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Jennifer McPhee
Northern News Services
She linked the lung disease to smoking, overcrowded living conditions and possibly a new bacteria. Now she's back to do more research.
 Anna Banerji with her one-year-old daughter, Sierra. Banerji studies 26 Baffin-area babies with lung infections. All 26 infants had mothers who smoked during pregnancy. - photo courtesy of Anna Banerji |
I was working as a pediatrician at the Baffin Regional Hospital in 1996 and noticed a high rate of lung infections. I noticed that every kid I saw had a lung infection. I decided to find out why so I started reviewing charts. I did a chart review over a one-year period. When I was looking at the charts I found out that one in three kids under the age of one on Baffin Island had been admitted to the hospital for bronchialitis. This was the first phase.
How serious are lower respiratory infections?
They range. In the Inuit population they seem more severe than in other populations. Many of the kids end up on life support and are transferred to larger centres.
Is the main reason for this cigarette smoke?
It's one of the things that's not helping. Things like overcrowding, being born prematurely, having the infection at a young age. Around the world poverty increases the risk of having lung infections, although we are not studying that.
How did you determine who was living in overcrowded conditions?
We found out how many people were living in their homes and compared that to the average for Canada. From our studies, the kids had two times the Canadian average of people living at home.
Were you surprised by results?
The one in 1996 made me do another study. And in the second study, we found out things such as all the kids are exposed to cigarette smoke in pregnancy and in their homes. We found out they lived in overcrowded conditions. There were high rates of admission and high rates of children going on life support.
But that study was very small so we couldn't prove a lot of things. And there were no controls--there was no healthy population to compare them to. So it was hard to come to conclusions.
Now you're comparing children to healthy populations?
Yes.
Is it difficult to get consent from parents?
I don't know yet (laughs). In the first study, our big problem was that parents were not there when the research assistant was there. So it was hard to get consent sometimes. But most people who were there were agreeable. Most people realize that a study like this ends up benefiting the whole community.
What feedback have you received?
For people in the North, this is nothing new. For people who don't live in the North, they are extremely surprised at the very high rates. People in North say the children are very sick, but I don't think others have realized how sick they are until they had it documented. It's one of the highest documented rates in the world.
There may be a new bacteria?
Right. The thing we found in the last study was that a large percentage of the kids seemed to have a new bacteria. But because we didn't have a control group, we don't know... maybe everyone has it. Maybe it means nothing. But if the sick children have it and the healthy kids don't then maybe this bacteria is responsible for some of the lung disease.
What would that mean?
Before we used to think that a lot of the bronchialitis was due to a virus. If we find out that it is a bacteria, it may be possible to treat it. Before there was very little we could do for these kids. Using an antibiotic may help some of these kids.
That would be a pretty amazing finding, wouldn't it?
It would. If it was true. If we could prove it.
How would you like to see your research used?
Education. The belief is most people want their children to be healthy. If we can educate people on what can improve the chances of a child being healthy, I think that will benefit the population.
The second thing is we are writing a report to the Department of Health and Social Services with suggestions about what measures the government can take to reduce the risk of infection. After the last study, we indicated the government needs to start an anti-smoking campaign. And, surprisingly, they did.
The other thing is vaccination. The Government of Nunavut is thinking about immunizing children against pneumococcal disease and influenza, which may reduce the risk of lung infections. Also, if we find out that children who live in overcrowded homes have higher risk of lung infection, then this can give groups lobbying power to try improve housing conditions in the North.
What's the role of breastfeeding in this?
In other populations, breastfeeding usually has a protective effect and often reduces rates of lung infections. But there was a study in Northern Quebec showing that sometimes breast milk has toxins. In the population on Baffin Island, we don't know yet.
In the study, was there a low number of women who breastfed their children?
In the study, a lot of the kids were adopted out so they weren't breastfed.
In one way, it must be rewarding for you to do this research, then go away for a while and come back to find the government has responded to it. But is it frustrating that someone has to show evidence that people already know is true before the government acts?
That's the way research is. I already know that cigarettes are contributing to lung disease. That's a known fact. By proving it, it makes the argument more solid so people can't argue against it. Because I'm a scientist I can understand how people find it hard to believe the obvious unless it is proven. In that way, it is not frustrating. Most of these things have been proven in other populations. But it hasn't been proven in the North. It's difficult to do research in the North.
Why?
People don't live up there. It's easier to do research where you live. Also, if you are looking for sources of infection, you have to transport specimens a far distance. That can cause specimen deterioration. It's also expensive to travel to remote communities and do research. So before very few people looked into these problems. If it was in another part of Canada this would have already been studied.
Where did your funding come from?
The first study there was no funding. The second study it was through the medical research council and other groups. This study is funded through the Nunavut Department of Health and Social Services.
After you finish this next study, will you come back to do more research?
It depends on what we find. Before I started this study, I told people I would only do the study if the people of the North wanted me to do the study. I think the important thing about the study is that many of the researchers involved live in Iqaluit. And they were all very interested in doing the study as well as some of the Inuit advocacy groups. They wanted me to pursue it. As long as people are interested, I am willing to do my part.
Do you have children?
I have a one-year-old girl.
Were you ever a smoker?
No. My husband was. I said, if he wants to be with me he has to quit. And he quit.
