• Thomas Kovesi, Gary Mallach, Yoko Schreiber, Michael McKay, Gail Lawlor, Nick Barrowman, Anne Tsampalieros, Ryan Kulka, Ariel Root, Len Kelly, Michael Kirlew, and J David Miller.
• 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.
• CMAJ. 2022 Jan 24; 194 (3): E80E88E80-E88.

BackgroundRates 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.MethodsWe 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.ResultsParticipants 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).InterpretationWe observed poor housing conditions and an association between endotoxin and wheezing in young FN children living in Northern Ontario.© 2022 CMA Impact Inc. or its licensors.

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