Above 6th Grade

Posted with permission from the Journal of Environmental Health, a publication of the National Environmental Health Association, www.neha.org.  Further posting of this article is restricted. For permission, contact jeh@neha.org. 

This article will appear in the January/February 2014 issue of the Journal of Environmental Health.

Abstract: Asthma, the most significant cause of pediatric morbidity and mortality, is exacerbated by adverse environmental conditions, especially substandard housing. The clinical care provider is often unable to address housing and environmental trigger issues. In Boston, Massachusetts, a web-based referral system called Breathe Easy At Home has been put in place, through which clinicians can refer patients to have their homes inspected for housing code violations that may be contributing to their asthma. Violations will then be brought to the attention of the landlord, who then has the option of redressing the issue or be taken to housing court. By bringing the local public health department, the city’s inspectional services department, and the clinical care provider together with the help of a program coordinator, Breathe Easy At Home is able to provide comprehensive care to asthma patients. This program also serves as a replicable model for other cities and jurisdictions to follow.

These guidelines are aimed at integrating environmental management of asthma into pediatric health care. These documents outline competencies in environmental health relevant to pediatric asthma that should be mastered by health care providers, and outlines the environmental interventions that should be communicated to patients. The interventions solutions are organized by environmental triggers.

Following a brief, targeted educational intervention, pediatricians reported a significant increase in knowledge about environmental triggers of asthma and a willingness to incorporate exposure history questions and remediation recommendations in their routine practice. These improvements persisted at a 3-6 month follow-up interval compared to baseline levels. The findings were published in Clinical Pediatrics. The study was conducted by NEEF's Pediatric Asthma Faculty Champions using a standardized PowerPoint presentation based on NEEF's Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers www.neefusa.org/health/asthma/asthmaguidelines. 

Improving Pediatrician Knoweldge About Environmental Triggers of Asthma--Roberts JR, Karr C, de Ybarrondo L, McCurdy LE, Freeland KD, Hulsey TC, Forman J. Clinical Pediatrics 2013 June; 52(6):523-30