According to Lara (2011), asthma is a lifelong illness that is characterized by aspects involving wheezing, coughing, and irritations. In this instance, the ailment is caused by the inflammation of the bronchi located in an individual’s lungs. Upon inflammation, the airways become blocked and thereby leading to increased difficulty in breathing. Asthma is deadly, owing to the increasing prevalence of the illness among both the adult and children population. Asthma is identified as one of the most chronic illnesses affecting children, approximately 6.3 million individuals (CDC, 2011). In this regards, almost 24% of children ranging from 5 to 17 years of age are limited in terms of participation in various activities as a result of asthma. Asthma is detrimental to all facets of the society, such as the federal government, schools, parents, and children themselves.
Serious cases of asthma often lead to death. In this instance, 187 children died as a result of this ailment in 2009 (Lara, 2011). The seriousness of the issue is further compounded by aspects of ethnic and racial disparities existing in the society. In this case, children from both African-American and Hispanic backgrounds are more prone to asthmatic attacks and as a result, susceptible to death from the ailment’s complications than compared to their Caucasian counterparts. This aspect is proven by the latest findings from the Centers for Disease Control and Prevention (CDC) which indicates that 1 in 9 or 11% of non-Hispanic black individuals as well as 1 in 6 or 17% of non-Hispanic black children were diagnosed with asthma in 2009 (CDC, 2011). These figures represented the highest rate of infection among all ethnic groups in the U.S. as a result of the challenging backgrounds of the majority of individuals from these minority groups, proper management and treatment of asthma is often an uphill task. This situation prompts the need to undertake an effective intervention program in order to control the symptoms of the disease. In order to design such a program, it is imperative to discuss and understand the triggers of asthma to determine the most appropriate strategies in dealing with the ailment.
Triggers of Asthma
According to the Regional Asthma Management & Prevention (2015), the environment is the most common culprit as a contributor to triggering asthma. Environmental triggers are classified into two main categories, allergens and irritants. Allergens are caused by a benign protein or allergen that forces the body to cause an inappropriate response to the body’s immune system. On the other hand, irritants cause inflammation and general discomfort in the body. In this case, the reaction caused by irritants is not caused by the body’s immune system as in the case of allergens.
With regards to causation, some environmental triggers of asthma can increase the risk level of a child. These triggers affect children independently. In this instance, some children may be affected by one of these, while others are affected by several triggering factors. The following are the relevant environmental triggers, both allergens and irritants in this regard:
Mold and moisture- According to RAMP (2015), mold spores and bacteria inherent in the air, surfaces, or behind walls are risk factors associated with the increase in risk development of respiratory diseases, asthma being one of these, as well as decreased lung function especially among asthmatic children. In this regards, research has revealed a close correlation between mold and moisture and development of asthma in children.
Dust mites- Mites are small bugs that are not visible to the naked eye. In a school environment, they are often found in dusty surfaces, bookcases, floors, curtains, among others. Dust mites have been associated with increased prevalence in asthma as well as allergic sensitization. Those allergic to dust mites might develop a reaction triggering an asthmatic attack.
Cockroaches and rodents- Research provides a close association or causal relationship between cockroach and rodent allergens and the prevalence of asthma symptoms and is severity. The proliferation of cockroaches and allergens is often caused by the availability of food and water.
Chemical irritants- These may be found in school products such as cleaning, building and finishing products and in some cases, some paints and markers. In this regard, such products contain Volatile Organic Compounds (VOCs) which has been associated with reaction with indoor ozone thereby causing adverse respiratory reactions.
Proposed Intervention
In order to effectively deal with the worrying issue of asthma in children especially in school environments, it is imperative to develop a holistic intervention plan that will take into consideration the active participation of every individual involved in the control and management of asthma among children. For this reason, the plan will be a bundled intervention plan divided into stages as indicated below:
Education
In this regard, education has been found to be one of the most effective measures of managing asthma in children. This concept has been supported by the National Asthma Education and Prevention Program Expert Panel which provided the causal relationship between education and reduced emergency hospital visits and an overall improvement in children’s health status. As such, educational interventions should be availed in schools such as educating school staff on how to remove allergens and irritants.
According to RAMP (2015), case management refers to an intervention plan that takes into consideration the importance of communication, advocacy, and general collaborative efforts aimed at addressing an individual’s or family’s health needs with the intention of ensuring cost-effective outcomes or promotion of service quality. In this regard, School Based Health Centers can implement programs meant to reduce the prevalence of asthma attacks among children both at home and in school. One of these is CEASE- Clinical Effort against Secondhand Smoke Exposure that is focused on assisting individuals who may be parents of school-going children to quit their smoking habits to prevent exposure to second-hand smoke which is proven to cause an asthmatic reaction.
Improvement of Indoor Air Quality
Children spend ample time in school environments and as such are exposed to allergens and irritants that may be found in schools thereby increasing the risk of developing allergic reactions. This indoor environment is host to a number of environmental triggers that can cause an asthmatic reaction thereby leading to decreased performance and productivity as a result of missed school days.
According to RAMP (2015), since air triggers are either inhaled or airborne, the aspect of air quality plays an important role in dealing with asthma. The U.S Environmental Protection Agency (EPA) indicates that indoor air quality is approximately two or five times more polluted than compared to outdoor air and in some cases almost 100 times. This situation is caused by the presence of pollutants and consequently triggers that may cause an allergic or irritant reaction.
In this case, schools should implement the Tools for Schools program that is provided by EPA as a guideline of ensuring healthy school environments. This program is geared towards identification, prevention, and resolution of situations involving air quality in schools. In addition proper ventilation should be provided to aid in improvement of indoor air quality.
The Impact
The implementation of the bundled intervention plan is bound to improve the environmental conditions and reduce the prevalence of asthma-related attacks. In this case, the improvement of the school’s Indoor Air Quality (IAQ) will provide a healthy environment that is free from allergens and irritants that cause respiratory illnesses.
In addition, the provision of educational programs targeting both parents and children will improve management of asthma. In this case, parents will gain insight on how they can improve their home environment and make them friendly to their asthmatic children. Also, children will learn more about their condition and as such learn how to cope with it as well as implement self-management measures and practices.
Educating children about Asthma Self Management will assist them to develop the confidence they need in managing the illness. In the same way, the provision of different school-based programs will make the environment friendly for children hence preventing the occurrence of asthmatic attacks.
As mentioned previously, asthma affects almost all facets of the society. In this regard, owing to the high costs associated with asthma, government spending in terms of hospital-related costs will reduce significantly following the implementation of the bundled intervention plan detailed above. In addition, parents will have a peace of mind when it comes to taking care of their children. As for children, their academic performance will improve significantly as their classes will not be affected as a result of hospitalizations that lead to their missing school lessons.
Conclusion
The implementation of intervention plans related to management and control of asthma will imperatively improve the lives of school-going children as well as their parents. The prevalence of the illness will also reduce significantly thereby resulting to a healthy society.
References
Centers for Disease Control and Prevention (2011). Asthma in the U.S. Retrieved from http://www.cdc.gov/vitalsigns/asthma/
Lara, M. (2011). Improving Childhood Asthma in the United States: A Blueprint for Policy Action. Santa Monica: RAMD.
Regional Asthma Management & Prevention (2015). Asthma environmental intervention guide for School-Based Health Centers. Retrieved from http://www.rampasthma.org/uploads/asthma_guide_sbhc.pdf
