Companies of all sizes now are being asked to comply with new and stricter reporting and recordkeeping requirements, to meet higher insurance limits, and to implement costly operational, employee training and management requirements.

The proliferation of regulations has brought criticism from business owners, who say they are frustrated by the government communication system for notifying businesses of regulations and by the lack of coordination between agencies writing regulations about hazardous materials and hazardous waste.

Hafling and others also have worked with the Alaska Health Project, a non-profit organization providing consultation in hazardous waste reduction and pollution prevention for small businesses. Alaska Health's Waste Reduction Assistance Program (WRAP) suggests practical, low-cost waste reduction techniques for businesses and has compiled detailed waste-reduction audits on 21 different types of Alaskan businesses, such as automotive repair shops and fish processors.

A. It’s huge. We start with a complete assessment of the patient, including their asthma history and get a sense of how well controlled it is. In an acute situation, we make a quick assessment and make protecting the patient’s airway our top priority. Often we will adjust medications and initiate specialty therapies, utilizing our department’s protocols, to immediately treat the exacerbation. Then we continue to follow and assess these patients, adjusting their treatment and educating them utilizing the NHLBI Guidelines. Typically, by the time they leave our hospital they understand how asthma affects their body and how to use their medications properly, they can identify their triggers and have learned how to control them. They have also learned how to monitor their peak flows and use the results to implement their personal AAP.