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.









"Eliminate, separate and ventilate"















Be aware of media advisories of high pollution or high
pollen levels
















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

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.


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

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).

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
Copyright © 2000 Canadian Association of Physicians for the Environment
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