Congress is currently considering funding for a key priority for the asthma and allergy community: healthy schools.

Healthy School Environments

The Environmental Protection Agency’s (EPA) Healthy School Environments program focuses on improving indoor air quality (IAQ) for kids in U.S. schools.

The EPA receives funding to help schools improve overall IAQ. Poor IAQ is a known asthma trigger. It also impacts tests scores and academic achievement. Better ventilation and air quality will help schools reduce asthma triggers and airborne viruses, such as the coronavirus that causes COVID-19.

This year, we are asking Congress to give the EPA $110 million in funding to support healthy school environments. These funds would allow the EPA to help schools improve IAQ through education and technical assistance.

More than 20 years of published research has shown that there are more pollutants indoors than outdoors. A large number of school buildings have been neglected for decades and contain many indoor pollutants.

Poor IAQ is a serious health concern for people with asthma and allergies. Indoor triggers increase the risks of asthma attacks and allergic reactions. Nearly 1 in 13 school-aged children have asthma, which is a leading cause of missed school days due to chronic illness.

The time for action is now. Let’s work together to ask Congress to fund healthy school environments for our kids.

Take Action for the Asthma and Allergy Community

You can help us advocate for funds for this important program. Fill out the information below to send a letter to key members of the Senate and urge them to fund these priorities for our school children.

You may have seen news reports of a shortage of albuterol – a common quick-relief medicine used for asthma – and have concerns.

The shortage is of liquid albuterol used for nebulizers mostly in the hospital setting.

Albuterol inhalers are not affected at this time. Most people with asthma will have other options for quick-relief medicines.

If you use nebulized albuterol, we have information to help you work with your doctor and pharmacist to find an alternative.

What Do I Need to Know About the Albuterol Shortage?

As of the date of this blog post, the shortage is mostly seen in liquid albuterol used by hospitals and outpatient clinics.

If you use a nebulizer or care for someone who does, you may be affected by this shortage. If so, you may be able to switch to an albuterol inhaler used with a spacer or valved holding chamber. These work just as well for all ages as nebulized albuterol. Albuterol inhalers and spacing devices are currently widely available.

If you or the person you care for do not have the physical ability or hand coordination to use an inhaler with a spacer or chamber, there are metered dose albuterol inhalers that are breath actuated and do not require pressing down on the canister (for example, ProAir RespiClick®).

If you are not able to use an MDI inhaler with a spacer, your doctor may recommend a different medicine and inhaler type or refer you to occupational therapy for help.

Should I Be Concerned About the Shortage?

The Asthma and Allergy Foundation of America (AAFA) community has not let us know that they can’t find an alternative that works for them during this albuterol solution shortage. If you have had trouble getting albuterol due to this shortage, please contact us. (You can comment on the blog below or contact us privately.)

Also, members of AAFA’s Medical Scientific Council have not seen widespread issues with asthma care due to this shortage. But our asthma community and medical experts have shared many other barriers to medicine access not related to the shortage. These include high costs, pharmacist shortages, and pre-authorizations or step therapy requirements that prevent people from getting the care they need.

What Can I Do If I Can’t Get Albuterol?

The asthma community is resourceful. People with asthma and doctors are working together to address the current supply issues. Most of you are not seeing problems because effective alternatives exist.

At this time, there is not a crisis. But if you have challenges getting nebulized albuterol in your area, please reach out so we can help you navigate this challenge.

Medical Review: March 2023 by Jeffrey G. Demain, MD

As we prepare for spring, the Asthma and Allergy Foundation of America’s (AAFA) has released our 2023 Allergy Capitals™ report.

AAFA’s report ranks the top 100 most challenging cities in the continental United States to live with seasonal pollen allergies. The report includes data from the previous year to create a ranking of the 100 most populated cities based on:

• Tree, grass, and weed pollen scores
• Over-the-counter allergy medicine use
• Availability of board-certified allergists/immunologists
  
  

This year’s report also highlights three topics related to seasonal allergies:

• Self-care for seasonal allergies
• Climate change and worsening pollen seasons
• The importance of pollen sensors across the United States
• Climate change and worsening pollen seasons
• Self-care for seasonal allergies
  
  

People with asthma and allergies should be able to find relief no matter where they live. AAFA releases this report each year to help you manage your seasonal allergies. With proper diagnosis, the right treatment, and by reducing contact with pollen, you can feel better and improve your quality of life.

