When people raised concerns about possible mold in one of the Lake Pend Oreille School District's schools last year, Superintendent Dick Cvitanich went further than investigating the alleged problem.

Following a recommendation from the district's facilities director, Cvitanich invited a team from the Environmental Protection Agency to check all the district's buildings.

"We think the environment in which children learn is really important," Cvitanich says. "Poor air quality makes kids sleepy, lethargic. We want kids attentive, engaged, alert, excited to learn."

Environmental problems are a primary trigger of breathing problems, says Bonnie Held, the Panhandle Health District's (PHD) asthma educator. Held coordinates the Asthma Coalition, a group of environmental and health professionals in the five northern counties that responded to Cvitanich's call as the Panhandle's EPA Tools for Schools team.

Tools for Schools is one of many programs developed to reduce asthma, a major cause of school absences. About 20 million people in the United States experience asthma in some form.  Any number of triggers cause the lining of their airways to swell and chests to tighten. Breathing becomes labored. They wheeze, cough. Mucus builds up.

Seven million of those asthma sufferers are children and they miss a total of about 14 million days of school each year. Asthma contributes to more than 100 days per year of lost productivity, more than 11 million visits to doctors' offices and more than 500,000 hospitalizations. Treating asthma costs the health care system more than $6 billion annually.

In Idaho, 8.1 percent of the population suffers from asthma. In the five northern counties, the rate is 8.8 percent. The rate for children with asthma in the state is 9.5 percent, but in the five northern counties it's 12.6 percent.

Held and the Asthma Coalition are determined to lower northern Idaho's high asthma rates.

Tools for Schools is a free program that offers schools an analysis and assessment of environmental problems and recommendations for free or low-cost solutions. The goal is to create a more asthma-friendly site.

"Old carpets and couches create an environment for dust mites. Decreasing the number of classroom pets can help. These irritants contribute to dander allergies and asthma triggers," Held says. "We check air flow, adjust vents, check carbon dioxide levels."

Cvitanich can't say yet if the low-cost corrections his district pursued lowered the student asthma rate. But he's more confident his district is free of common asthma triggers now and that his students are working in an environmentally better setting.

"There are so many triggers that we can do something about," Held says. "We work with school nurses, train health providers on new asthma guidelines, work with Head Start."

Asthma is the second most prevalent chronic condition among children. It's managed with bronchodilators-inhalers-and anti-inflammatory medicines. It's not a condition people outgrow and it's not an emotional condition, although stress can aggravate an ongoing asthma episode. Allergens are primary triggers for asthma in children and adults.

Held coordinates an asthma prevention and control program out of the Panhandle Health District. She builds an Asthma Patient Action Plan that helps sufferers identify their asthma triggers, such as pet dander or pollens.

The plan reminds patients to take prescribed medications on schedule and/or use a bronchodilator before strenuous activities to prevent asthma symptoms. It tells patients how to handle a serious attack and encourages them to record their rescue medication and doctor's phone number where they and others can find them.

The Asthma Coalition's Open Airways program provides four-week asthma classes for elementary school kids. It teaches children what asthma is and helps them understand that they can do the same thing kids without asthma can do if they follow their asthma management plan.

Idaho has a statewide asthma plan available to the public at www.healthandwelfare.idaho.gov. In the search box, type in Asthma Action Plan. The American Lung Association of the Northwest's 2008 Spokane Asthma Walk and Lung Health Expo is May 17 at the Spokane Valley YMCA, 2421 N. Discovery Place in the Spokane Valley. The 5-K walk starts at 10 a.m. and is sponsored by SafeCo Insurance.

To register, visit www.mrsnv.com/evt,