Monday, December 8, 2014
Introducing an environmental assessment and intervention program in inner-city schools
Few studies have comprehensively examined the role the school environment plays in asthma and how effectively changing the environment may reduce morbidity, when adjusting for exposures in the home. In their review, Huffaker and Phipatanakul summarize the importance and common challenges of school-based environmental assessment and intervention studies linked to health effects (J Allergy Clin Immunol 2014; 134: 1232-1237). They discuss the challenges and potential benefits of comprehensive environmental assessment and health outcomes in inner-city schools.
The school environment has been shown to be a significant reservoir for allergens and pollutants. Indoor allergens known to be important in urban home environments may also be important in schools, including cockroach, cat, dog, mouse, dust-mite, and molds. Studies have identified children with asthma in inner-cities have markedly higher levels of mouse allergen in their schools compared to levels in their individual bedrooms. Given the paucity of comprehensive data on school-based environmental interventions and health outcomes, successful home-based strategies currently serve as the model for school-based interventions. For example, practical interventions to reduce environmental exposures at home such as the use of air filtration systems and integrated pest management can be utilized in schools.
Despite the challenges associated with implementing environmental interventions in schools, evidence supports the importance of school and classroom exposures and health outcomes. School-based interventions have the potential to reduce exposures for many symptomatic children, in contrast to the individual families impacted by home-based interventions. If effective, results from school-based interventional studies could inform public policy change, funding and initiatives. If it can be demonstrated that reduction of classroom-specific exposures leads to improved asthma outcomes, then findings can be translated into efficient and cost-effective strategies to benefit communities of children through improvement of the school environment, where children in America spend the majority of their day.