Why Johnny Cant Breathe

Brian Stauffer

The Kleenex ran out in February--and that, Terry Fritz figured, meant something was wrong. A veteran teacher at north Minneapolis's Henry High School, Fritz had long been in the habit of keeping a box of tissues on her desk. She'd ordered her normal supply at the beginning of the 1997-98 school year, figuring she'd have a little left over when school let out in the spring. "I have a pretty good grasp on how many Kleenexes my kids will use each year," she laughs.

But this time the kids didn't wait for cold season to dig into the stash. From the first day of school on, they snorted and sniffled their way through box after box. And Fritz herself was reaching deep into the separate supply of tissues she'd brought for her own use--which also seemed uncommonly frequent.

"I've always been a really healthy person," she explains. "So I'd think, 'I just need to eat better or get more rest and I'll be fine.' I remember thinking, 'I'll just take a little soak in the tub and I'll be okay.' But I kept getting sicker and sicker. I didn't know what it was, and I felt like I was always complaining."

Fritz wasn't the only one who noticed. She says colleagues would come up to her during lunch break to ask, "What's wrong with you? You look horrible." A videotape made during a critique session showed her looking "like I'd been in a fight--big black circles around my eyes."

The condition was far from cosmetic. "My fingers were numb," Fritz recalls. "I was shaky. I never sit down, but I was sitting down all the time. I needed to; I was exhausted. We'd have a vacation and I'd start feeling better and think, 'Great, I'm on the mend.' Then I'd come back and I'd be sick again."

Maybe, Fritz reasoned, there was something wrong with the air in the room. She called the school district's Environmental Health and Safety Division (EH&S); staffers ran some tests and found nothing wrong. Next she cut a sample of the carpet and took it to an allergist. Lab tests detected "a high bacteria count, probably from fecal matter."

That's when she remembered the pigeons. All year they had huddled on the ledges outside her windows, and their droppings had piled up two or three inches deep. She had told an engineer in the building, who she says recommended that the gunk be removed "because people can get really sick from that." Janitors had sprayed the ledges with water, but their machine had backed up and the carpet had gotten soaked.

By early April, Fritz was in the hospital, diagnosed with the beginnings of meningitis--a disease that can be transmitted by bird droppings. "I woke up as I was starting to get better and looked around the room," she recalls. "All

I could see was used Kleenexes everywhere, on the table, on the floor, in the trash can. As far as I could see."

Fritz eventually went back to a freshly scrubbed and carpeted Room 312, and her symptoms didn't return. But she has never felt quite the same. "I've become really sensitive," she says. "If a janitor sprays a cleaner or something around here, my nose starts burning."

Fritz's story is far from unique. In the past few years, indoor-air quality has emerged as a major--and potentially expensive--concern for schools around the nation. A 1996 study by the U.S. General Accounting Office found that 22 percent of U.S. school districts surveyed reported "unsatisfactory" or "very unsatisfactory" indoor-air quality in at least some of their buildings. In Minnesota the figure was 30 percent--the seventh-highest in the country. The GAO report concluded that bad air was likely to affect student performance, and that "wide disparities in the physical condition of school facilities might contribute to inequalities" in education.

Locally, the Minneapolis Federation of Teachers conducted a survey in 1997, asking school staffers whether they'd ever sought medical attention "as a result of environmental health-related issues at their school." One-third said they had, and an equal number said such problems had caused them to miss several days of school.

Officials say that in the two years since, Minneapolis has emerged as a leader in dealing with air-quality issues, putting together a multimillion-dollar renovation plan and creating construction guidelines for schools statewide. But the problem is not about to go away. In fact, says Audrey Johnson--a newly elected school board member whose daughter has suffered respiratory problems at school--the real challenge may still be ahead. "This has mostly been driven by complaints from teachers," she points out. "But we are wondering: If teachers--adults--are complaining, what about the kids?"


