1 1, NUMBER

VOLUME Septe ber 2008 Septe ber

American Lung Association of New England launches new Own Your Air Initiative

Sleep: School Daze

Air Pollution’s Assault on American Architecture

Back to School with Asthma

The healthy air people Air Matters / 2

Septe ber 2008 VOLUME 1, NUMBER 1 Contents

OwnYourAir.org Launched 3

School Daze: A Wake-Up Call 4

Air Pollution's Assault on American Art and Architecture 5

New England Legislative Summary 6 Discounts at over 300 locations across New England. Autumn in New England: The Colors of Pollution? 7 Act now and save the moment the 2009 season begins.

Renewable Energy in Rhode Island 7 Visit lungne.org or call 1-800-LUNG USA today to learn more about the Back to School With Asthma 8 Golf Privilege Card in your area.

Maine Native Honored 9

CFC-free Inhalers 10

ALANE Events 11

Planned Giving Q&A 12

Printed with soy-based inks on recycled paper.

KEENE MEDICAL PRODUCTS, INC. Bringing Healthcare Home Since 1975 Accredited by CHAP Th e American Lung Association of New England has offi ces in • East Hartford, Connecticut Keene Medical Products is • Augusta, Maine • Waltham and Spring eld, Massachuse s the lifeline for individuals • Concord, New Hampshire • Providence, Rhode Island in New England with • Williston, Vermont breathing dif culties. and serves the six New England states.

Contributors to Healthy Air Matt ers are from 800-639-3305 ALANE staff unless noted otherwise. keenemedicalproducts.com lungne.org | 1-800-LUNG USA | ownyourair.org OwnYourAir.org Launched Warm weather is New England’s reward for winter. Yet, we now know that the air we breathe when we are outside may be hazardous to our health.

his past March, the U.S. state, as much as 40 percent of our pollution As owners of the air, we are empowered to Environmental Protection Agency comes from cars and other local polluters. take those steps necessary to protect it, per- (epa) changed its outdoor air quality Few people realize that lung disease sonally and as a community. Th is includes standards. But, according to its own panel claims about 335,000 lives each year in the taking responsibility for keeping our air clean of scientists, the new standards are not strict U.S. and is the third leading cause of death. and healthy and assuring that others are not enough to protect public health. Th eepa sci- In New England, that number is 20,000. “trespassing” on it with health-damaging entists, along with other health and medical In addition, New England has the highest pollution. Visit OwnYourAir.org today. organizations, including the American Lung asthma rates in the nation. Association, are calling for stricter standards. Just a decade ago, who could have pre- What this means is that when the epa tells dicted that smoking bans would be in place us that air quality is “moderate,” it is actually today in most U.S. states and in many foreign unhealthy. For example, last year in New countries? Th en we considered secondhand England during ozone season, there were smoke a nuisance. But, the scientifi c evidence 54 days that the epa said were unhealthy. If proved that secondhand smoke is dangerous the stricter standards had been in place, that even with limited exposure. Th e American number would have jumped to 98. Lung Association and its partners educated Free Decals We used to think that bad air quality had the public and public policymakers about a negative impact only on those with lung this new-found evidence and ultimately Available disease. Scientifi c studies now prove that changes were made in laws and in lifestyle. Display this reusable decal breathing bad air for a short amount of time Our challenge today is to educate the public in support of healthy air and can be dangerous for everyone. Scientists and public policymakers about the health healthy lungs for all. It shows actually refer to the eff ects of bad air on the impact of breathing bad air. your commitment to making en- lungs as the “other sunburn.” When you are OwnYourAir.org was designed to do vironmentally sound decisions in short of breath outdoors or your lungs feel just that. If you visit this new website, you your everyday life. And, it encour- like they are burning for no reason, chances can learn how to protect yourself and your ages others to do likewise. are your lungs are being “burned” by ozone family on bad air quality days, get tips for pollution. improving air quality, and get the daily air Request your free decals We oft en blame Midwestern states for quality rating. at Oorr.or our pollution, yet in a typical New England Th e air we breathe belongs to everyone. Air Matters / 4 School Daze: A Wake-Up Call Think your teen is lazy? Maybe not...

