Housing conditions and respiratory morbidity in Indigenous children in remote communities in Northwestern Ontario, Canada.
Autor: | Kovesi T; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont. kovesi@cheo.on.ca., Mallach G; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Schreiber Y; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., McKay M; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Lawlor G; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Barrowman N; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Tsampalieros A; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Kulka R; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Root A; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Kelly L; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Kirlew M; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont., Miller JD; Department of Pediatrics (Kovesi), Children's Hospital of Eastern Ontario (CHEO), University of Ottawa; Water and Air Quality Bureau (Mallach, Kulka), Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ont.; Northern Ontario School of Medicine (Schreiber), Sioux Lookout, Ont.; Nishnawbe Aski Nation (McKay), Thunder Bay, Ont.; Energy Matters (Lawlor), Pickering, Ont.; CHEO Research Institute (Barrowman, Tsampalieros), University of Ottawa; School of Public Policy and Administration (Root), Carleton University, Ottawa, Ont.; Sioux Lookout First Nations Health Authority (Root); Sioux Lookout Meno Ya Win Health Centre (Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Kirlew), Sudbury, Ont.; Department of Chemistry (Miller), Carleton University, Ottawa, Ont. |
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Jazyk: | angličtina |
Zdroj: | CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne [CMAJ] 2022 Jan 24; Vol. 194 (3), pp. E80-E88. |
DOI: | 10.1503/cmaj.202465 |
Abstrakt: | Background: Rates of lower respiratory tract infection (LRTI) among First Nations (FN) children living in Canada are elevated. We aimed to quantify indoor environmental quality (IEQ) in the homes of FN children in isolated communities and evaluate any associations with respiratory morbidity. Methods: We performed a cross-sectional evaluation of 98 FN children (81 with complete data) aged 3 years or younger, living in 4 FN communities in the Sioux Lookout region of Northern Ontario. We performed medical chart reviews and administered questionnaires. We performed a housing inspection, including quantifying the interior surface area of mould (SAM). We monitored air quality for 5 days in each home and quantified the contaminant loading of settled floor dust, including endotoxin. We analyzed associations between IEQ variables and respiratory conditions using univariable and multivariable analyses. Results: Participants had a mean age of 1.6 years and 21% had been admitted to hospital for respiratory infections before age 2 years. Houses were generally crowded (mean occupancy 6.6 [standard deviation 2.6, range 3-17] people per house). Serious housing concerns were frequent, including a lack of functioning controlled ventilation. The mean SAM in the occupied space was 0.2 m 2 . In multivariable modelling, there was evidence of an association of LRTI with log endotoxin ( p = 0.07) and age ( p = 0.02), and for upper respiratory tract infections, with SAM ( p = 0.07) and age ( p = 0.03). Wheeze with colds was associated with log endotoxin ( p = 0.03) and age ( p = 0.04). Interpretation: We observed poor housing conditions and an association between endotoxin and wheezing in young FN children living in Northern Ontario. Competing Interests: Competing interests: Thomas Kovesi reports being a member of the board of governors of the Ontario Lung Association. Dr. Kovesi also reports using equipment from Health Canada for this study, and that sample analysis and data compilation were performed by Health Canada and Environment Canada. Yoko Schreiber reports receiving fees from the Indigenous Services Canada–First Nations and Inuit Health Branch Pharmacy and Therapeutics Committee, and acting as chair of the Indigenous Health Committee, Association of Medical Microbiology and Infectious Diseases Canada (unpaid position). Gail Lawlor reports receiving payment from the study operating grant for time spent in the homes conducting the surveys and setting up the IAQ Testing, as well as reimbursement from the study operating grant for expenses incurred for travel and accommodation in the four First Nations communities. No other competing interests were declared. (© 2022 CMA Impact Inc. or its licensors.) |
Databáze: | MEDLINE |
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