Academic journal article International Journal of Child Health and Human Development

Indoor Environmental Risk Factors for Pediatric Respiratory Diseases in an Underserved Community in Santiago, Chile

Academic journal article International Journal of Child Health and Human Development

Indoor Environmental Risk Factors for Pediatric Respiratory Diseases in an Underserved Community in Santiago, Chile

Article excerpt

Introduction

Human health is determined by sex, age and/or constitutional factors, as well as individual lifestyle factors, social and community networks, living and working conditions, education, water, sanitization, health care services, housing, and general socio- economic, cultural and environmental conditions (1- 3). This is especially relevant for the pediatric population because children are highly vulnerable to environmental factors (4-6). According to the World Health Organization, every year more than 3 million children under 5 years of age die because of environment related causes (7-10). While the burden of environmentally related ill-health affects all children, it is greatest among the poor. "Poor children are more likely to die in the first year of life, or before they reach the age of five; are sick more often and more seriously; are more likely to lag behind in growth and psychosocial development and they are more likely to have difficulties at school" (11).

Children under 5 years of age spend more than 90% of their time indoors (6, 12, 13); therefore, it is crucial to identify risk factors indoors. Children are more vulnerable to air pollution for many reasons. They have an increased ventilation rate, about twice as high on a per kilogram basis as that of adults (14). Their airways are narrower and are more likely to suffer a significant airflow obstruction as a response to an irritating airborne agent. Children breathe closer to the ground where particulate matter settles compared to adults. Finally, children's lungs grow continuously until adolescence (14) so any damage caused in childhood can have lifelong consequences.

More than half of the 2.1 million annual worldwide deaths in children under five are caused by acute lower respiratory infections may be associated with indoor air pollution, lack of adequate heating, or other precarious living conditions (12). Indoor air pollution from cooking and heating, tobacco smoke, and inadequate ventilation are the major hazards in developing countries (6,12, 15). Furthermore, asbestos and other suboptimal building materials represent a significant hazard to children, and may impair lung function (6). Household air pollution has also been shown to be the major cause of upper respiratory tract infections, thus it is crucial to identify and try to eliminate these risk factors (11).

Santiago, the capital city of Chile, is one of the most polluted cities in Latin America (16). It is therefore not surprising that one finds an increased incidence of acute respiratory infections (ARI) compared with other countries (17). In Chile, ARI are recognized as the leading cause of pediatric morbidity and the most frequent reason for use of health services (17-19). Also, they are the leading cause of pediatric hospital admissions and repeated health care visits, corresponding to 60% of all outpatient visits for illness (17-19). Between 20% and 40% of pediatric hospitalizations are due to these diseases. The Chilean Ministry of Health has designed various strategies to reduce mortality and morbidity associated with ARI with good results, but there are some environmental risk factors requiring further mitigation (17).

Many projects have been carried out to reduce air pollution, but some of the causes cannot be modified, such as the city's geographic characteristics. In Santiago, studies have mainly focused on outdoor air pollution; only a few studies have investigated risk factors in homes (20-22), especially in those of poor children.

The aim of the present study was to describe the perceived household risk factors for respiratory symptoms, as well as determine the knowledge and attitudes towards pollution and its effects on health, in poor families living in a low-income community in Santiago, Chile.

Methods

We conducted a descriptive study in a university- affiliated primary health care center located in the municipality of La Pintana, a poor community in the southeast area of Santiago, Chile. …

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