fter puberty, teens’ daily short-term memory and learning ability, younger children. Police statistics indicate waking and sleep cycles, or circa- negative moods, inconsistent performance, that teen crime most often occurs between dian rhythms, shift into a delayed poor productivity and loss of some forms school dismissal and the time parents arrive phase. Indicators of the circadian rhythms of behavioral control. Daily waking and home from work. The later dismissal time such as temperature, hormone secretion sleep cycles influence cognitive skills, social for teens minimizes that time period. Also, and melatonin production all start and end functioning and emotional health. High since sleep patterns for young children are later in the day than when they had prior to school students on the roads in the early not delayed, they typically perform better puberty. Therefore, teens’ body clocks make morning hours are also a safety issue. Each in the early morning, which is now when them go to sleep later and wake later than year, 1500 people in the United States die they are in school. younger children. However, school start times from sleep-related auto accidents. Drivers Some question whether teens will actu- are not in alignment with this shifted body under the age of 25 cause more than half of ally go to bed later since they will be able to clock. In addition, teenagers require more these fall-asleep crashes. sleep longer in the morning. While some sleep than younger children, typically about To accommodate teen sleep needs, students may do just that, the research shows 9.25 to 9.5 hours nightly. school districts around the country are that switching to later school start times did Since high school students typically changing high school start times to later not alter bed times. start school between 7:00 and 8:00 a.m., they in the morning. The most studied school According to James B. Maas, MD of are driving to school and attending classes district is the Minneapolis Public School Cornell University, a leading expert on the when their body says they should still be System, which has experienced improved topic, “sleep, in essence, is food for the brain.” asleep. Also, they typically are required to grades, a decrease in student depression, Tiredness should not be confused with lazi- take standardized testing (e.g. SATs) in the improved behavior, better attendance and ness. All teens should have the right to learn early morning, which is their worst time for increased continuous enrollment. To achieve in an optimum environment. Rather than performance. Students who are tired also have this and avoid a financial impact, school the “early to bed . . .” adage, the new adage an increased likelihood of using stimulants districts have flip-flopped high school and should be, “Wake up later and your grades such as caffeine and nicotine. elementary school start times. will be greater.” For years, teachers have reported that The Minneapolis experience shows The National Institutes of Health have students in the first and second periods of the that this actually works well for working identified teens as a population at high risk day are typically weary and bleary-eyed. Ex- parents. They now require only afternoon for problem sleepiness. cessive sleepiness is associated with reduced and not morning and afternoon day care for

Studies have shown that a later start for high-schoolers may lead to improved academic performance. Air Matters / 5 Air Pollution’s Assault on American Art and Architecture Air pollution can harm our lungs and our Earth, but what many don’t realize are the affects of air pollution on art and architecture.

he affects of air pollution on vibrancy—the air pollutants in New Eng- limestone and marble, which then require buildings have been noticed since the land’s air are besieging our American works almost constant upkeep. They also tarnish beginning of the Industrial Revolution of art. Additionally, we only ever see about 10 and corrode metals, cause paint to peel, and over 200 hundred years ago. Buildings that to 20 percent of any museum’s holdings. The wood to soften and rot. Copper and bronze had been standing in all types of weather for other pieces owned are stored, sometimes in may be visually pleasant when they turn to thousands of years suddenly began to decay large warehouses that can never match the pale green, but that green is metal corrosion rapidly. All things considered, the United environmental control standards of the gal- in its most visible form. It is sulfur dioxide, States is still a young nation, and as such, leries themselves. Air pollutants eat away at carbon dioxide, and particulate pollution our oldest architecture has been assailed stored works of art we may never get to fully that eat away at these surfaces. Damaging since its construction. appreciate as they wait to be exhibited. color, surface, and structural integrity, these While art galleries and museums go to In addition to fine art, our architec- pollutants degrade art and architecture in- great lengths to preserve the artwork in their ture is at risk from air pollution, as well. As side and out. care through carefully controlled humidity, the oldest settled part of the United States, The destruction, however slow it may temperature, and lighting, air pollutants New England is home to some of the oldest appear, of our American works of art— can greatly affect a piece as it enters these examples of Early American architecture indoors and out—highlights the necessity controlled spaces. Air pollutants such as and statuary. From the Old North Church for stricter air pollution standards in New sulfates, carbon monoxide, carbon dioxide, in Boston where the warning lanterns were England. With routinely failing air quality and even calcium can destroy paintings, hung before Paul Revere’s historic ride, to grades, New England needs to tighten pol- sculptures, and furniture over time. Despite the majestic Capitol in Hartford, our build- lution restrictions to preserve our health as varnishes on paintings—a common practice ings are assaulted daily by air pollution. The well as our artistic heritage. to protect the painting and give colors more effects of the pollutants in air affect mainly