“Managing pollen allergies is possible,” says Dr. Neeta Ogden, allergist and spokesperson for AAFA. “While it is best to avoid pollen allergy triggers, that may not always be possible, as this report makes clear. Working with a specialist can offer you solutions to improve your quality of life. It is important to consult with your allergist about your symptoms so you can devise a treatment plan that best helps you manage them. Allergy testing is also a way to better understand your allergy triggers and, therefore, better manage them.”

Symptoms of Seasonal Allergies

Seasonal allergies are known as seasonal allergic rhinitis. You may have heard it called “hay fever.” Seasonal allergies can cause symptoms during the times of year when pollen counts are high. This is usually in the early spring, during the late summer, and early fall. Some states even have pollen year-round now.

The symptoms of seasonal allergic rhinitis are:

• Sneezing
• Stuffy nose (due to blockage or nasal congestion)
• Runny nose (also known as rhinorrhea – usually a thin, clear discharge)
• Red and watery eyes
• Itchy nose, eyes, ears, or mouth
• Swelling around the eyes
  
  

Practice Self-Care for Seasonal Allergies

If you think you have seasonal allergies, see a board-certified allergist to confirm your allergies and help you come up with a plan to manage them.

You can manage your allergy symptoms with self-care and an allergy treatment plan. Now more than ever there are a number of available and accessible options to help you find relief. Follow these steps outlined in our report to practice self-care:

• Manage your contact with pollen
• Take allergy medicine
• Rinse out your nose
• Ask your doctor about immunotherapy
  
  

See the 2023 Allergy Capitals report for more information on how these steps can help you manage your seasonal allergy symptoms. Talk with your doctor about which allergy treatments are right for you.

The 2023 Allergy Capitals report is an independent research project of AAFA and is made possible by a research support grant from the Consumer Healthcare Products Association.

If you have chronic spontaneous urticaria (CSU), you may often feel powerless to fight the hives and painful swelling you experience during a flare. Managing CSU can be difficult because the symptoms can impact your appearance and quality of life. It can take a long time to get diagnosed. And even with a diagnosis, common treatments may provide little or no relief.

The good news is you can get some help. By staying informed of recommended and newer treatments, you can communicate effectively with your health care provider. Want to learn how? Join us for a live webinar on managing CSU, “It’s Not in Your Head! How to Manage Your Chronic Spontaneous Urticaria and Feel Better,” on Monday, March 27, at 4 p.m. ET.

REGISTER NOW

The webinar will feature a doctor, a representative from a patient advocacy group, and a person with CSU. The expert panel will talk about:

• The latest information on CSU
• Causes of CSU
• Difficulty diagnosing CSU
• CSU treatment options and signs you should change treatment
• And much more
  
  

During this webinar, you will also learn how to talk with your doctor about appropriate treatment options and learn about medicines that may soon be approved for CSU.

If you miss the live webinar, you will also be able to watch the recording later on demand.

Have questions about CSU? The expert panel will answer questions from the audience during the session. Submit your questions now until the start of the webinar.

SUBMIT YOUR QUESTIONS NOW

Earlier in 2023, the Environmental Protection Agency (EPA) released a proposed update to the National Ambient Air Quality Standards (NAAQS) for Fine Particulate Matter (PM_2.5). These standards are more commonly known as the soot pollution standards.

Below you can learn:

• More about the soot pollution standards
• How the standard impacts people with asthma
• How you can join the Asthma and Allergy Foundation of America (AAFA) in urging the EPA to set stronger, evidence-based standards that will protect our health
  
  

The National Ambient Air Quality Standards

The NAAQS are regulations set by the EPA to protect public health and the environment. They limit the levels of harmful pollutants in the air.

The NAAQS set maximum limits on six common air pollutants:

• Ground-level ozone
• Particulate matter
• Carbon monoxide
• Sulfur dioxide
• Nitrogen oxides
• Lead
  
  

By setting these standards, the EPA aims to ensure that the air we breathe is clean and safe. The EPA reviews and updates NAAQS regularly to reflect the latest scientific research on air pollution and its effects on human health and the environment.