From the outside, northeast Minneapolis's Edison High bears the stately look of a classic city school: old brick, wide doors, lots of windows. It's a gorgeous late-autumn afternoon, and a few students are taking advantage of the weather in the alley, balling up notebook paper and beaning each other. Inside, corridors are lined with cheery blue and yellow lockers; sheets of construction paper announce who made the volleyball squad or the honor roll.  

But there's something else in those corridors--and in the classrooms, offices, even the lockers. The typical school building, experts say, is home to a unique collection of contaminants. A 1998 report from the U.S. Department of Health and Human Services lists everything from chalk dust to "fungi, bacteria, and viruses brought to the school environment by children and adults, and vapors and fumes from chemistry laboratories, wood-working shops, and art classes." A 1997 article in the trade magazine Contractor puts it more bluntly: "Most complaints about indoor-air quality come from occupants of office buildings," it reads. "Few office buildings, however, have the potential for bad indoor air as schools do. Not many office buildings have science labs or hamster cages, not to mention vomiting second graders."

Pat Budd isn't terribly concerned about the occasional bout of barfing or clump of gerbil hair. When the English as a Second Language teacher takes inventory of Edison's environmental hazards, she begins with the diesel fumes.

A talkative woman with brown hair cut in a clean bob, Budd commences a tour of her school by pointing at an air vent: During the 1998-'99 school year, she explains, staffers noticed that every morning and midafternoon the entire building smelled like a parking ramp. It turned out that during a recent upgrade of the ventilation system a fresh-air intake had been placed right beside the spot where school buses idled at the curb. After teachers complained a timer was added to the system, shutting down the air intake at the times when bus traffic is heaviest.

Next, Budd stops at a door leading into a space no larger than three economy cars. Inside, a teacher is watching a gaggle of kids scribble in their notebooks. "I've heard that these rooms are supposed to have two or three students at a time," says Budd. "How many do you have?"

"Nineteen," answers the teacher. "I have 19, first hour. I don't think there's any ventilation. During the summer it gets so hot in here, I want to expire."

Like a hospital in a war zone, Edison has found ways to cram people into every nook, cranny, and closet; it's one strategy, district officials say, to cope with a population growing by about 1,000 students per year citywide. Half a dozen new schools have been added in the past five years, and two more are scheduled for completion by 2001. But quarters remain tight. "We're using more and more spaces in these old buildings," Budd says. "Places that were originally closets and storage rooms."

Not that regular classrooms are any picnic. Last year, Budd says, she asked for an air-quality test in her own room; it had always seemed stuffy in there, she explains. According to school-district documents, two separate measurements showed high levels of carbon dioxide, which can be an indicator of faulty ventilation.

The Minneapolis schools follow air-quality standards set by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). According to the guidelines, carbon-dioxide concentrations are best kept under 1,000 parts per million (ppm), and levels above 1,200 warrant corrective action. Budd's room registered at 1,140 ppm in one test, 1,400 in another. Yet an EH&S memo noted that "the air quality is good." (District environmental health specialist Lee Setter says that in retrospect, the second reading does seem high; but, he notes, the school's ventilation system has since been fixed).

But stale air and diesel fumes were nothing compared to what Edison faced on July 1, 1997, when Minneapolis saw its biggest rainstorm of the decade. At Edison, a giant sinkhole opened near the music department's storage room in the basement. Sewage-laced water poured in, rising to six feet in some places. The school lost most of its books, TV sets, computers, band instruments, and sports equipment. The kitchen, several gyms, and the boiler room were ruined. To this day, staffers at Edison adhere to a diluvial calendar: Events are referred to as having taken place "before the flood" or "after the flood."

The building was so badly damaged that officials figured it might not reopen its doors that fall. But the teachers insisted that classes begin on schedule. "We struggled--no library books, no computers or equipment," says Budd. "The kids were eating bag lunches, and the entire building was like a construction zone.