The Connecticut State Capitol building in Hartford shown after extensive renovation in the 1980s. Air Matters / 6 New England Legislative Summary

focused on supporting healthy air measures. to ban vehicle idling on school grounds, one Below are some of our key efforts: to support better management of asthma, New Hampshire • We were successful in and a bill to improve lung cancer detection passing a bill that regulates high-polluting and treatment. The Commonwealth did outdoor wood boilers. The state receive doz- increase the tobacco tax by $1 a pack and ens of air quality complaints from neighbors. gave a modest boost in funding to tobacco One We now have the system in place to assure prevention efforts. In non-legislative action, way the that the devices are not a health hazard to we are involved in supporting regulation A mer ican others. We also saw passage of a law creating of outdoor wood boilers and opposing a Lung Association a School Air Quality Commission to assure biomass energy project in Western Mas- of New England ac- that the air in schools is healthy. sachusetts. complishes our mis- Vermont • Despite a tight budget, the Connecticut • The State will allow more sion is by advocating Tobacco Prevention Program level was money to be spent on tobacco prevention. for public policy funded. The State also banned internet There is also progress being made on banning (laws and regu- sales of tobacco and raised the age to 16 smoking in casinos. Bills to ban smoking in lations) that promote lung health and for those selling tobacco. cars with children present and to reduce prevent lung disease. Each year we are ac- vehicle idling did not pass. Maine • Smoking in cars with children pres- tively involved in promoting legislation and Rhode Island • A tax loophole was closed regulations that will improve the health of ent is now banned. Maine became the first state to ban the sale of flavored cigarettes and and small cigars will be taxed just like ciga- people in our New England states. Our ef- rettes. Parts of the Governor’s health care forts combine the talent of volunteers with cigars. A state building code that includes measures to protect indoor air quality was reform initiative were approved. These that of our paid staff. include requirements to establish a Health While most of our New England states approved. A number of laws were passed to make wind power development easier. Care Strategic Plan, a Health Care Quality struggled with serious budget challenges, database and a Chronic Care Management we saw a number of legislative successes Massachusetts • The Massachusetts Program. that will reduce lung disease now and in legislature is still in session with many of the future. Much of our legislative agenda our key bills still alive. These include a bill Air Matters / 7

Autumn in New England: The Colors of Pollution?

Carbon dioxide pollution may be responsible for the annual onslaught of leaf-peepers.

uestions about the natural their leaves) have spent the warm months own pores: they let air and pollutants out of world are so oft en answered by new fi ltering from our air fi nally causes a chemi- the “body” of the plant through its skin, or and exciting developments in the world cal change to the chlorophyll. Chlorophyll its leaves. Stomatal pores, let the CO₂ out of science that a simple truth is is the naturally occurring chemical that, of the leaves. As pollution decreases the oft en forgott en: scientists still do not know among other things, gives plant life its green size of these pores, more CO₂ is trapped what causes the leaves in autumn to change color. Th e theory is that the more CO₂ that inside the leaves. from their summery green to the vibrant and gets built up in the leaves and tree itself, the If the theory that it is, at least in part, beautiful reds, oranges, and yellows that brighter the colors of the leaves are when a build-up of CO₂ that creates the colorful characterize our New England autumn. fall arrives. changes in leaves to occur, could it be that Th at is not to say there are not a number Now consider what air pollution does pollution has a hand in making our New of theories fl oating around the scientifi c to the structure of the leaves themselves. A England fall so beautiful? And if this is true, community about why these changes occur. recent study found that air pollution causes would we all look at fall the same way if we One theory is that the carbon dioxide (CO₂) the size of the stomatal pores in each leaf to knew those gorgeous hues of red, orange, that our deciduous trees (trees that shed shrink. Th ink of stomatal pores just like your and yellow are the colors of pollution?

