Poorly ventilated, overcrowded homes linked to Inuit kids' infections

Inadequate ventilation and overcrowding appear to contribute to the high incidence of lower respiratory tract infections in young Inuit children, according to a new study.

Previous work has shown Inuit children have the highest rate of lower respiratory tract infections in the country.

Dr. Tom Kovesi of Ottawa'sChildren's Hospital of Eastern Ontario andhis colleagues set out to see whether there was a link between the respiratory problems andindoor air quality.

They studied 49Inuit children under age five in four communitiesin Nunavut's Qikiqtaaluk (Baffin) Region Cape Dorset, Iglooik, Clyde River and Pond Inlet. When more than one child lived in a household, the researchers included only the youngest in the study.

"We found a strong association between indoor CO2 levels and the risk of lower respiratory tract infection among Inuit infants and young children in the study," the authors write in the study, to be published in Tuesday's issue of the Canadian Medical Association Journal.

"An elevated CO2 level per se would not cause a respiratory infection, but it is a proxy for crowding and reduced ventilation, which may enhance the transmission of infection."

Kovesi and his team found27 of the children, or 55 per cent, were reported to have experienced a lower respiratory tract infection, either bronchitis or pneumonia, at some point in their lives.

Of those, 21 of the children, or 43 per cent, were reported to have been admitted to hospital in Nunavut for treatment for the infections. And 11 of the children, or 21 per cent, had to be transferred to hospitals outside the territory.

In looking at the homes, researchers found themsmall and crowded, relative to most Canadian dwellings.

Each household in the study had, on average, 6.1 people living in single-storey house. In southern Canada,by contrast, there are about3.3 to 4.4 people per household.

As well, the dwellings, which haveno basements because of permafrost, had about three rooms each, on average.

80% of houses had poor ventilation

Indoor air quality tests were carried out for periods of three to five days in the homes. The tests were conducted in 2005 from January to March, when winter brings bitterly cold temperatures and doors and windows are kept shut.

Researchers saidgiven the living conditions, they were not surprised to findhigh levels of carbon dioxide, which people exhale.

The average concentration of carbon dioxide indoors was found to be 1,358 parts per million, much higher than the recommended level of 1,000 ppm.

They found that the average ventilation rate per person was 5.6 litres per second 80 per cent of the houses had ventilation rates below the recommended rate of 7.5 litres per second.

The reduced ventilation may increase the concentration of airborne viruses and crowding can increase viral transmission from person to person, they said.

Raises questions about northern housing

Dr. Pamela Orr of the University of Manitoba, who wasn't involved with the study but whohas looked athousing needs in aboriginal communities, said the research raises several questions, including whethercurrent housing designs in the North are appropriate.

The layouts, she told CBCNews.ca,reflect Euro-Canadian designs for single nuclear family life rather than the extended communal family life of Inuit.

Another issue, Orr said, is Nunavut's fast-growing population, which is contributing to overcrowding.She said many would prefer homes with a larger, single room forparents, grandparents and children to gather, and less emphasis on individual sleeping areas.

The exposure of babies and young children in Nunavut to cigarette smoke is another concern for Dr. Geraldine Osborne, the territory's deputy chief medical officer of health.

"One of the major risk factors is smoking," she told CBC News. "Environmental and tobacco smoke in particular, is a big risk factor for severe respiratory infections in young children.

"Unfortunately this particular researcher couldn't look at that impact because virtually all the houses he investigated had smokers in the house."

The study foundsmokers in 46 of the 49 households tested.