"Looking back, I think that it would have been safer for students and teachers to have waited," she continues. "Filters got thick with dust and dirt all last year. And some of us were really sick." Budd says she experienced dizziness, sinus problems, and a new sensitivity to chemical odors. Many of her fellow teachers had similar problems, she says, but they muddled through.  

That changed when school opened again in September 1998. Teachers who'd felt better over the summer break found themselves getting sick again. By November of that year, they had assembled a petition to the school district, demanding a full-fledged investigation of the building. One column in the handwritten document contained 21 teachers' names, while the other detailed an exhaustive list of symptoms: memory loss, nausea, lack of appetite, congestion, dizziness, asthma, sinus drainage, skin rashes, coughs, itchy eyes, blurry vision, headaches, stomachaches, moodiness, fatigue, sore throat.

On December 9, EH&S staffers conducted a series of tests at Edison, checking carbon dioxide, temperature, humidity, and carbon monoxide levels in 14 areas of the school. Most of the values seemed normal, their report noted. But the document also identified a series of problems, from sawdust in the wood shop to faulty ventilation systems and ceiling tiles showing stains (a sign of persistent moisture, which can lead to microbial growth).

In retrospect, district environmental health specialist Lee Setter says, it appears that ventilation was the most serious problem: The fan serving the entire west side of the building had been turned off for asbestos abatement in the 1980s. He ordered it repaired. "And Edison has been a much happier place since," he beams.

Budd confirms that air quality in the building has improved. But what really made staffers happy, she says, was the change they perceived in the attitude of school district officials: "Now when we call, we're being treated with respect," she says. "It's not, 'You crazy lady.' Instead it's, 'What do you smell?'"


Dr. Malcolm Blumenthal, director of the Asthma and Allergy program at the University of Minnesota, has seen the pattern before. Workers complain that their building makes them sick. Managers can't find a cause. "It's very easy to blame things on your emotions," says Blumenthal. "People come in all the time who were told, 'It's all in your head.'"

Still, he says, over the past decade indoor-air quality has come to be recognized as "a major, major issue." The change was prompted in part by the skyrocketing rates of asthma and allergic reactions to irritants like mold and dust. Nationally, according to the U.S. Department of Health, the incidence of asthma in children rose more than 70 percent between 1984 and 1992; asthma and allergies were found to be the top reasons for both students and teachers missing school. In Minnesota, according to the state's Department of Children, Families and Learning, 5 percent of students need "asthma emergency kits" that contain inhalers and medication, and 30 percent of students and school staffers have allergies.

What's tricky, says Blumenthal, is figuring out what exactly causes a specific health problem. Air-quality-related symptoms, he notes, are generally vague: headaches, nausea, fatigue, dizziness. "If people are working in one place five days a week, eight hours a day, it's likely that any condition they have will crop up there," he explains. "But is it due to the workplace environment? You can't say that automatically--that would be like saying, 'I've got a headache; I'm breathing oxygen; so blame it on oxygen.'"

Lee Setter, the Minneapolis schools' environmental health specialist, concurs. "A teacher will say, 'I only get a headache in school,'" he posits. "It could be indoor-air quality. Or it could be the stress of teaching a classroom of 29 eighth-grade kids."

Sherri Rutman, chair of an environmental health committee formed by the local teachers' union two years ago, says teachers often ask themselves the same question. "You're sick, and you try to think of things that could be the problem," she says. "If you jump right away to something in your classroom, you think, 'How could that be?' A headache could be this, nausea could be that. Often it's not the whole building, just one room or a sector, or it's not all the people, just a few who maybe have existing conditions that make them more sensitive. It gets really sticky."

Rutman can remember talk about air-quality problems in the schools going back almost a decade. But organized efforts to deal with the problem didn't begin until two years ago, she says, when the union negotiated a new clause in its contract with the district. It acknowledges that "air quality, lighting, noise level and other environmental factors may greatly impact the performance of some students and staff in a school or other work location," and sets out a formal complaint process.  