American Lung Association partners with People’s Power & Light to bring renewable energy to Rhode Island Households

New England GreenStart, a program of the non-profi t People’s Power & Light (PP&L), is a way for National Grid customers in Rhode Island and Massachusetts to choose renewable energy. When you sign up, your household electricity usage will be matched to local renewable resources including solar, wind, biomass, and small hydroelectric plants from New England.

New England GreenStart sources in Rhode Island include the Portsmouth Abbey wind turbine and the solar panels on Scituate High School.

Renewable energy, having few to no emissions, protects the health of our As an added bonus, select “American Lung Association” from the pull- lungs. When you choose green power, you can breathe easier knowing down menu on the sign-up page, and that you are reducing the amount of smog and soot in our air. Support the a donation will come back to the mission of the ALA by making the switch to green power for your home American Lung Association from PP&L. today! Go to ripower.org to sign up for New England GreenStart. Air Matters / 8 American Lung Association Offers Parents Seven “Back to School” Tips for Kids with Asthma Your child’s inhaler may soon be unavailable at your local pharmacy.

early 7 million children In preparation for the school year ahead, the American Lung Association of New headed back to school this fall have England also urges parents who have children with asthma to complete the following asthma. Annually, school aged chil- checklist: dren with asthma miss about 13 million days of school making asthma related illness one 1. Schedule Asthma Check-up Doctor’s Appointment. Even if your child’s of the most common reasons kids are absent asthma is well managed, scheduling a check up with your pediatrician is critical to from school. New England has the highest rate ensuring your child’s asthma continues to be effectively controlled. This is also an of childhood asthma at 9.3 percent, compared opportunity to evaluate medications and physical activity restrictions. to 7.1 percent nationwide. The American Lung Association of New England offers parents 2. Confirm Medicines Are Up-to-Date and Fill Prescriptions. If your child a seven-step checklist to ensure a safe and uses an inhaler, ensure you have a current prescription for an hfa inhaler. Check your healthy school year for children who suffer medicine cabinet to make certain your child’s asthma prescriptions have sufficient from this often debilitating disease. refills available and have not expired. To minimize asthma’s grip on this school 3. Know About Prescription Assistance Services. No one should have to do year ahead, parents must first be aware that without their asthma medications because of financial need. Two organizations are per government regulation, manufacturers available to help. The Partnership for Prescription Assistance can be reached by calling are phasing out production of a common 1-888-4PPA-NOW. Rx Outreach also provides information on their website: www. type of albuterol inhaler, often called acfc rxoutreach.com. inhaler. By December 31, 2008, cfc inhalers will not be available to the consumer and will 4. Asthma Action Plan. All students with asthma should have a written Asthma be replaced by an hfa inhaler. Action Plan that details personal information about the child’s asthma symptoms, Thefda has found that hfa inhalers are medications, any physical activity limitations and provides specific instructions about safe and just as effective as their cfc coun- what to do if an asthma episode does not improve with prescribed medication. terparts. One significant difference is that 5. Visit Your Child’s School Nurse and Teachers. All of the student’s teachers, hfa inhalers do not contain ozone-depleting coaches, as well as the school nurse, should have a current copy of their Asthma Ac- chemicals found in cfc inhalers. tion Plan. Discuss with your child’s teachers specific triggers and typical symptoms Some kids might find their new inhaler so that they can be prepared to effectively assist your child should an asthma episode has a slightly different taste or feel. Since all occur during the school day. hfa inhalers do not contain the same inactive ingredients, parents may have their children 6. Advocate for Your Child. It is also important to learn if your child’s school allows try more than one kind. It is important to students to carry and independently administer their asthma medication. Some schools take care of this now and not wait until the require students to carry a note from their doctor. Learn what steps need to be taken end of the year. to have your child carry and use their inhaler if recommended by their doctor. It is also important for parents to con- fer with their child’s doctor to ensure their 7. Know Your School’s Emergency Plan. Make certain your child’s school knows asthma prescriptions are current and are how to contact you in case of an emergency. Parents should confirm that school staff, best managing the child’s symptoms. It is including after-school coaches and bus drivers, have been trained in responding to important this be done at least once a year. asthma emergencies. In some cases, pharmacies will not be able to simply substitute the new hfa inhaler for For additional information on asthma and children, existing cfc inhaler prescriptions. visit lungne.org or call 1-800-LUNG USA. Air Matters / 9 Maine Native Receives National Award Arthur Cerullo, Esq., of North Yarmouth, ME received the 2008 American Lung Asso- ciation Volunteer Excellence Award. Cerullo has been a volunteer for the American Lung Association since 1989 when he began as a fundraising cyclist in the Trek Across Maine. Since, he has served as a member of the Board of Directors and was the first trekker to serve as board chairman. Cerullo is also a National Assembly Mem- ber At Large, and was a key figure in the for- mation of the American Lung Association of New England. In addition, he was an active participant on the Community Wind Feasibility Study advisory group that provided oversight to the first study of its kind in Maine. His ex- emplary leadership and legal skills have guided the organization for decades on both the state, regional and national levels. The Volunteer Excellence Award is a na- tional award presented annually to an exemplary volunteer of the American Lung Association.

