U.S. Department of Health and Human Services Centers for Disease Conrol and Prevention. America Breathing Easier (CDC Publication). Chamblee, GA: U.S. Retrieved from http://www.cdc.gov/asthma/pdfs/breathing_easier_brochure.pdf

Wargo, J., Brown, D., (February 2002). Children’s Exposure to Diesel Exhaust on School Buses. Environment and Human Health, INC. Retrieved from http://www.ehhi.org/reports/diesel/dieselintro.pdf

Weinmayr G, Romeo E, De Sario M, Weiland SK, Forastiere F, 2009 Short-Term Effects of PM10 and NO2 on Respiratory Health among Children with Asthma or Asthma-like Symptoms: A Systematic Review and Meta-Analysis. Environ Health Perspect 118(4): doi:10.1289/ehp.0900844

Picture References:Cover:BoVom  Right:  hVp://www.theflowermillflorist.com/images/junk-­‐food-­‐basket.jpgBoVom  LeY:  hVp://kitchenzones.com/images/Lesson-­‐Plan-­‐About-­‐Healthy-­‐Foods.jpgTop  Center:  hVp://blog.gyminee.com/images/food_decision.jpg

Table  of  Contents:Top:  hVp://blogs.miaminew>mes.com/shortorder/childhood-­‐obesity-­‐junk-­‐food-­‐high-­‐calories.jpgBoVom:  hVp://howto-­‐gainmusclefast.com/wp-­‐content/uploads/2009/07/weight-­‐loss-­‐in-­‐prac>ce1.jpgMiddle:  hVp://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/ar>cles/health_tools/diet_mistakes_slideshow/photolibrary_rf_photo_of_feet_on_scale.jpg

Abstract:hVp://www.blogcdn.com/www.thatsfit.com/media/2009/11/woman-­‐overweight-­‐walking-­‐425km112409.jpg

IntroducBon:Top:  hVp://healthblog.yinteing.com/wp-­‐content/uploads/2009/11/do-­‐not-­‐hit-­‐the-­‐snooze-­‐buVon.jpgMiddle:  hVp://carolynncarreno.files.wordpress.com/2009/07/bigmac.jpgBoVom:  hVp://cache1.asset-­‐cache.net/xc/73400833.jpg?v=1&c=IWSAsset&k=2&d=EDF6F2F4F969CEBD899B843FF9EA308CAF7B3AFA3CDF83E94B995F54EB4C6EA3

Problems:Top:  hVp://i68.photobucket.com/albums/i24/Kakarotoni/Affiliate/dogwalkqo2.jpgBoVom:  hVp://imway2fat.files.wordpress.com/2009/04/fast-­‐food-­‐exit-­‐sign.jpg

Market  Drivers:hVp://healthhabits.files.wordpress.com/2009/07/us-­‐obesity-­‐stats-­‐2008-­‐map.jpg

Historical  Approach:hVp://www.goodtoknow.co.uk/imageBank/cache/d/DetoxdietpicNEW.jpg_e_9c567201e399f642ec5b23cddb32ee17.jpg

SoluBon:Page  8:  hVp://blogs.glam.com/glamspirit/files/2009/09/ea>ng-­‐apple-­‐234x300.jpg

Page  9:  hVp://www.sweatyguineapig.com/wp-­‐content/uploads/2008/09/crossing-­‐the-­‐finish-­‐line.jpg

Call  to  AcBon:hVp://preven>al.com/wp-­‐content/uploads/2009/01/fortune-­‐cookie.jpg

13