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Environmental Health Consults in Children Hospitalized with Respiratory Infections

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Abstract

Indoor air pollutants contribute to respiratory infections and asthma exacerbations in children. Rural Alaska Native children experience some of the highest U.S. rates of respiratory hospitalizations, which are associated with lack of in-home running water, household crowding, and woodstove use. In our previous study, in-home education and modifications reduced respiratory symptoms, and medical visits. In this study, we evaluated the feasibility of providing in-hospital environmental health consults for parents/guardians of children < 5 years old hospitalized at the Alaska Native Medical Center with respiratory infections or asthma. Environmental health specialists conducted 92 in-hospital consults and mailed Healthy Homes Toolkits to households. Local housing authorities completed low-cost home modifications in 47 eligible households. Participants reported changes in household behaviors that were specifically addressed in the consult or included in the Toolkit (e.g. allergen-impermeable pillow covers). Reported respiratory symptoms were decreased at the 6-month follow-up. Over a 2 year period the median overall medical costs for respiratory illness in study children were $70,500. Children with in-home piped water had half the daily overall medical costs than children without in-home piped water ($74 compared to $144). In this study, we demonstrate that it is feasible to provide environmental consults, mail Toolkits, and arrange home modifications to the homes of children hospitalized with respiratory illness. These findings, along with the high costs of medical care for these children, suggest in-hospital environmental health consults are a cost-effective intervention.

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Acknowledgements

The authors wish to extend their deep appreciation to the Alaska Native families who participated in this study. The authors would like to thank the following organizations for their support of this project: Tribal Healthy Homes Network (THHN), The Environmental Protection Agency (EPA), CDC, ANTHC, YKHC, BBAHC, Maniilaq Association, SCF, Native Village of Kotzebue, Northwest Inupiat Housing Authority (NIHA), Bering Straits Regional Housing Authority, Bristol Bay Housing Authority (BBHA) and Association of Village Council Presidents (AVCP) Housing.

Funding

This study was funded by an ANTHC Strategic Initiative: SI17051000 Helping Children Breathe Easier Strategic Initiative.

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Correspondence to Abigail Nelson.

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Nelson, A., Salkoski, A.J., Richards, B. et al. Environmental Health Consults in Children Hospitalized with Respiratory Infections. J Community Health 46, 324–333 (2021). https://doi.org/10.1007/s10900-020-00886-w

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  • DOI: https://doi.org/10.1007/s10900-020-00886-w

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