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Indoor air quality and the risk of lower respiratory tract infections in young Canadian Inuit children

From the Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario; the Air Health Effects Division (Gilbert, Stocco), Health Canada; the Policy and Research Division (Fugler), Canada Mortgage and Housing Corporation; the Department of Medicine (Dales), Ottawa Hospital; the Biostatistics and Epidemiology Division (Dales, Guay), Health Canada; and the Department of Chemistry (Miller), Carleton University, Ottawa, Ont.

Correspondence to: Dr. Thomas Kovesi, Pediatric Respirologist, Children's Hospital of Eastern Ontario, 401 Smyth Rd., Ottawa ON K1H 8L1; fax 613 738-4886; kovesi{at}cheo.on.ca

Background: Inuit infants have the highest reported rate of hospital admissions because of lower respiratory tract infections in the world. We evaluated the prevalence of reduced ventilation in houses in Nunavut, Canada, and whether this was associated with an increased risk of these infections among young Inuit children.

Methods: We measured ventilation in 49 homes of Inuit children less than 5 years of age in Qikiqtaaluk (Baffin) Region, Nunavut. We identified the occurrence of lower respiratory tract infections using a standardized questionnaire. Associations between ventilation measures and lower respiratory tract infection were evaluated using multiple logistic regression models.

Results: The mean number of occupants per house was 6.1 people. The mean ventilation rate per person was 5.6 L/s (standard deviation [SD] 3.7); 80% (37/46) of the houses had ventilation rates below the recommended rate of 7.5 L/s per person. The mean indoor carbon dioxide (CO₂) concentration of 1358 (SD 531) ppm was higher than the recommended target level of 1000 ppm. Smokers were present in 46 homes (94%). Of the 49 children, 27 (55%) had a reported history of lower respiratory tract infection. Reported respiratory infection was significantly associated with mean CO₂ levels (odds ratio [OR] 2.85 per 500-ppm increase in mean indoor CO₂, 95% confidence interval [CI] 1.23–6.59) and occupancy (OR 1.81 for each additional occupant, 95% CI 1.14–2.86).

Interpretation: Reduced ventilation and crowding may contribute to the observed excess of lower respiratory tract infection among young Inuit children. The benefits of measures to reduce indoor smoking and occupancy rates and to increase ventilation should be studied.

This article has been cited by other articles:

				C. W. Purdy, R. N. Clark, and D. C. Straus Ambient and indoor particulate aerosols generated by dairies in the southern High Plains J Dairy Sci, December 1, 2009; 92(12): 6033 - 6045. [Abstract] [Full Text] [PDF]

				P. H. Orr MSc MD Respiratory tract infections in Inuit children: "Set thine house in order" Can. Med. Assoc. J., July 17, 2007; 177(2): 167 - 168. [Full Text] [PDF]

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