Academic journal article Canadian Journal of Public Health

Respiratory Symptoms and Exposure to Wood Smoke in an Isolated Northern Community

Academic journal article Canadian Journal of Public Health

Respiratory Symptoms and Exposure to Wood Smoke in an Isolated Northern Community

Article excerpt

ABSTRACT

Background: Wood smoke has been associated with respiratory symptoms. This study examined the prevalence of respiratory symptoms and health effects of wood smoke exposures (from home heating, curing meat, and tanning hides) among residents of Deline, Northwest Territories (NWT).

Methods: A survey was conducted of all residents. Relationships between wood smoke and respiratory symptoms were examined.

Results: The response rate was 70.2% (n=402). 71% of people at least 18 years old were current smokers. Prevalence of symptoms was higher for women (odds ratios (ORs) 1.3-3.1). Women who smoked were more likely to be exposed to indoor smoke from curing and tanning. ORs for respiratory symptoms were higher for females, increased with age, and were strongly affected by smoking. Among those at least 18 years old, phlegm on winter mornings (6.5 (95% Cl: 2.3-18.1)), dyspnoea (5.1 (95% Cl: 1.9-13.2)), and watery or itchy eyes (3.6 (95% Cl: 1.4-9.0)) were significantly related to self-reported outdoor wood smoke and smoke curing. Home heating was marginally associated with wheeze. No significant associations were found for males.

Conclusions: Women engaged in curing/tanning demonstrated increased prevalence of respiratory symptoms. The cultural importance of these activities precludes abandoning them. Smoking cessation, limiting wood smoke exposure times, and process modifications in curing and tanning could reduce risk of adverse health effects.

The health of Aboriginal people in North America is poorer than that of the non-Aboriginal population.1-6 Although life expectancy and functional health status have been gradually improving over the last decade,7 life expectancy for males and females in the Northwest Territories (NWT) was, respectively, four and three years shorter than for their counterparts across Canada.

Respiratory health is particularly compromised among the Aboriginal population. Age-standardized mortality for respiratory conditions in the NWT was 34% higher than the rate for Canada. Respiratory diseases accounted for over 10% of all inpatient hospital visits in the NWT. This is consistent with data for US Indians.5 Approximately one quarter of visits to community clinics in the NWT are for respiratory conditions.7 A study in an Aboriginal community in northwestern Ontario found that respiratory diseases accounted for almost 50% of all episodes of illness.8 Emergency department visits for both asthma and chronic obstructive pulmonary disease were found to be 2.1 and 1.6 times more common, respectively, among Aboriginal compared to non-Aboriginal residents of Alberta.9 Among those visiting the emergency department for either of these conditions, Aboriginal patients were significantly less likely than non-Aboriginal patients to be seen by a specialist or to undergo spirometry.

Some risk factors for respiratory diseases are more common among Aboriginal populations than among their non-Aboriginal counterparts. Aboriginal people generally live in poorer housing and this is particularly common in smaller, isolated communities. Over 50% of Aboriginal people in the NWT over age 15 are current smokers, compared to 29% for Canada.7 In the US, it was reported in 1990 that houses on reserves were more likely to be heated by wood (34%) than all US houses (4%).10

Larson and Koenig showed a consistent association between exposure to wood smoke and increased respiratory symptoms and lower respiratory tract infections, and decreased pulmonary function among children at concentrations observed in homes in developed countries.11 Based on 13 studies, Smith et al. calculated odds ratios (ORs) between 2.2 and 7.0 for acute lower respiratory tract infections in children exposed to indoor biomass smoke in developing countries.12

The importance of respiratory disease in Aboriginal populations throughout North America, the growing evidence of an association between wood smoke and respiratory problems, and a high exposure prevalence in remote, northern communities prompted the present study. …

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