• Other Authors: The Pennsylvania State University CiteSeerX Archives
• Format: Text
• Language: English
• Subjects: Canada; Greenland; Nunavut; Baffin; inuit; Iqaluit; Qikiqtaaluk; Alaska
• Online Access: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.512.9097; http://www.cmaj.ca/content/177/2/155.full.pdf

Inuit infants in Qikiqtaaluk (Baffin) Region, Nunavut,Canada, have the highest reported rate of hospital admis-sions because of severe respiratory syncytial virus infec-tion in the world, with annualized rates of up to 306 per 1000 infants.1 High rates of hospital admission because of lower respiratory tract infections have also been reported among Native infants in Alaska2 and Inuit infants in Greenland.3 In-vasive Streptococcus pneumoniae infection, including pneu-monia, is also relatively frequent.4 Respiratory syncytial virus infection is also unusually severe in this population: 12 % of infants admitted to the Baffin Regional Hospital in Iqaluit (Qikiqtaaluk Region’s regional hospital) required intubation and mechanical ventilation, necessitating costly and difficult air transport to tertiary care hospitals in southern Canada.1 Inuit and Alaska Native infants also have disproportionately high rates of permanent chronic lung disease after a lower respiratory tract infection.5 Alaska Native infants have been reported to have the highest prevalence of bronchiectasis recorded, nearly always preceded by recurrent severe lower respiratory tract infection.6–8 The reasons why young Inuit children have such severe respiratory infection remain un-clear. Their immune function appears to be normal,6,9 and cystic fibrosis and primary ciliary dyskinesia are rare.6,7 Over-crowding and exposure to environmental tobacco smoke are believed to play important roles.1,10 Ventilation is the process by which fresh air is introduced and stale air removed from an occupied space.11 Adequacy of ventilation can be evaluated directly or indirectly: directly, by measuring air change rates and occupancy and then calculating ventilation per person; indirectly, or by monitoring the indoor concentration of carbon dioxide (CO2), which is a function of the number of occupants (the primary source of indoor CO2) and the amount of airflow available to clear CO2 from the build-ing.12 In the winter of 2003, we completed a pilot study evaluat-ing ...