r a c e u p b o s t o n p l a c e February 7, 2009 at One Boston Place Boston, Massachusetts

c l im b p r o v id e n c e February 28, 2009 at One Financial Plaza Providence, Rhode Island

c l im b w o r c e s t e r March 8, 2009 at Sovereign Bank Glass Tower Worcester, Massachusetts

c l im b springfield March 14, 2009 at One Monarch Place Springfield, Massachusetts

q u e e n c it y c l im b March 21, 2009 at Hampshire Plaza Manchester, New Hampshire

t a c k l e t h e t o w e r a t h a r t f o r d 21 March 28, 2009 at Hartford 21 Hartford, Connecticut Air Matters / 10 The Transition to CFC-Free Inhalers for Asthma Sufferers

col, a 1987 international treaty to eliminate is most likely to have an impact on patients the production and consumption of ozone- without health insurance. “Depending on depleting chemicals. Th e American Lung your insurance, these new inhalers may be Association led the successful eff ort to have more expensive, but our hope is that as more metered-dose inhalers (mdis) exempted from people move to the cfc-free delivery method the Montreal Protocol in 1994, to give inhaler that the price will come down ,” says Norman manufacturers time to develop cfc-free H. Edelman, md, Chief Medical Offi cer of devices and provide an adequate transition the American Lung Association. time for patients and doctors. If you have questions about the transition to hfa inhalers or to learn about assistance any people who use inhal- What should I do? programs that may help you pay for your pre- ers containing the drug albuterol Some people have already switched scriptions, including a coupon off er, call the will need to change their inhalers. over to the new hfa inhalers, either because American Lung Association Lung HelpLine Manufacturers are phasing out one type of they want to get comfortable with the new at 1-800-LUNG USA, and press “2” to speak albuterol inhaler, called a cfc inhaler, and product or because their cfc inhaler is no to a nurse or respiratory therapist. increasing production of another, called an longer available. Since everyone who uses hfa inhaler. If you use an albuterol inhaler, an albuterol inhaler will have to stop using How can I reduce here’s what you need to know. cfc inhalers by the end of 2008, now is a my dependence on good time to speak with your physician albuterol inhalers? What is albuterol? about making the change. To get an hfa Since albuterol inhalers are not meant to Albuterol is a type of drug known as a inhaler, you’ll need your doctor to write a control asthma for the long term, if you are short-acting beta2-agonist. It quickly relaxes new prescription. Your pharmacist can’t using your inhaler more than two to three and opens airways and relieves asthma symp- simply substitute the new inhaler for your times a week, it means your asthma is not toms. Th is is a quick-relief medicine that only existing cfc inhaler prescription. being properly controlled. lasts about four hours. It does not prevent Th e fda has found that hfa inhalers are “If you are using your albuterol inhaler asthma att acks. Some people with chronic safe and eff ective, and patients should not more frequently than this, talk to your doc- obstructive pulmonary disease (copd) also fi nd any signifi cant diff erences from their tor about taking inhaled steroids, which are use albuterol inhalers. cfc inhalers. But it is possible that some recommended by the National Institutes patients might