Jeff Seyler is the CEO of the American Lung Association of the Northeast. He presented at the PVAC monthly meeting on April 30, 2014.

ALA Advocacy and Grassroots Efforts

• Historically, Massachusetts has been a leader in tobacco prevention. Recently, however, tobacco prevention dollars have been cut significantly.
• Mid-90s: ALA began advocating for tobacco product bans in retail stores.
  • Target removed tobacco products from their stores in 90s.
• 2000s: ALA revived efforts to ban tobacco products in stores.
  • 2008: ALA asked CVS, Walmart, Walgreens, etc to voluntarily remove tobacco products from shelves. All stores initially declined.
• 2009: Boston banned tobacco in pharmacies.
  • Once critical mass of towns support bans, it becomes easier to pass bans in other towns.
• February 2014: CVS announced that the drugstore chain would stop selling tobacco products in its stores by October 2014.

E-Cigarettes: The New Battle

• Recently, FDA passed regulation for e-cigarettes. This is a big step since there were no regulations beforehand.
  • Ex. Retailers can no longer sell e-cigarettes to individuals under 18.
• Need to change writing of laws to include e-cigarettes with other tobacco products.
  • E-Cigarettes can currently be used in places where other tobacco product cannot be used, like stores, restaurants, etc.
  • Youth are targeted in e-cigarettes advertisements.

Sylvia Brandt is an Associate Professor at UMass Amherst in the Department of Resource Economics. Her research looks into why the health impacts of asthma fall disproportionately on the young and poor in the US.  

• During lung development from birth to adolescence, there is risk that air pollution can lead to:
• Chronic cough and bronchitis
• Reduced lung function
• Wheezing and asthma attacks
• Respiratory-related school absences
• Respiratory symptoms and illnesses
• Respiratory death
• California is the only state with a law preventing schools from being built next to highway. However, even in the state of California, there are loopholes.
• For children, living in close proximity to Class 1 Highways has been linked to significantly increasing the chance of developing asthma.
• The Case of Los Angeles County
• 2.5 million children
• Pollution-attributable outcomes
• 8% of asthma cases (27,100 cases)
• 20% of hospitalizations
• 31% school absences (especially bad ozone days)
• Categories of Cost
• Direct Costs (explicit costs): Associated price tag
• Cost of inhalers
• MD and ER visits
• Indirect Costs (implicit price): Opportunity costs (implicit price)
• Missed work or school
• Reduced productivity
• Quality of life impacts
• Bottom-Line
• Childhood asthma has large impacts
• It represents a large intergenerational transfer of welfare.
• There is only economy and environment NOT economy versus environment.  

• Agenda for Action
• National Level
• Push for tighter limits on PM on ozone
• Improve car tailpipe standards to reduce sulfur emissions.
• Immediate-run initiatives
• Enforcing bans on idling
• Retrofitting of existing school buses and replacing older ones.
• Medium-run changes
• Buffers between roadways and homes & schools
• Filtration systems in schools
• Longer-run
• Regional planning – locating schools, playgrounds away from highways
• Replacing auto fleet electric vehicles
  
• View the powerpoint presentation
  

Bill Bell is a Radiation Scientist and a supervisor of the Radon Unit, Massachusetts Department of Public Health. Bill has extensive experience in radon testing and mitigation and regularly provides consultation and technical assistance to consumers, the radon industry, as well as local, state, and federal agencies. He presented an overview of the risks from radon as well as testing and remediation.

• What is Radon?
• Naturally occurring radioactive gas
• Can be found anywhere – can’t smell it, taste it, feel it, see it, etc…but you can detect it!
• Can have high concentrations indoors

• Radon causes lung cancer
• Known human carcinogen
• #1 cause of Lung Cancer – Non-Smokers
• #2 cause of Lung Cancer – Smokers
• Many deaths are preventable

•  Radon in Massachusetts
• 1988 State/ EPA Survey of 1650 homes
• Elevated radon levels have been found in all regions of the state
• We cannot predict which buildings have high levels
• All homes and schools should be tested

