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Int J Circumpolar Health. 2018 Dec;77(1):1422669. doi: 10.1080/22423982.2017.1422669.

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

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a Division of Community Health Services , Alaska Native Tribal Health Consortium (ANTHC) , Anchorage , AK , USA.
b Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases , Centers for Disease Control and Prevention (AIP-CDC) , Anchorage , AK , USA.
c Community Environment and Health , ANTHC , Anchorage , AK , USA.
d AIP-CDC , Anchorage , AK , USA.
e Division of Environmental Health and Engineering , ANTHC , Anchorage , AK , USA.
f Office of Environmental Health , Yukon Kuskokwim Health Corporation , Bethel , AK , USA.
g School of Natural Resources and Extension , University of Alaska, Fairbanks , Bethel , AK , USA.
h Bristol Bay Area Health Corporation , Dillingham , AK , USA.
i Division of Environmental Health and Engineering , ANTHC , Anchorage , AK , USA.
j Department of Pediatrics , University of Ottawa , Ottawa , ON , Canada.
k AIP-CDC , Anchorage , AK , USA.


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.


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

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