While that may sound like a relatively minor change, Rutman reports that the move has attracted national attention. "When I go to seminars in Washington, people tell me that this is monumental," she says. "People are concerned about these issues, but if they have a complaint and no system to follow up, it often just gets passed off."

According to Rutman, district officials have been cooperative so far, scheduling regular meetings with committee members and working with local consulting firms to create a set of school air-quality guidelines. Still, she says, the issue remains "a can of worms, and people are afraid that if we start opening the can, the worms are going to jump out all over. It's easier to turn their heads and say to the people who are experiencing it: 'You are crazy.'"


One thing those officials might be worried about is money--and rightly so, says Bartlett (Bake) Baker, an architect with Minneapolis-based Hammel, Green and Abrahamson who specializes in school design. It's relatively simple to ensure good air quality in a new building, Baker explains. "But when you're working with existing schools, costs are extremely high. You tear out ceilings and floors, you expand ductwork. It's very pricey, very time-consuming, and often very disruptive."

And though conventional wisdom might suggest that the oldest schools have the biggest problems, Baker and other experts say the worst air-quality dilemmas are actually found in newer buildings--especially the ones constructed back when Jimmy Carter wore his cardigan sweater around the White House. In the days of the energy crisis, explains Minneapolis Public Schools environmental health manager Ken Meyer, ventilation systems were designed to let in as little outside air as possible, allowing toxins like carbon monoxide to accumulate. Then there was the trend toward "schools without walls," where teachers convened class in the corners of a big open space: When the fad waned, open buildings were often carved up into smaller rooms without adequate ventilation.

Older schools didn't have those problems. In the days of profligate energy use, they had been equipped with massive ducts and fans. But those ventilation systems were also often insulated with asbestos, now recognized as a carcinogen. When school officials began an asbestos-cleanup program in the 1980s, Meyer says, they determined that it was too expensive to clean up every blower and vent. So they shut some of them down instead.

The biggest problem faced by people like Meyer, however, has nothing to do with the way the schools were built: It stems from the way they've been kept up since. "Deferred maintenance" has come to be a major buzzword in engineering circles, explains Don Haydon, the Minneapolis Public Schools' director of finance and operations. "Deferred maintenance is very common in any public infrastructure system," he says. "When the decisions are between books and computers and fixing the building, it usually goes to books and computers. The work doesn't get done, and it has a tendency to accumulate. Something like a roof deteriorating will eventually allow water to enter, and that tends to cause further problems. It just gets worse."

According to the Maintenance and Operations Cost Study, a national survey conducted annually by the Kansas-based magazine American School & University, deferred maintenance constitutes "a crisis situation" in most U.S. public schools. The report says the problem is especially severe in large cities, where perennial budget troubles have cut down on bricks-and-mortar spending: "Urban school districts spend on average about 3.5 percent of their budget on facilities maintenance compared to a nationwide average of 9.4 percent." (In Minneapolis, the maintenance budget currently amounts to $10 million, or 2.6 percent of the $400 million operating and capital renewal budget.) Nationally, says the report, some 85 percent of maintenance dollars goes to urgent repairs--things like bursting boilers and other emergency fixes--rather than ongoing maintenance. And thus small leaks turn into bigger, more expensive ones. Tiny cracks become massive masonry problems. Mold spots here and there spawn a full-blown infestation.

In Minneapolis, administrators began tallying deferred-maintenance problems in 1992; the result was a catalog of needed repairs filling two shelves' worth of ring binders and including everything from roof and window replacements to tuckpointing, ventilation, boilers, and parking lots. The total price tag was close to $300 million--far more than the district could hope to come up with from its regular budget.

