Overcrowding and bad ventilation appear to be to blame for the high number of lung infections in young Inuit children, finds a new study in the Canadian Medical Association Journal.
Dr. Tom Kovesi, a pediatric respirologist at the Children's Hospital of Eastern Ontario, looked at the respiratory health of 49 Inuit children under five years of age in the Baffin region of Nunavut, as well as the indoor air quality in the homes where they lived.
They found that lower respiratory tract infections, such as pneumonia and acute bronchitis, were significantly associated with poor carbon dioxide levels in the children's housing and overcrowding.
The children they studied lived in homes with an average of 6.1 occupants per house. That compares to homes in southern Canada that typically have an average of 3.3 to 4.4 occupants. Most of the homes studied were smaller than 1,000 square feet (93 square metres).
Ventilation rates in the homes studied were below the recommended Canadian standard in 80 per cent of the houses, with carbon dioxide levels often exceeding recommended concentrations.
Elevated carbon dioxide is an indication of crowding and reduced ventilation. Contributing to the problem of poor air quality was the fact that smokers were present in 93 per cent of the homes.
Inuit infants in the Baffin region of Nunavut have the highest reported rate of hospital admission in the world, because of severe respiratory syncytial virus (RSV) lung infections, with annualized rates of up to 306 per 1000 infants.
The infections are unusually severe in these infants: 12 per cent of those admitted to hospital in Iqaluit require intensive care, which often means they have to be airlifted to hospitals in southern Canada.
Inuit infants also have disproportionately high rates of permanent chronic lung disease after a lower respiratory tract infection.
In a related commentary, Dr. Pamela Orr of the University of Manitoba notes that the results of this research come as no surprise to those who live, work and study in the Canadian North.
She notes that it is not clear whether crowded housing and inadequate ventilation are actually causing the lung infections or whether they are simply risk markers, reflecting an association with other risks, for example: poverty.
She says Kovesi's study raises questions about how appropriate current housing, which was designed for the typical nuclear family of southern Canada, are for the extended communal family life of the Inuit.