• Conducting a Radon Test
• Short Term – 48 hours
• Test lowest livable area of the house
• Ex. basement
• Avoid kitchen, laundry, bathrooms, closets
• Test during heating season
• Building should be heated
• Heat is main thing that draws radon into a house
• Closed house condition
• All doors and windows in whole house closed except for normal entry and exit; begin 12 hours before and all during the test period
• Action Guide: 4 pCi/L
• Consider action: 2 – 4 pCi/L
• Radon Mitigation Approach
• Active soil depressurization
• Works by changing relative pressure
• Reverse the flow of air – stops the radon entry
• Goal is to get less than 2 pCi/L
• Usually, cost can be around $1,500
• View powerpoint presentation
  

Kathy Wicks is the Project Manager at Live Well Springfield. She presented at the January PVAC Monthly Meeting about Live Well Springfield and the organization’s current marketing campaign. 

• What is Live Well Springfield?
• Coalition of over 25 organizations,  an umbrella group for the healthy living movement.
• Initiatives include improving food access, planning for safe walking and biking around Springfield, and revitalizing the riverfront.
• Ex. Mobile food market
• Oversee the coordination of organizations and government initiatives to bring about citywide improvements.
  

• Current Marketing Campaign
• Focus groups led to a story-based poster campaign.
• Each poster features the story of one person, and includes a quote, tagline, organization, and the LiveWell website link.
• Stories focus on people who make small but significant changes in their lives and the lives of people they care about.
• Currently they have 20 stories, and they are still collecting more.  
• LiveWell website includes the full stories of the people featured on the posters, as well as videos.
• Posters will be published in local newspapers, advertised on social media, and exhibited in print at multiple Springfield locations.

Learn more about LiveWell Springfield. 

Chrystal Wittcopp, MD is the Director of Baystate Children's Hospital Weight Management Program and an Assistant Professor of Pediatrics at Tufts University School of Medicine. She presented on the possible link between asthma and obesity at the PVAC monthly meeting on October 23, 2013.

Obesity and Asthma in Springfield

• Springfield has one of the worst obesity rates in the state, with 44% of 5^th Graders overweight or obese (2005).
  
• Springfield also has a high rate of asthma, and this may not be a coincidence.

Are asthma and obesity connected?

• Over the last 30 years, there has been an increased incidence of both asthma and obesity in children and adults.
• NHANES 2006 data showed the risk of asthma in youth increased by 1.3 if overweight and 1.7 if obese.
• Although there are multiple theories on the mechanics of this link, it seems to strengthen the longer an individual is obese.
• Studies have shown weight reduction in obese patients reduces asthma symptoms.

The MIGHTY Program

• A 6-month, interdisciplinary program at the YMCA that promotes healthy nutrition, activity, and lifestyle.
• It serves children age 2 – 21 that have been diagnosed with obesity higher than the 95^th percentile.
• Learn more about the MIGHTY Program.

View the entire PowerPoint presentation.

Jamie Klingensmith, PVAC’s recent interm coordinator, recently presented a poster entitled “Implementation of Evidence- Based Practices to Improve Asthma in a Urban School System” about the Springfield School Nurse Asthma Champion program at the American Public Health Association conference. The poster was co-authored by Matthew Sadof, PVAC Chair and Kathleen Szegda, former PVAC Manager and currently Partners for a Healthier Community Director of Research and Evaluation.  She shared the poster at the PVAC monthly meeting on November 20, 2013.

Key Poster Points

• Background
• 20% of school-aged children in Springfield have asthma, compared to 11% overall in Massachusetts.

• Program Components
• The program combines the Environmental Protection Agency’s Tools for Schools, the American Lung Association’s Open Airways curriculum and Asthma Action Plans, and better data collection.
• School Nurse Asthma Champions are key to the program, playing a role in asthma education, medical management, and environmental management.

• Results (2009 – 2013)
• Signed and filed action plans increased from 156 to 502.
• Scheduled asthma treatments increased from 1,356 to 1,947.
• Unscheduled asthma treatments decreased from 2,826 to 2,479.

Conference Feedback

• The poster was well received by other conference participants.
• Conference participants liked how the program combined the asthma action plans and medication orders in one form.
• The concept of school nurse asthma champions is unique.

View the conference poster.