fi nd that the new inhalers of Health for controlling asthma,” says Dr. Why are CFC inhalers have a slightly diff erent taste or feel. Since Edelman. Inhaled steroids reduce the airway being phased out? all hfa inhalers do not contain the same swelling that makes asthma att acks more inactive ingredients, you may want to try Th e U.S. Food and Drug Administration likely. out more than one kind in advance of the (fda) has told makers of albuterol inhalers It is important to see your doctor regu- deadline to fi nd the best one for you. that they must stop using the ozone-deplet- larly if you have asthma. Over time, you ing propellants called chlorofl uorocarbons may need to increase or lower your dose of (cfcs), which send albuterol into the lungs. Will I see a price difference? medicine, or change the type of medicine you Manufacturers have already begun to make take. Work with your doctor to fi nd the best or ramp up production of -  e e inhalers, Th ere can be a signifi cant price diff erence treatment to control your asthma. also called hydrofl uoroalkane hfa( ) inhal- between the cfc inhalers and the new hfa ers, in advance of the December 31, 2008 inhalers, particularly if you currently use a deadline. generic cfc inhaler. Th e hfa inhalers cost Th is decision resulted from the United from $30 to $60, compared with $5 to $25 for States’ participation in the Montreal Proto- a generic cfc inhaler. Th e price diff erence Air Matters / 11 Event Scrapbook  erc L ssocto o e E 2008 Walks and Climbs —Calendar of Events— Healthy Air Walks massachusetts May 2, 2009 Forest Park, Springfield May 9, 2009 Artesani Park, Boston rhode island May 30, 2009 Slater Memorial Park, Pawtucket connecticut May 30, 2009 Riverside Park, Hartford vermont September 19, 2009 Battery Park, Burlington new hampshire October 3, 2009 NHTI Community College, Concord Stair Climbs

race up boston place February 7, 2009 at One Boston Place Boston, Massachusetts climb providence February 28, 2009 at One Financial Plaza Providence, Rhode Island climb worcester March 8, 2009 at Sovereign Bank Glass Tower Worcester, Massachusetts climb springfield March 14, 2009 at One Monarch Place Springfield, Massachusetts queen city climb boe: rtcpts ee  erc L ssocto o March 21, 2009 at Hampshire Plaza e E Healthy Air Walks  Climb of Your Life str- cbs ro troot te reo. o et oe orse,   Manchester, New Hampshire te eet(s) o or coce o te rt  cotct s or ore tackle the tower at hartford 21 orto t e.or or 1-800-L G S . See o tere! March 28, 2009 at Hartford 21 Hartford, Connecticut Thanks to our participants! Air Matters / 12 Planned Giving

What is planned giving and how can it help the American Lung Association of New England?

Planned giving is a process, often executed with the assis- tance of your estate planning or tax advisor, by which you can make a gift to the American Lung Association using a variety of methods that may help you meet both your per- sonal financial goals and fulfill your charitable goals.

A planned gift can meet a wide range of planning needs such as providing you and/or another person with payments for life through a charitable gift annuity, reducing your taxable estate through a charitable trust, or ensuring the continuation of the programs you care about through a gift in your will.

Find out more at www.lungusa.org/donate.

Thank you. Your gift helps us all breathe easier.

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