States and local governments are responsible for applying and enforcing the NAAQS. They often do this through measures such as:

• Emission controls on industrial sources
• Vehicle emissions testing
• Other air pollution reduction programs
  
  

The soot pollution standards are part of the NAAQS regulations.

Soot Pollution Impacts Lung Health

Soot or particle pollution is produced by power plants, vehicle tailpipes, and other industrial sources. These sources release small particles into the air. They can be found in haze, smoke, and airborne dust.

People with asthma are at greater risk of being affected by small particles in the air. Breathing in these particles can make asthma worse. Both long-term and short-term exposure can cause health problems, such as reduced lung function and more asthma attacks.

Soot pollution is also linked to more emergency room visits, hospital stays, and missed school days related to asthma. Asthma is one of the most common chronic illnesses in children and is the leading chronic cause of missed school days.

In the United States, the burden of asthma falls disproportionately on Black and Hispanic populations, especially on minority children. These groups have higher rates of poor asthma outcomes, including hospital stays and deaths. These are the same populations that confront higher exposure to air pollutants like soot.

The Soot Pollution Standards

The NAAQS for PM_2.5, or the soot pollution standards, set by the EPA are two different standards that regulate the amount of soot in the air.

1. The first standard limits the annual average level of soot. This is important because of the negative health outcomes related to long-term exposure to soot.
   
   
2. The second standard limits short-term spikes of soot. This is also important because people exposed to higher levels of soot for hours or days can have immediate health effects like asthma episodes and other respiratory symptoms.
   
   The second standard, or daily standard, is especially important for people with asthma because it informs the daily Air Quality Index (AQI). The AQI is the national system that alerts you when air quality is unsafe in your area.
   
   

Both of these standards are necessary to ensure that the air we breathe is safe and healthy for everyone.

EPA’s Proposed Soot Standards Are Not Strong Enough

Despite the severe health risks associated with soot exposure, soot pollution standards have not been updated since 2012. AAFA has long advocated for updating the standards to better protect our health. We are pleased that the EPA has decided to take action.

But the EPA’s proposed soot standards must be stronger to line up with the current science to protect the health of people in the United States.

AAFA and other public health groups have repeatedly called on the EPA to set an annual standard of 8 micrograms per cubic meter (µg/m³) and a daily standard of 25 µg/m³. But the EPA’s proposal only sets the annual standard at 9-10 µg/m³. It does not propose a change to the daily standard, leaving it at 35 µg/m³.

The EPA’s own Regulatory Impact Analysis shows that changing the annual standard from 9 µg/m³ to 8 µg/m³ would prevent more than twice as many diagnosed cases of asthma.

Take Action!

There is still time to ask the EPA to strengthen the proposed soot pollution standards. The EPA is taking comments on its proposal until March 28.

This is an important opportunity to show the EPA that the asthma and allergy community supports stronger standards that ensure clean air for all.

AAFA will be sending a letter in support of an annual standard of 8 µg/m³ and a daily standard of 25 µg/m³. Science shows that these levels will save thousands of lives, advance environmental justice, and protect our health.

You can add your voice by filling out the form below. AAFA will then collect the responses and submit your responses to the EPA.

Thank you for your advocacy!

Black Americans bear a much higher burden of asthma than white Americans. Compared to white Americans, Black Americans are five times as likely to visit the emergency department due to asthma, two times as likely to stay in the hospital due to asthma, and three times as likely to die from asthma. This is why reducing asthma disparities is a critical part of the mission of the Asthma and Allergy Foundation of America (AAFA).

Despite these statistics, people like Darren Riley are making an impact within their local communities. In honor of Black History Month, AAFA spoke with Darren about the important work he does.

Q: What led you to measure air quality data?

Darren: Getting diagnosed with asthma a few years ago made me more aware of how much our environment influences our quality of life and how many chronic diseases, such as asthma, disproportionately impact communities of color. I believe your health should not be determined by where you are born and your skin color. I am inspired and hopeful to contribute to the great work of leaders who came before me and continue to fight for the quality of life their community deserves unapologetically.

