Nancy J., MA

We live in western Massachusetts, where mountains surround us. It’s like sitting in the middle of a bowl. Our communities are suburban and rural, but there is a coal plant nearby in the City of Holyoke, which contributes to the poor air quality in our region of the state. We have very high rates of asthma here, which I see evidence of every day in my job as the school nurse in the city of Chicopee.

On days when the air feels particularly heavy, all of us have to work a little harder to take a breath, but it's especially difficult for kids with respiratory problems. When the air is really bad, the clinic is full of kids who are coughing and wheezing, short of breath and struggling to get air. When we test their oxygen saturation levels, they're almost always quite low, and their lungs sound tight and diminished, which is a major concern.

We give out rescue inhalers to the kids for whom we have written authorization. But some days, we get an influx of students for whom we don't have paperwork on file. Then we have to place an emergency call to their parents to come give their inhalers or to pick them up from school.

Luckily, we haven't had a serious crisis at our school, but I know of other schools that have had to call 9-1-1 and even one school in Philadelphia where a child died because there was no school nurse on duty.

Asthma is not ever something that can be taken lightly. Asthma is not only a focus of my job; it's also personal for me. My two sons, ages 11 and 7, both have asthma. Although my older son's condition is well managed now, he had the swine flu four years ago and missed three weeks of school when his asthma flared-up to a critical level.

My younger son was finally diagnosed this past spring and now that he's on maintenance medications, it's made a world of difference. Part of my job as a school nurse is to educate children, parents and teachers about asthma – the symptoms to watch for, what to do if a flare-up occurs, and the importance of continuing medication even if the child has not had a problem in a while.

But I'm also a strong advocate of the need for all of us as a society to take a stand for cleaning up our air. Kids need to breathe pollutant-free air to enjoy active, healthy lives. And we still have a long way to go to get there, whether it's reducing emissions from our vehicles or limiting pollution for power plants. Our children deserve better.