Ear infections prevalent

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Aboriginal populations have a lot more middle ear problems than do other populations. A 1999 First Nations and Inuit regional health survey reports rates 11 per cent to 20 per cent higher in First Nations and Inuit youth than in non-Aboriginal youth, declining as their age rises.

Dawn Walker, special advisor to the assistant deputy minister of First Nations Health in the First Nations and Inuit Health Branch of Health Canada, said, "There is a link between ear infections and . . . exposures to environmental tobacco smoke. And it's thought that that is one of the major causes of ear problems."

And one reason the Aboriginal population has more ear problems is "because the rates of exposure to environmental tobacco smoke is higher in Aboriginal children than non."

Under five years of age, First Nations and Inuit children were observed to have a 20 per cent higher rate of ear problems. From ages six to 11, it was 17 per cent higher, and in children above the age of 12, the incidence of ear problems was 11 per cent higher than in the general population.

"Similar rates (15 per cent and 16 per cent) were found in females and males," the report stated.

Brenda Tullio, audiologist at Northwestern Health Unit in Fort Frances, serves communities from Atikokan to Rainy River.

"I am the only audiologist in the Rainy River district and so anybody who requires audiology services would come here, and we do have a fair First Nations population, so I do see a fair number, about 25 to 30 per cent."

She said she sees an even number of children and adults.

The numbers of Aboriginal people experiencing ear problems could be higher, she said. "I don't think that all of them who require services seek treatment or seek the service."

Tullio said her non-Aboriginal clients are mostly elderly people or those who have a noise-induced hearing loss from the papermill in town; whereas, most of her Aboriginal patients have problems secondary to ear infections. "The majority of my First Nations clients are coming to me because of either active ear infections or hearing loss caused by chronic ear infections in the past."

She said children with ear infections often have problems with speech development, because they're not able to hear properly.

"Usually ear infections cause anywhere from a mild-to-moderate amount of hearing loss, and so they (school children) do tend to suffer a little bit because they can not hear the teacher well in the classroom. It's estimated that about 30 per cent of children with learning disabilities have a history of ear infections early in childhood."

Tullio named two causes why the Aboriginal population has a higher rate of infections.

"Part of the reason is they tend to be less likely to seek medical treatments for their health concerns." The other part, she said, is the structure of their anatomy. "The eustachian tube, which serves to keep the middle part of the ear pressurized, is a little flatter and straighter than it is in the Caucasian population, and so they tend to have a little more problems."

Among the Metis, "it depends on the genetics there, I guess," she said.

The most common cause of ear infections is upper respiratory infections like a sore throat, cold or flu. "It migrates from the back of the throat up to the middle ear through the eustachian tube," said Max Setliff, an audiologist at the Northwestern Health Unit in Kenora.

"The only preventative mechanism we know for ear infections is don't get an upper respiratory infection. And the way you avoid upper respiratory infection is don't rub your eye, don't pick your nose, don't eat anything without washing your hands, wash your hands a lot," said Setliff.

He said that at least 20 per cent of his patients are Aboriginal. And half of his young patients are Native with problems "because of middle ear disease."

Setliff said chronic ear infections, untreated, occasionally cause a permanent hearing loss in the inner ear. But "usually the hering loss is associated with the middle ear infection. Usually it's temporary and usually it's caused by fluid that accumulates behind the eardrum."

Permanent hearing loss can also be caused if the connection between the eardrum and the ear is lost as a result of an infection that erodes the bones in the middle ear, he said.

Signals of ear infection include pain, sudden decreased hearing or balance problems. Signs to notice in small children would be when they tug at their ears, have a fever, are unsteady on their feet, ask "What? What?" or their speech diminishes in quality or quantity.

Ear infections in children require the immediate attention of a pediatrician or an otologist (ear doctor).

Usually a general practitioner will treat the infection first, but if it doesn't clear up referral to a specialist is required. If a child has frequently recurring infections or chronic fluid in the middle ear, he or she may need to see an audiologist and a speech-language pathologist to deal with hearing problems.