In May, the Asthma & Allergy Foundation of America (AAFA) brings its educational message to government insurers, educators, and the public at large.

For many people throughout the United States, the month of May is a time when flowers begin blooming, gardens get planted, and the outdoors becomes alive after being dormant during the winter freeze. But for the estimated 75 million Americans suffering from allergies, asthma, or both, the month is a time for irritated eyes, sneezing, wheezing, and other respiratory problems. That is why the Asthma & Allergy Foundation of America (AAFA) found it appropriate to declare May the National Allergy and Asthma Awareness Month.

The Awareness Month, initiated by the AAFA, became official in 1984 by a proclamation by former President Ronald Reagan and a joint resolution by the US Congress as a means of drawing attention to the seriousness of allergies and asthma. Consider that since 1984, the United States Centers for Disease Control and Prevention (CDC) reports that asthma rates in the United States have increased 75 percent. As a result, asthma is recognized as a major national public health problem. Just as significant are the statistics for allergy sufferers in the country. The National Institute of Allergy and Infectious Diseases estimates that between 1990 and 1994, 40 to 50 million Americans were affected by allergies, with chronic sinusitis, most often caused by allergies, affecting nearly 35 million people nationwide.

Public Awareness
National Allergy and Asthma Awareness Month is a vehicle that allows the AAFA to get its message out to numerous groups of people, among them people with asthma and allergies and their families and friends, people with mild symptoms and those with chronic and severe symptoms. As its name implies, the month also is designed to bring awareness of asthma and allergic diseases by educating people such as employers, school personnel, coaches, insurers, HMOs, legislators, and others who may have encounters with individuals who have asthma and/or allergies. “The number one reason why National Allergy and Asthma Awareness Month was started was because of the growing concern over these conditions,” says Colleen Horn of the foundation’s public and media relations. “It’s a way for the AAFA to promote awareness, and the month of May is an appropriate time because it’s the height of the season for springtime allergies.”

Childhood Asthma
Because asthma rates among children are increasing to near epidemic proportions, the theme for this year’s 16th observance of National Allergy and Asthma Awareness Month is “Children Without Limits.” The theme was chosen to coincide with the Clinton Administration’s plan to spend more than $68 million to fight childhood asthma. Clinton plans to present the proposal to Congress in his fiscal 2000 federal budget. The comprehensive national initiative includes the implementation of school-based programs that teach children how to manage their asthma; funding for research to determine environmental causes of asthma and reduce children’s exposure to asthma triggers; funding to states and providers for effective disease management strategies aimed at lowering hospitalizations, emergency department visits, and deaths from asthma; and a new public information campaign to reduce exposure to asthma triggers and dust mites.

“Thousands of children are needlessly dying from this disease every year and the numbers are growing,” says the AAFA’s Executive Director, Mary Worstell. “A number of studies clearly show that children who live in our inner cities are most at risk of dying from asthma. It’s also evident that children are facing obstacles at home and at school that make asthma management difficult.” According to recent statistics from the CDC, the rate of asthma among schoolchildren ages 5 to 14 has increased nearly 75 percent over the past decade. And the rate of preschool children with asthma has increased 160 percent, reaching epidemic proportions. In addition, more than 100,000 children are hospitalized each year because of asthma, making it the leading cause of hospitalization due to chronic illness for children at a cost of $1.9 billion in medical expenses each year. Asthma also is among the leading causes of school absenteeism, resulting in more than 10 million missed school days annually.

A number of events and public awareness campaigns that center around the prevalence of childhood asthma will be conducted by the AAFA during the month of May. The foundation will be launching a day care facilities program that will help day care providers in making their facilities environmentally controlled. The monthly observance also will be used as an opportunity to bring more awareness of the AAFA’s Power Breathing, the first asthma education program designed specifically for teens. The Power Breathing program provides a basic understanding of asthma and its management in a peer-friendly environment and motivates teens to take control of their asthma on a personal level. In addition, the foundation hopes to obtain more funding support to expand its school nurse provider programs throughout the United States. “The AAFA has developed community-based programs with the goal of decreasing the high number of deaths, emergency department visits, and lost school days–all of which are preventable,” Worstell explains. “And the AAFA will continue to develop programs to meet the needs of the underserved.”