The district did what any homeowner would do when faced with a massive repair bill: It took out debt. In 1993 the state Legislature gave Minneapolis the authority to sell bonds for renovation projects. Soon afterward the district kicked off a two-part plan involving some $280 million in expenditures. Phase I, which began in 1995 and ran through this year, spent $158 million on fixes designed chiefly for fire-code compliance and accessibility under the Americans with Disabilities Act. Phase II, begun this year and slated for completion in 2002, calls for $120 million worth of repairs, with an emphasis on deferred maintenance and air quality.  

"Five years ago air quality wasn't something that school districts focused on," explains Setter, the district's environmental health specialist. "Now we hear about it every day, and we're forced to deal with the consequences. We don't want schools closing down because there's the fear of an indoor-air-quality problem. We can't afford that."

Not that it hasn't happened. In the past few years, schools from rural Ortonville and Willmar to suburban Farmington, Roseville, and Crooked Lake have been shut down, sometimes for months, because of problems with mold, carbon monoxide, bacterial contamination, and the like. In fact, says Phil Allmon, health and safety coordinator for the Department of Children, Families, and Learning, Minneapolis seems to be doing better than most other districts: For one thing, he notes, it has seven staffers in charge of environmental health and safety, while his statewide unit boasts "a staff of one: me." Part of his job is to review district requests for special state funds to fix environmental health emergencies. In the past two years, the state has handed out $2 million annually for such projects.

Still, Allmon says, the magnitude of the problem is barely beginning to become apparent, especially in districts where the majority of schools date from the airtight Seventies. "It's safe to say that of the 1,600-some-odd buildings in the state, there are certainly 100 with serious indoor-air-quality issues," Allmon estimates. "We have a ways to go yet." Allmon and other state staffers are reviewing a legislative proposal authored by state representative Kathy Tingelstad, a Republican from Andover, that would require school districts to install state-of-the-art air-filtration systems in every building and mandate periodic ventilation upgrades in "portable classrooms"--the trailers in which many growing districts house their burgeoning student populations.

Ironically, all that fixing, renovating, and upgrading isn't necessarily good news for those who sniffle and wheeze their way through the school day. Anytime you mess with a building, notes the University of Minnesota's Blumenthal, you create pollution--even if the work is intended to improve indoor-air quality. Construction brings fumes and often liberates contaminants previously locked up. "You're destroying old walls that may have molds and dust," Blumenthal points out. "That gets in the air."


Looking back, Audrey Johnson wonders why she didn't notice sooner. Her fifth grader Lilli is "a hard-working, self-motivated girl who doesn't complain," she explains. "So it's sometimes hard for me to measure: Is she sick or not?"

The problems began last February, when Lilli began coming home from school with headaches--and more. "She was going to bed at 7:30, wasn't hungry, had stomachaches," Johnson recalls. "And even after she'd gone to bed early, she'd get up and still be tired." If it had been her 11-year-old son, Johnson explains, she might not have worried. "But Lilli loves school--she hates to miss it. For her to say, 'I'm too tired, Mommy, can I sleep?' sets off all sorts of alarms."

In April, Johnson--a longtime DFL activist--happened to mention Lilli's problems in a phone conversation with a fellow DFLer. There was a brief silence on the other end of the line. Then the other woman, who happened to be a teacher in a north Minneapolis school, told Johnson what she'd heard about Lilli's building.

The site--Ramsey International Fine Arts, at 49th Street and Nicollet Avenue South--was in the midst of a gargantuan construction project aimed at replacing the entire heating, venting, and air-conditioning system, Johnson learned. The construction zone was supposed to be sealed off from the classrooms, but dust had been finding its way through the barriers, sometimes creating a visible haze in the hallways. It had gotten so bad that staffers had asked the district to supply dust masks for them. (EH&S documents confirm that the request was made, on April 7--and turned down. According to a note from environmental health specialist Setter to the school's union steward, "[B]ased on experience and investigations performed by EH&S, it has been determined that the use of respirators...is not required or necessary.")

