PT  - JOURNAL ARTICLE
AU  - Kovesi, Thomas
AU  - Mallach, Gary
AU  - Schreiber, Yoko
AU  - McKay, Michael
AU  - Lawlor, Gail
AU  - Barrowman, Nick
AU  - Tsampalieros, Anne
AU  - Kulka, Ryan
AU  - Root, Ariel
AU  - Kelly, Len
AU  - Kirlew, Michael
AU  - Miller, J. David
TI  - Housing conditions and respiratory morbidity in Indigenous children in remote communities in Northwestern Ontario, Canada
AID  - 10.1503/cmaj.202465
DP  - 2022 Jan 24
TA  - Canadian Medical Association Journal
PG  - E80--E88
VI  - 194
IP  - 3
4099  - http://www.cmaj.ca/content/194/3/E80.short
4100  - http://www.cmaj.ca/content/194/3/E80.full
SO  - CMAJ2022 Jan 24; 194
AB  - 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 m2. 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.