Other Activities
Additional activities for National Allergy and Asthma Awareness Month are under way by local AAFA chapters located in Alabama, California, Florida, Georgia, Missouri, Maryland, Michigan, New England, New York, Texas, Pennsylvania, and Washington. The Maryland Chapter, for instance, selects a poster child and has a ceremony at the governor’s office. “Throughout the month, we also increase our public service announcements throughout the state to bring awareness of asthma and allergies,” explains Maryanne Ellis, executive director of the chapter. “And we also honor our volunteers throughout the month.” In Michigan, the AAFA chapter plans to hold a Walk-a-Thon at Michigan State University to promote awareness of the seriousness of asthma and allergies in the country.

During the May observance, the New York chapter plans to expand its educational campaign by offering its free asthma education program called “Meetings in a Box,” a kit for physicians, respiratory therapists, nurses, pharmacists, or other health care professionals that contains various components for a successful asthma presentation. Other educational offerings include the free booklet, “How to Outsmart Your Allergies.” Because asthma is prevalent in inner cities, especially among children, the chapter will be increasing its meetings around New York City during the month of May.

On tap for the Greater Kansas City Chapter in Missouri is a May Golf Tournament. The event, which will feature local celebrities, is designed to bring awareness of asthma and allergies while raising money for the chapter. The AAFA Washington State Chapter will hold a fair at a major mall and offer free asthma screenings as part of the event. “We’ll also have professional education training with continuing education credits available for nurses, pharmacists, and respiratory therapists to educate them about asthma management and how to teach it to their patients,” says Cheryl Selvar, the chapter’s executive director.

In previous years, the AAFA-sponsored activities during the month of May took asthma and allergy education into schools, the workplace, and the marketplace. According to the AAFA 1996 statistics, an estimated 15 million Americans now have asthma and about 60 million Americans have allergies, one of the most prevalent diseases known to medicine. Untreated asthma has led to about 5,000 deaths each year.

Working in partnership with the AAFA for National Allergy and Asthma Awareness Month is the American College of Allergy, Asthma & Immunology (ACAAI). One activity that is becoming key to the monthly observance is a free asthma screening program. The program, which is a volunteer effort funded by an education grant from Astra, a pharmaceutical company that manufactures asthma medication, encourages people experiencing breathing problems to be tested to determine if they are at risk for asthma. “The purpose of the nationwide screening program is to find adults and children with symptoms of asthma, such as coughing, wheezing, or shortness of breath,” explains John Winder, MD, this year’s chairman of the program. “The objective of the program is to keep people on their feet and out of the hospital by using prevention efforts to help them understand and manage their disease. This is our third year and the popularity of the program is growing by leaps and bounds.”

Free Asthma Screening Program
People participating in the free asthma screening program first complete a 20-question Life Quality Survey. Next it is on to a pulmonary function breathing test, which is performed by respiratory therapists who volunteer their time for the event. The questionnaire and results are then reviewed by asthma and allergy specialists, who also work on a volunteer basis. The specialists determine whether a more thorough examination and diagnosis are needed. This year, close to 250 sites throughout the United States will offer the screening program. Since this year’s program features a special outreach for children, screenings will take place in shopping malls, schools, zoos, civic centers, and other public locations popular with youngsters. “This is the first year that we are targeting one certain group. The thrust of our research shows that the earlier you treat asthma, the better the outcome is, especially lung function,” Winder says. According to the ACAAI, of the 15 million people with asthma, almost 5 million are children who might be at risk for irreversible lung damage if their asthma is not diagnosed and treated early. The lung damage, Winder explains, is a result of “airway remodeling” from persistent inflammation that asthma causes in the lungs’ airways. Although specific reasons for the rise in asthma rates in the United States have yet to be defined, Winder notes that allergies should not be overlooked. “Allergies are a trigger for asthma and we’re seeing about a 10 percent crossover of people with allergies having asthma,” Winder points out. In addition, about 80 percent of children and 50 percent of adults with asthma also have allergies.

