Almost 20 per cent of hospital admissions of young children with acute respiratory infections could be prevented if their houses were free from damp and mould, researchers have found.

The research, published in the international medical journal Thorax today, is the largest ever case-control study of the association between housing quality and hospital admissions for young children with acute respiratory infections.

Lead author, Dr Tristram Ingham, a Senior Research Fellow at the University of Otago, Wellington, says reducing exposure to poor quality housing could cut the number of hospital admissions for the under-twos by 1,700 (19 per cent) a year.

In 2015, 9,003 under-two-year-olds were hospitalised in Wellington for acute respiratory infections out of an estimated population of 118,580, a rate per population of 7.6 per cent.

“If all housing was free from damp and mould, the country could save just under $8 million a year solely in hospital costs,” Dr Ingham says.

“Improving housing quality to prevent such hospitalisations is also highly desirable in terms of future costs, with poor housing quality in childhood associated with adverse health outcomes in adulthood.”

The researchers conducted the case-control study in two paediatric wards and five general practice clinics in Wellington during winter and spring seasons between 2011 and 2013. The quality of housing was assessed using the Respiratory Hazard Index (RHI), a 13-point scale of household quality factors including an eight-item damp/mould subscale.

The researchers studied 188 children who were admitted to hospital with acute respiratory infections and 454 control patients – those who saw their GP either with a respiratory illness which did not require hospitalisation or for a routine immunisation.

The children who became ill had significantly higher levels of dampness and mould in their homes, which could be addressed by a number of measures, including better heating, insulation and ventilation.

The research was part of a wider Whiti Te Rā Case-Control Study which examines the broader risk factors for hospitalisation for acute respiratory infection using a kaupapa Māori research framework.

Acute respiratory infections are a major cause of early childhood illness, and account for 50 per cent of consultations general practitioners have with children under five. Upper respiratory tract infections are the most common, but acute respiratory infections also include lower respiratory tract infections, such as bronchitis and bronchopneumonia.

Asthma and Respiratory Foundation NZ’s Chief Executive Letitia O’Dwyer has commented on the research.

“There can be a sense of futility among health professionals in treating people for respiratory conditions caused by poor housing, if they’re put right back into that unhealthy environment afterwards,” says Letitia. “These issues hit the most vulnerable among us hardest; dampness, crowding, and improper building materials are major culprits in exasperating asthma, bronchitis, and Chronic Obstructive Pulmonary Disease (COPD), especially in humid regions such as Wellington, and among iwi.
“The Foundation’s mission is to reduce emergency visits for acute respiratory conditions by 20% by 2022, but our focus doesn’t seem to resonate with Government, or the Ministry of Health. Respiratory disease is the third leading cause of death in New Zealand; it should be a priority for any Government focused on public wellbeing.”

Green Party housing spokesperson Marama Davidson says that poor housing standards that harm children are “totally unacceptable”.

“We need to see more urgent progress on enforcing the Government’s healthy homes standards. Housing New Zealand is the country’s largest landlord and needs to lead the way on good housing.

“All rental properties in this country, whether private or state owned, need to free from damp and mould. We know children will continue to be sent to hospital because of preventable illnesses caused by the condition of their home. Our health system ends up working overtime for something that could be prevented through properly enforced standards.

“We need to see an enforceable “Warrant of Fitness” scheme for homes, so we can ensure that rentals are safe are and not harming people. The burden should not be on the tenants to raise safety issues with their landlord,” says Davidson.

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