EPA’s Air Quality Flag Program influences behavioral change on poor outdoor air quality days in D.C. elementary school

Caitlin M. Tompkins (1,2)
Laura Anderko (2,3,4)
Manus Patten (1,5)

1. Department of Biology, Georgetown University

2. Mid-Atlantic Center for Children’s Health and the Environment

3. Nursing and Health Studies School, Health Systems Administration

4. External RISE mentor

5. Internal RISE mentor


Asthma is the leading cause of school absences in the U.S. Outdoor air pollution exacerbates existing respiratory disease and causes acute asthmatic symptoms in children, who are particularly vulnerable. Ozone and particulate matter in the air can have harsh short-term effects on children such as shortness of breath, coughing, wheezing, chest pain, and other symptoms that may lead to hospitalization. A school-based intervention program, like the Environmental Protection Agency’s (EPA) Air Quality Flag Program, can potentially alleviate the burden air pollution and heat place on children with respiratory illnesses. The program provides education and guidance on poor air quality days and incorporates instructions for asthma action plans. I compared the number of absences that may be attributed to asthma before and after implementation of the program in a D.C. elementary school. I also evaluated the program’s effectiveness through surveys assessing parental knowledge of air quality’s impact on health. The survey results indicated that parents changed their behavior and are more aware of air quality’s impact on their child’s respiratory illness. While there was no indication from absence data that the program decreased absences, the Air Quality Flag Program increased awareness of air quality’s effect on children’s respiratory health. The EPA’s Air Quality Flag Program has the potential to reduce absences attributed to poor air quality if expanded to more schools nationwide.

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