The screenings also are beneficial to previously diagnosed asthmatics because they can find out how to manage their disease. “A lot of people who have asthma may not know how to control it. But if they act early, they can prevent damage to their lungs,” Winder stresses. “We also have various literature available at the screening site with information on how to manage asthma.”

During the asthma screening program’s first 2 years, more than 11,000 people nationwide were screened. Of that number, Winder reports, 50 percent were referred for further evaluation. “It’s a high referral rate, but we’re happy to have been able to identify the potential problem in people and get them the help they need,” he said.

Another cosponsor of the asthma screening program is the Allergy and Asthma Network/Mothers of Asthmatics Inc (AAN MA), a nonprofit patient education group based in Fairfax, Va. In addition to the asthma screenings, for the first time last year they sponsored Asthma Awareness Day on Capitol Hill in Washington, DC. They plan to do the same this year on May 5 as part of National Allergy and Asthma Awareness Month. Throughout the day, members of Congress will be informed about the national and personal impact of asthma and allergies in the United States. “It’s a day for legislators, their families, and staff to learn about allergies and asthma, become familiar with peak flow meters, and have the opportunity to speak to physicians and obtain information,” says Kathy Borghi, AAN MA marketing assistant. “We have vendors come in from different drug manufacturers, as well as nonprofit groups and school nurses. It’s basically a health fair about asthma for legislators.”

This year’s Asthma Awareness Day also features an art and essay contest for 5- to 15-year-olds and will focus on school issues from kindergarten to college. “Schools do not allow children to have medication on their person, so this is a problem for asthmatics. In addition, school nurses are not available in all educational facilities. On college campuses, asthmatics face an environment where smoking is all around them. So we’re taking various issues and centering them around school-age children and college students,” Borghi explains. “Because the number of children with asthma and related conditions continues to increase, this year’s Asthma Awareness Day will focus on the serious issues that students, parents, and school administrators face.”

Legislation Gets Involved
For the first year, US Representative Deborah Pryce (R-Ohio) served as the first cochair of Asthma Awareness Day. This year, more than 50 US Senators and Representatives to date have signed on as honorary cochairpersons. “As prevalent as it is, asthma remains a mystery to most people,” Representative Pryce notes. “It is my hope that with a better awareness of this disease, people will learn how to detect it and what can be done to fight it. Many people may be experiencing symptoms of asthma and not even know it. Some symptoms include tightness in the chest, shortness of breath, and wheezing or coughing. It is critical that people have these basic facts so that important warning signs are not overlooked.”

Because legislators are faced with so many subjects on a weekly basis, the Asthma Awareness Day provides them with in-depth knowledge about asthma so they can make informed decisions when it comes to legislation pertaining to the subject and its funding. “There remains a number of unanswered questions regarding this disease, and consequently, there is extensive research under way to help find the answers,” Representative Pryce explains. “One conclusion can already be drawn from years of research. Studies have shown that when patients and their families know more about their disease, they experience fewer problems. That is why Asthma Awareness programs, such as the one on Capitol Hill, play a critical role in assisting asthma patients in learning more about their disease.”

It appears that May’s National Allergy and Asthma Awareness Month is making strides. Although Horn explains that the impact of Awareness Month’s activities has not been measured over the years, the foundation has found the observance successful in promoting visibility. “We receive millions of calls throughout the year, and more and more support groups are being formed throughout the country,” Horn says. “The statistics are pretty alarming, so promoting awareness is the key to action.”

Maryellen Cicione is a contributing writer for RT.