Asthma-Friendly Schools in Vermont | Vermont Department of Health

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Becoming an asthma-friendly school is simple to do and benefits all students and staff—especially those who have been diagnosed with asthma. roughly 9,000 (1 in 12) of Vermont's children has asthma, and Vermont is among the top five states in the country in asthma rates. That means the potential for lots of missed school and workdays, and even asthma-related emergencies.

Why Become an Asthma Friendly School?

Today as we emerge from the COVID-19 pandemic, it is important to keep building on all the amazing work that schools and their staff have carried out to keep children learning in safe environments. With schools back to their regular schedules, children and staff with asthma may need extra support to reset their asthma management routines and bring their asthma under control. Continuing to take actions that make your schools as asthma-friendly as possible is key, including helping students and staff members with asthma avoid triggers, manage their symptoms, and successfully learn and thrive.

Many asthma-friendly strategies are simple to implement, low-cost, and likely to help schools satisfy other policy requirements and best practices as many of the steps have already been taken to address COVID-19 challenges.

How to Become an Asthma Friendly School?

Below are some proven practices, protocols, programs, and policies that can help to create asthma-friendly school environments. The following should be adopted by all schools and Local Education Agencies (LEAs):

Tier 1 | These are the most important steps for your school and any 3 of the following may qualify a school for recognition as a gold level asthma friendly school.

Complete an ENVISION Environmental Walkthrough. (available as a dynamic online tool or as a printable checklist)

The Envision Program’s goal is to improve indoor air quality so that all members of a school community—including students and school staff with asthma—stay healthy and thrive in the school environment. This walkthrough will help school staff identify potential environmental health issues and areas to improve the school environment for people with asthma.

» ENVISION Dynamic Online Tool
» ENVISION Printable Checklist

Offer Asthma Self-Management Education.

An example of Asthma Self-Management Education is the Open Airways for Schools program, which educates and empowers children to better manage their asthma. The program teaches children with asthma about common symptoms, understanding medications, identifying and avoiding their triggers, managing asthma, detecting the warning signs of worsening asthma, and knowing what to do in an emergency.

Obtain a written Asthma Action Plan for at least 75% of students with asthma.

Asthma Action Plans are completed by the student’s health provider. These plans should be shared with the student’s school nurse, coaches, and any other caregiver as they provide easy access to information and guidance on how to support the student in managing their asthma, and what to do in an emergency. Prior to the start of the school year, ensure that an up-to-date Asthma Action Plan is on file for all students with asthma.

» Learn more and download an Asthma Action Plan.

Include an Asthma Emergency Plan in the official handbook(s) to reach all three (3) audiences – staff, parent(s), and student(s).

Asthma Emergency Plans help staff members, students, parents, and guardians know how schools prepare for and deal with emergencies related to asthma. These Plans help ensure everything is in place before they are needed.

Have a Whole School, Whole Community, Whole Child (WSCC) or equivalent team that addresses indoor air quality and meets at least two times per year.

Schools play a critical role in promoting the health and safety of young people and helping them establish lifelong healthy behaviors. The WSCC model is the CDC’s framework for addressing health in schools and emphasizes the role of the community in supporting the school, the connections between health and academic achievement, and the importance of evidence-based school policies and practices, including those that improve air quality.

Tier 2 | These steps bolster the best practices and policies in Tier 1 and any 3 of the following may qualify a school for recognition as a silver level asthma friendly school.

Obtain a written Asthma Action Plan for at least 65% of students with asthma.

Prevent parents, teachers and staff from bringing in unauthorized, non-third-party certified cleaning products or fragrance products (e.g., air fresheners, essential oils, candles) into your school.

Make HVAC improvements, install air purifiers and/or conduct maintenance on these systems to increase ventilation, improve filtration and/or address humidity.

Encourage annual well-child exams, and achieve the state average of 72% of students whose parents report the child received an annual check-up.

Staff members are trained in asthma basics, asthma management, and asthma emergency response.

Include an Asthma Emergency Plan in the official handbook(s) to reach any two (2) audiences – staff, parent(s), and student(s).

Tier 3 | Together, these steps act as a strong foundation for asthma-friendly policies & programs; and any 4 of the following may qualify a school for recognition as a bronze level asthma friendly school.

Use electronic health records to identify, track, and maintain individual health plans for students with asthma.

Uphold Vermont state law that bans the use of cigarettes, tobacco products, and tobacco substitutes (e.g. e-cigarettes) on school property, school buses, and at school-sponsored events.

Uphold Vermont state law that establishes students’ right to self-carry and self-administer prescribed asthma medication.

Enforce Vermont state law on vehicle idling policies on school grounds and at school-sponsored events.

Purchases only 3rd party certified asthma friendly cleaning products.

Have a written indoor air quality (IAQ) management plan that reduces or eliminates allergens and irritants.

