Prevention
Counseling patients on how to prevent or eliminate the exposures
of concern is an important facet of the treatment mandate for children
with environmentally related respiratory conditions.
Children with pre-existing asthma or allergies may experience aggravation
of their condition upon being exposed to a variety of contaminants
as listed above. These especially sensitive children will benefit
from preventive behaviour that reduces or eliminates their exposure
to these pollutants. However, given what we know of the potential
for children to have greater exposure and susceptibility to respiratory
health problems from environmental factors, prevention is a critical
step in reducing the burden of respiratory illness for all
children.
Indoor Air
Indoor air quality is of crucial importance. One source suggests
that the underlying strategy for improving indoor air quality once
potential problems are identified is to "eliminate, separate
and ventilate."21
- Smoking is a prime trigger of asthma attacks and eliminating
this exposure is the best approach. Adult smokers should be encouraged
to quit smoking, or minimally, to avoid smoking indoors.
- Pregnant women should be encouraged to quit smoking and educated
on the risks of passive smoking to their fetus and children.
Other Preventive Strategies
Reducing exposure to biological contaminants and allergens:
- Wash bedding (including pillows) and soft toys regularly in
hot water (> 55oC, 130oF) to kill dust
mites
- Use allergy-proof covers for mattresses, box springs and pillows
- Remove carpets, especially in bedrooms and areas of high humidity
(like bathrooms and basements)
- Vacuum carpets regularly with central vacuum or a HEPA filter
vacuum
- Use fans in kitchen and bathroom to vent cooking fumes and moisture
- Use a dehumidifier in damp areas
- Carefully clean mouldy surfaces
- Clean rooms with damp cloths to avoid spreading dust and resuspending
particles
Reducing exposure to chemical contaminants and outdoor pollutants:
- Gas fireplaces and stoves should be checked and serviced regularly
to prevent gas leaks
- Forced-air furnace ducts should be cleaned every year prior
to heating being turned on in September to help reduce airborne
allergens
- Use good quality furnace filters and change them regularly
- Avoid the use of pesticides both indoors and outside
- Choose low toxicity products for cleaning, painting and home
renovations (i.e., avoid airway irritants such as chlorine bleach,
ammonia and oil-based paints)
- Keep unused, opened chemical products tightly sealed in storage
areas that are separate from main living space
- Air-out new carpets and other items such as furniture before
they are installed in the home to help reduce noxious vapours.22
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The Canadian Mortgage and Housing Corporation
(CMHC/SCHL) has a number of resources under their "Healthy
Housing and Sustainability" web page that relate to indoor
air and health. These include:
- What You Can Do About Your House to
Help With Asthma
- Healthy Housing Renovation Planner
Also available from CMHC is:
- The Clean Air Guide: How to Identify
and Correct Indoor Air Problems in Your Home
This useful booklet includes a worksheet
for detailing the family health profile and an air quality
questionnaire to assess possible sources of indoor air problems
in the home as well as detailed suggestions for corrective
measures.
For details, contact your local CMHC office,
or call 1-800-668-2642.
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Outdoor Air
Air Quality Index
Smog formation requires heat, sunlight and low air movement, and
therefore smog levels are mainly a concern during the summer. When
ozone levels are predicted to exceed 82 ppb, Environment
Canada issues air quality advisories that warn the public about
the elevated health risks from exposure to smog. The Air Quality
Index (AQI) is the figure that translates the levels of key pollutants
such as ozone, measured at air monitoring stations, into one value
that indicates the overall condition of outdoor air.
The AQI value ranges from a low of 0 (no measurable pollution level,
good air quality) to 100 and above (very poor air quality).
AQI values are associated with the following rating of air quality:
- 0-24 represents "good" air quality
- 25-49 is fair
- 50-99 is poor
- 100+ represents very poor air quality23
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Air quality is reported in weather forecasts
for many Canadian cities and on the local weather network
during summer months.
In Ontario, current
and past AQI readings are available on the Ministry of
the Environment Web site. Daily AQI values and forecasts are
also available from the Ontario Ministry of the Environment
by calling (416) 246-0411 in Metro Toronto, or 1-800-387-7768
(English) or 1-800-221-8852 (French).
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If an AQI of poor or very poor is issued, exposure can be reduced
by:
- Encouraging children to play outdoors earlier in the day when
pollutant levels are lower.
- Children with asthma should be urged to stay indoors if possible.
- Avoiding strenuous outdoor activity.
Primary Prevention
There are also a number of activities that contribute to air pollution
that all of us should consider such as:
- Limiting unnecessary use of a car, or gas-powered machinery
(e.g., lawn mower)
- Avoiding car idling for longer than two minutes
- Car pooling or taking alternate transportation such as bicycle
or public transport
- Limiting application of solvent-based paints
- Keeping cars properly maintained and tuned
- Buying a low emission vehicle
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