Institut national de santé publique du Québec, Quebec City, QC, Canada.
Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada.
Can J Public Health. 2024 Jan;115(Suppl 1):136-151. doi: 10.17269/s41997-022-00722-9. Epub 2023 Jan 9.
Respiratory diseases are the leading cause of hospitalization in Nunavik (northern Québec, Canada) and contribute to disparities in life expectancy with the rest of Canada. As part of Qanuilirpitaa? 2017, a cross-sectional population-based health survey, we sought to describe the prevalence of respiratory health indicators, including the first estimate of airway obstruction based on spirometry in an Inuit population, and explore their associated characteristics.
We analyzed data from 1296 participants aged 16 years and older, using multivariate logistic regression to assess characteristics associated with spirometry-determined airway obstruction and self-reported respiratory symptoms, i.e., wheezing in the last year and chronic cough during at least 3 months.
In this relatively young population (83% aged 16 to 54), the prevalences of wheezing, chronic cough, and airway obstruction were, respectively, 27% (95% CI 24-30), 21% (18-23), and 17% (14-20). These estimates are prone to biases due to the relatively low participation rate (about 37%). The most consistent associations were with smoking (≥ 15 pack-years; odds ratio [OR] 3.13, 3.39, and 2.86 for the three indicators, respectively) and food security (OR 0.55 with wheezing and OR 0.26 with chronic cough), as defined in the Household Food Security Survey Module. Wheezing was also associated with allergic sensitization to dogs (2.60) and obesity (2.18). Chronic cough was associated with respiratory infections during childhood (2.12), housing in need of major repairs (1.72), and housing crowding (1.50), and was negatively associated with participation to traditional activities (0.62) and going on the land (0.64). Airway obstruction was associated with being underweight (3.84) and post-secondary education (0.40). Among young adults and women, wheezing was also associated with any inhalation of solvents for recreational purposes during their lifetime (2.62 and 1.56, respectively), while airway obstruction was associated with regular marijuana use (2.22 and 1.84, respectively).
Smoking and food insecurity are both highly prevalent and strongly associated with respiratory symptoms in Nunavik. Together with essential smoking prevention and cessation programs, our findings suggest that solving food security and housing crises, improving socioeconomic conditions, and promoting traditional lifestyle may improve respiratory health in Nunavik.
在努纳武特（加拿大魁北克省北部），呼吸系统疾病是导致住院的主要原因，这导致当地居民的预期寿命与加拿大其他地区存在差异。作为 Qanuilirpitaa？2017 的一部分，一项基于人群的横断面健康调查，我们旨在描述呼吸系统健康指标的流行情况，包括在因纽特人群中首次基于肺活量计估计气道阻塞，并探讨其相关特征。
我们分析了 1296 名 16 岁及以上参与者的数据，使用多变量逻辑回归评估与肺活量计确定的气道阻塞和自我报告的呼吸系统症状相关的特征，即过去一年喘息和至少 3 个月慢性咳嗽。
在这个相对年轻的人群中（83%年龄在 16 至 54 岁之间），喘息、慢性咳嗽和气道阻塞的患病率分别为 27%（95%CI 24-30）、21%（18-23）和 17%（14-20）。由于相对较低的参与率（约 37%），这些估计值容易出现偏差。与吸烟（≥15 包年）和食品安全（喘息的 OR 为 0.55，慢性咳嗽的 OR 为 0.26）最一致的关联，如家庭食品安全调查模块所定义。喘息还与对狗过敏（2.60）和肥胖（2.18）有关。慢性咳嗽与儿童时期的呼吸道感染（2.12）、需要大修的住房（1.72）和住房拥挤（1.50）有关，与传统活动的参与（0.62）和土地（0.64）有关。气道阻塞与体重不足（3.84）和中学后教育（0.40）有关。在年轻成年人和女性中，喘息也与终生任何吸入溶剂用于娱乐（分别为 2.62 和 1.56）有关，而气道阻塞与经常使用大麻（分别为 2.22 和 1.84）有关。
吸烟和食品安全不足在努纳武特都非常普遍，并与呼吸系统症状密切相关。除了开展预防和戒烟的基本计划外，我们的研究结果表明，解决食品安全和住房危机、改善社会经济条件以及促进传统生活方式可能会改善努纳武特的呼吸系统健康。
