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Indoor Air Quality and Health: Working with First Nations communities

The air quality in our homes is important to our general health. As part of the Government of Canada’s investment in understanding and improving air quality, Health Canada worked with First Nations communities in the Sioux Lookout Zone and other partners to measure indoor air quality, and to examine links with high rates of respiratory infections seen in the region’s First Nations children.

The First Nations indoor air quality study examined the relationship between indoor air quality and lower respiratory tract infections (like bronchiolitis and pneumonia), asthma and skin infections in children of 3 years or less living on reserve.

As a parent of young children himself, Health Canada researcher Gary Mallach was deeply interested in the topic.

He, along with partners from the Children’s Hospital of Eastern Ontario, Carleton University, the Nishnawbe First Nation, the Sioux Lookout First Nation Health Authority, and Indigenous Services Canada, set out to complete this critical study.

For children living in the First Nations communities of the Sioux Lookout zone, a group of mainly remote, fly-in communities in northwestern Ontario, the rate of lower respiratory tract infection is much higher than the Canadian average.

“Neither Health Canada nor the First Nations communities had the type of information needed to understand air quality in the region’s homes, or how indoor air quality may affect respiratory health in these children,” explains Mallach.

The study included over a quarter of the homes with young children in the participating communities.

Upon examining the data, the research team found that young children living in these communities indeed had high rates of respiratory illnesses, with a quarter of the children having been evacuated from their communities at least once for respiratory illness.

Living conditions in homes with poor indoor air quality likely contributed to these health conditions, with the study showing that levels of endotoxin in particular were associated with the children’s respiratory health issues.

It showed that many homes had elevated levels of air pollutants, possibly due to factors such as high occupancy, inadequate ventilation, and indoor sources of contaminants such as firewood storage and excess dampness.

Indoor air quality depends on many factors, including home design and maintenance, occupant behaviours, and ventilation.

Investigating indoor air quality involves detailed home inspections, speaking with residents, and monitoring for a broad range of contaminants, because a full picture is needed to understand the issues and improve conditions.

Researchers collaborated closely with the Chiefs and Councils, and the health facilities in the communities to ensure that they were involved throughout the process. Local First Nations community research assistants recruited participants, gathered health information and data on temperature, relative humidity, and levels of various pollutants in the homes.

“This was a true partnership between First Nations, the government, clinical partners, and academics. Everybody contributed their expertise, their connections and worked together to ensure the project was a success,” says Mallach.

It is important that the participating communities benefit from this type of research. The project team used some of the knowledge generated during the study to improve the indoor air quality in homes, whenever possible.

“While we were still in the communities, we made sure that some of the safety issues were remedied. Training was provided for the local housing authorities on how to fix some of the issues we identified, including on installing and maintaining heat recovery ventilators, and preventing mold,” says Mallach.

To support further improvements through education, study partners worked with local First Nations to develop and disseminate evidence-based, culturally appropriate materials to help occupants recognize and address indoor air quality issues identified by the research.

Mallach is proud of the success of the project. He is now using the knowledge he acquired through this project as a collaborator on the Food, Environment, Health and Nutrition of First Nations Children and Youth (FEHNCY) study.

The results of the study were recently published in the Canadian Medical Association Journal in an article titled Housing conditions and respiratory morbidity in Indigenous children in remote communities in Northwestern Ontario, Canada.

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