Impact of home remediation and household education on indoor air quality, respiratory visits and symptoms in Alaska Native children

ABSTRACT

Alaska Native children experience high rates of lower respiratory tract infections (LRTIs) and lung conditions, which are associated with substandard indoor air quality (IAQ). We conducted an intervention of home remediation and education to assess the impact on IAQ, respiratory symptoms and LRTI visits. We enrolled households of children 1–12 years of age with lung conditions. Home remediation included improving ventilation and replacing leaky woodstoves. We provided education about IAQ and respiratory health. We monitored indoor airborne particles (PM2.5), CO₂, relative humidity and volatile organic compounds (VOCs), and interviewed caregivers about children’s symptoms before, and for 1 year after intervention. We evaluated the association between children’s respiratory visits, symptoms and IAQ indicators using multiple logistic regression. A total of 60 of 63 homes completed the study. VOCs decreased (coefficient = −0.20; p < 0.001); however, PM2.5 (coeff. = −0.010; p = 0.89) did not decrease. Burning wood for heat, VOCs and PM2.5 were associated with respiratory symptoms. After remediation, parents reported decreases in runny nose, cough between colds, wet cough, wheezing with colds, wheezing between colds and school absences. Children had an age-adjusted decrease in LRTI visits (coefficient = −0.33; p = 0.028). Home remediation and education reduced respiratory symptoms, LRTI visits and school absenteeism in children with lung conditions.

KEYWORDS:

• Alaska Native
• children
• air pollution
• indoor
• lung diseases
• volatile organic compounds

Acknowledgements

The authors wish to extend their deep appreciation to the Alaska Native residents who generously shared their personal stories and experiences. The authors would like to thank the following organisations for their support of this project: The Commission for Environmental Cooperation (CEC) of the North American Agreement on Environmental Cooperation (NAAEC), U.S. Department of Housing and Urban Development’s Office of Lead Hazard Control and Healthy Homes (HUD OLHCHH), Environmental Protection Agency (EPA), CDC, ANTHC, YKHC, BBAHC, Bristol Bay Housing Authority (BBHA) and Association of Village Council Presidents (AVCP) Housing.

Disclaimer

The findings and conclusions in this article are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the tribal organisations.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding for this study “Improving the Respiratory Health of Alaska Native People through Home Based Interventions” was provided by the North American Commission for Environmental Cooperation, Environmental Protection Agency [Project # 1.6.2.1.1.1] and the U.S. Department of Housing and Urban Development [Grant # AKHU0009-13].