Special Certification Helps RTs Battle Asthma

Vol. 15 •Issue 13 • Page 66
Parting Thoughts

Special Certification Helps RTs Battle Asthma

Most respiratory therapists have never heard of the American Lung Association’s Master Home Environmentalist (MHE) certification program. But RTs will find this unique trademarked program highly beneficial in efforts at preventing severe asthma attacks.

MHE certification offers RTs an opportunity to serve their communities as volunteers in finding asthmatic triggers in homes. RTs can obtain the certification by attending 35 hours of volunteer training offered by the ALA. Once certified, RTs assess the homes of community residents who request a survey.

Although the program is open to non-caregivers and caregivers alike in most states, in some locations, there are special ALA courses tailored just for health care professionals.

Surveys are offered free to families whose income is at or below a certain level. For example, in Portland, Ore., those at the $30,000 level or lower may qualify for a free evaluation if they have an asthmatic residing in the home. Those with higher incomes may obtain an assessment by contributing a tax-deductible donation of $100 to the MHE program, according to Margaret McConnell, who heads up the MHE program for the entire state of Oregon. One of her counterparts in Washington state is Eileen Gagney, of the Seattle office.

As breathing experts, RTs know asthma is bronchoconstrictive, inflammatory and mucogenic in nature and the lungs of asthmatics are already sensitized to allergens which may trigger an acute asthma attack.


In some instances, triggers may be found outside the home. A likely source is air pollution. The ALA is working with the U.S. Environmental Protection Agency to determine how much of a role air pollution plays as an asthma trigger. The ALA also promotes legislation to improve air pollution in a global sense.

The MHE program, however, focuses entirely on indoor air pollution. Since Americans spend about 90 percent of their time indoors where pollutant levels may be severe (up to 100 times greater than outdoor air), this seems a logical arena in which to concentrate detection efforts.

Volunteers are trained to identify factors in the home that may lead to stimulation of reactive airway disease or asthma. These include dust, contaminates from dust mites and cockroaches, animal dander, pollen and fungi, especially mold. Aerosols and smoke particulates may also play a role. Volunteers learn to spot sources of moisture that may predispose a home to mold and mildew growth. They become versed in pest control, including the use of pesticides, and in household chemicals that may trigger breathing problems.

One huge area of attention is environmental tobacco smoke (ETS) and second-hand smoke. The ALA has been an advocate for smoking cessation for years and has spearheaded many drives to eliminate ETS from the workplace. On a smaller scale, the ALA attempts to help those affected by ETS in the home by providing literature designed to build a healthy home atmosphere. Parents of asthmatic and bronchitic children are encouraged to quit smoking, cut down or smoke outside at the very least.

Children are not the only ones susceptible to respiratory infections because of exposure to ETS. Those over 60 years old and those immunocompromised are at risk as well. In general, anyone who is confined to the home for 12 or more hours per day is at a greater risk. The ALA sponsors a smoking cessation initiative called the Quit Smoking Action Plan. One component is Freedom from Smoking, offered free on-line to anyone who is thinking of quitting, including RTs.


Some recommendations are no cost or low cost in nature and may be relatively non-labor intensive. Among simple measures may be adding impermeable covers to mattresses and pillows, increasing the temperature on the hot water heater so bedding is better sanitized, getting beds higher off the floor and removing stuffed animals and anything stored under a bed.

The goal is to impact the health of a family unit in any way possible. MHEs form an action plan for and with the entire family, working closely to obtain a good fit between their needs and capacities. MHEs are agents involved in increasing the level of health and, therefore, the quality of life, by touching one of the most basic aspects of human culture–the home environment.

The program’s success can have a major impact on battling asthma, whose prevalence is increasing around the globe and in our own back yards.

Rhonda Turner is an Oregon caregiver.