Include an Asthma Emergency Plan in the official handbook(s) to reach any (1) audience – staff, parent(s), and student(s).

Obtain a written Asthma Action Plan for at least 50% of students with asthma.

Be Recognized as an Asthma Friendly School

Good news! Implementing these practices, in addition to other key steps, also make you eligible to be recognized as an asthma-friendly school, which recognizes schools at bronze, silver and gold levels that demonstrate a commitment to asthma-friendly strategies and practices.

Learn More

Vermont’s Asthma Friendly Schools Recognition Program

The Vermont Department of Health’s Asthma Program annually recognizes schools that can demonstrate the highest commitment to improving and maintaining asthma friendly policies and practices in their schools and to promoting good asthma management among their students. Asthma-friendly strategies are simple to implement, low cost, and benefits all students and staff—especially those diagnosed with asthma. With Vermont second in the country in asthma rates it is important for schools to be as asthma-friendly as possible to help students with asthma avoid triggers, manage their symptoms, avoid missed school days and asthma-related emergencies, and be able to successfully learn unhindered.

Asthma Friendly Schools Task Force

Feel free to reach out to any of our Asthma Friendly Schools' Task Force members for technical support and clarification on any of the asthma friendly criteria. We'll be happy to offer technical assistance and encouragement to help you reach bronze and continue to improve to "go for gold."

Karen Casper, PhD, Asthma Program Manager, AHS.VDHAsthmaProgram@vermont.gov
Kaitlyn Kodzis, MSN, BSN, RN, State School Nurse Consultant, Kaitlyn.Kodzis@vermont.gov
Michelle Thompson, MPH, Public Health Industrial Hygienist and ENVISION Program Manager, envision@vermont.gov
Charen Fegard charenfegard@gmail.com, Informed Green Solutions
Carol Westinghouse cjwestinghouse@gmail.com, Informed Green Solutions
Lauren Ressue, PhD, Public Health Analyst, Lauren.Ressue@vermont.gov

Asthma & COVID-19

Individuals with moderate to severe asthma may be at a higher risk of developing severe illness from COVID-19. Since COVID-19 can affect the respiratory tract, being exposed to the virus may lead to an asthma attack, and possibly acute respiratory disease and pneumonia.

» Get the most up-to-date information on Vermont’s response and guidance surrounding COVID-19.
» Learn more about the link between COVID-19 and asthma via the CDC.

Important COVID-19, Flu Season, and Asthma Considerations for Schools

Do students and staff members with asthma need to wear masks?

While it is a requirement to wear a mask in Vermont, if an individual has breathing difficulties or another medical or behavioral reason making it difficult to wear a mask, then this requirement may be waived. These decisions should be made in partnership with a health care provider or school nurse.

Which products are recommended to be used for cleaning schools?

Since many cleaning products and chemicals can trigger asthma symptoms and attacks, schools are strongly encouraged to use cleaning products that are fragrance-free, non-toxic, and certified by a third-party like Green Seal or EPA’s Safer Choice. Disinfectants should be certified by The EPA's Design for the Environment Program or contain safer active ingredients such as hydrogen peroxide, citric-acid, ethanol, or l-lactic acid.

Under Vermont’s Act 68 of 2012, commercial vendors are required to only sell third-party certified, environmentally preferable cleaning products to Vermont schools.

Schools and LEAs should also prohibit staff members, teachers, and parents from bringing in cleaning products.

How can schools use disinfectants properly to control COVID-19, knowing that some students and staff members have asthma?

People with asthma may find that their symptoms are made worse when exposed to smells and fumes from cleaning chemicals and disinfectants. The United States Environmental Protection Agency (EPA) encourages individuals to take the following safeguards when using cleaning products in any setting:

Select products with safer ingredients, like ethanol, isopropanol (isopropyl alcohol), hydrogen peroxide, L-Lactic acid, or citric acid
Always read labels and only use products as directed
Use products that could reduce inhalation exposure (e.g. damp paper towels or wipes, rather than sprays) when disinfecting surfaces
Wash hands after handling any cleaning product or after coming into contact with a surface that may be contaminated with COVID-19

» Review the CDC’s cleaning recommendations for COVID-19

What about indoor air quality systems and preventative maintenance procedures?

Did your school make HVAC improvements to increase ventilation, improve filtration and/or address humidity? Keeping these air quality systems and preventative maintenance procedures up-to-date and implemented properly can help support good air quality and COVID-19 prevention efforts.

The following steps are recommended with regard to ventilation and HVAC:

Ensure that the school ventilation system is properly cleaned and meets the operating standards recommended by the manufacturer.
Operate HVAC systems in occupied mode for at least a week prior to reopening while assuring that the outdoor air dampers are open.
Encourage staff members to provide additional outside time, as well as open windows when it is safe to do so (e.g., when there is no risk of falling, noise, or triggering an asthma attack).
Ensure ventilation systems work properly and increase circulation of outdoor air.