Q: Why are you passionate about working to end asthma disparities and improve air quality?

Darren: The experience of an asthma attack – where there is nothing in the world you want more than to breathe normally – is something that no one should experience. From writing code and drafting proposals to deploying air quality monitors, I am deeply driven by recalling moments of panic, wheezing, and gasping. Just the thought that someone is experiencing an asthma episode where their lungs are working against their well-being keeps me focused on easing the burden of asthma.

Q: What is your favorite part of the work you do with your local community?

Darren: As a Black founder in the environment/climate tech space, I appreciate the opportunity to collaborate with the community that has and will continue to lead this work. JustAir is a supportive infrastructure for solutions, such as tree canopying or electric school buses, and means that can help create a more equitable breathing environment for all.

Q: What recommendations do you have for people interested in reducing asthma health disparities in their local communities?

Darren: We can reduce allergy, asthma, and health disparities by changing our behaviors, environment, and policies. Before jumping to solutions, I recommend discovering who is working on similar efforts and what has already been done in your community. There is also an opportunity to learn from other communities who may have faced similar disparities for inspiration and/or collaboration.

Q: Is there anything else you’d like to share as you reflect on Black History Month and your work?

Darren: As I reflect upon Black History Month, I feel hopeful that we are building toward a more just world. I find it hard to accept the status quo when so many before us had to overcome seemingly impossible odds to give us a better quality of life. We all deserve equitable access and quality – from the food we eat to the water we drink and the air we breathe. I am both grateful and committed to working toward a future where the community you are born into doesn't determine the quality of the air you breathe.

Why You Need to Rinse and Spit

Did you know there is a connection between oral health and asthma?

When you use an asthma inhaler that has corticosteroids [CORE-te-coh-STAIR-oids] in it, the medicine can stick to the inside of your mouth. When the medicine stays in your mouth, it may cause problems with your teeth, gums, tongue, and cheeks.

Using corticosteroid inhalers can lead to:

• Thrush – a fungal infection on your tongue or cheeks
• Dry mouth
• Gum irritation and swelling
• Cavities (dental caries)
  
  

Examples of inhalers that have corticosteroids include:

• Advair Diskus® (fluticasone/salmeterol)
• AirDuo® (fluticasone/salmeterol)
• ArmonAir™ Digihaler® (fluticasone propionate)
• ARNUITY® ELLIPTA® (fluticasone furoate)
• Asmanex® Twisthaler® (mometasone)
• Dulera® (mometasone/formoterol) HFA
• Flovent® (fluticasone propionate)
• Pulmicort® Flexhaler® (budesonide)
• QVAR® RediHaler™ (beclomethasone dipropionate)
• Symbicort® (budesonide/formoterol) HFA
  
  

The good news is you can keep your mouth healthy! After you use your asthma inhaler, rinse your mouth well with water and spit it out or brush your teeth. If you have a child with asthma, they may be more likely to get cavities, so it is important to teach them to rinse and spit after using their asthma inhaler.

Don’t forget to also floss, brush your teeth twice a day, and limit sugary foods and drinks. See your dentist twice a year so they can make sure your mouth and teeth stay healthy.

The flu, respiratory syncytial [sin-SISH-uhl] virus (RSV), and COVID-19 have been spreading this winter, creating what has been called a “tripledemic.” Managing asthma as these illnesses spread is important. The Asthma and Allergy Foundation of America (AAFA) and John James, MD, hosted a webinar titled, “Asthma and the ‘Tripledemic.’” You can now watch the replay on demand.

During the webinar, we talk about:

• What is the “tripledemic”?
• The effects of respiratory illnesses on people with asthma
• Disparities and burden of asthma
• Ways you can stay healthy
  
  
  

Watch on YouTube

About John M. James, MD

John M. James, MD, is a board-certified allergist. He is also President of Food Allergy Consulting and Education Services, LLC. He has worked as a medical specialist in the field of allergy, asthma, and immunology for over 30 years. Dr. James received his bachelor’s degree from the University of Arkansas and his Doctor of Medicine degree from the University of Tennessee. He is board certified by the American Board of Allergy and Immunology.