Johnson was stunned. Like an estimated one in ten Minneapolis students, Lilli has asthma; she also suffers from cerebral palsy, a nerve disorder that among other things affects the function of the heart and lungs, making patients particularly vulnerable to bad air. School officials knew about both diagnoses, Johnson notes, since Lilli was registered with the school nurse's office. Yet no one had bothered to mention the construction to her.

On April 23 of last year, Johnson met with school officials, including environmental-health manager Meyer; she recalls telling them she was "shocked that as a parent these problems were never brought to my attention." Meyer responded that the school district had issued an alert about the construction. ("When things get sent home, they're sent home with children," he notes now.) Johnson countered that the only notification she'd received had been a brief mention in the school's newsletter--which, she pointed out, contained no reference to potential health problems.  

Ramsey music teacher Margaret LaFleur, the union steward who requested the dust masks, says the construction didn't bother her much, but that teachers who had respiratory problems seemed to suffer. "[Administrators] said, 'We have this in place, that in place,'" she recalls. "But I could see the dust, smell the dust."

Things did change, LaFleur says, when Johnson raised a stink. "Anytime after Audrey's meeting, when we saw anything, we'd call and right away they'd come in. They'd say, 'If you need anything, just let us know.'" The district's Setter says officials have also changed their notification procedure: In the future parents will be alerted to any major construction projects through an official letter.

Setter has good reason to take Johnson's concerns seriously. In November she was one of four DFL-endorsed candidates elected to the Minneapolis School Board. When she takes her seat in January, Johnson says, environmental health issues will be among her top priorities.

"Parents who are worried about the conditions in schools will be able to get answers without getting the runaround," says the board member-elect. "The schools are always worried about liability, but I think that when you ask a question, you should get a simple answer. Right now the only way you'll get what you need is to threaten litigation or get involved." (School officials say they have heard of no lawsuits against the district over environmental-health complaints, though a few teachers have filed "initial reports of injury" in the workers' compensation system.)

Johnson's crusade, however, is no longer a personal matter. The air in Lilli's building, she says, has gotten "a lot, lot better," and her daughter is well--so well, in fact, she has been lobbying her mother to keep a low profile. "She says, 'Mom, don't complain--it embarrasses me,'" Johnson laughs. "She's at that age."

That's fine by Johnson, who says her recent education in the intricacies of air quality has left her with lots of concerns that don't involve Lilli's tale. She supports a legislative effort to require parental notification when pesticides and other toxic chemicals are used in schools. And she wants to know more about how air-quality standards are set. "All the measurements I've seen are calibrated for what an adult male can take," she points out. "So if the schools are saying that 1,000 ppm is considered safe for carbon dioxide, I want to know: Is that for adults? For kids? For kids with respiratory ailments?"

Johnson's concerns are not unreasonable, says Tessa Hill, cofounder of Minneapolis-based advocacy group Kids for Saving Earth. Hill, who also serves on the advisory board for the U.S. Environmental Protection Agency's children's health office, points out that most of the standards governing air quality were set more than 20 years ago. More recent regulations regarding pesticides on foods, she adds, specify that "everything that is tested by the EPA in terms of safety has to be ten times safer for kids. The same should go for air quality. It should be ten times safer for kids."

School administrators may not be ready to go that far. But they do realize, says Haydon, that the concern about air quality is here to stay--and not just because of the occasional cough and sniffle. As education officials fret over student test scores, they are beginning to worry about what kids are breathing while they wield a No. 2 pencil. "That's basically the reason we're spending lots of money on this," Haydon says. "We believe that the air quality does have an influence on student achievement. We said, 'Hey, if there's high CO2 readings, you tend to get sleepy, lose concentration.'"

"As a kid I would fall asleep in school a lot," echoes Audrey Johnson. "It was like passing out. But when I think back, I realize that it mostly happened in certain rooms--the ones with no windows, where it was very hot and the doors were closed. We're starting to realize that that was not just from staying up late."


Additional reporting contributed by Monika Bauerlein.

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