Anchorage Daily News

Rural Alaska Natives in homes without running water experience far higher rates of pneumonia and other serious lower respiratory tract infections than do Natives in homes where water is readily available for bathing and hand-washing, according to a new study by the federal Centers for Disease Control and Prevention.

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Areas where residents haul their water from a central source and dispose of wastewater in "honey buckets" also suffer higher rates of antibiotic-resistant staphylococcus aureus, or "staph," and other skin infections, the study found. The results were published Tuesday in the American Journal of Public Health.

While it's long been known that access to modern sanitation services can reduce death from gastrointestinal illnesses, the study is believed to be the first in the U.S. to demonstrate a link between water availability and respiratory infections.

Infants in villages with the lowest percentage of homes with running water are hospitalized for pneumonia 11 times more often than infants in the overall U.S. population, the study found.

In one region in particular, which the study does not name, 35 out of every 100 babies in villages with the lowest level of water service had to be hospitalized due to lower respiratory tract infections.

"Which is really quite astounding," says Dr. Thomas Hennessy, the study's author and director of the CDC's Arctic Investigation Program in Anchorage -- "to think that one out of three babies (in such villages) gets hospitalized for breathing problems where they need to be brought into the hospital for oxygen and IV fluids and for fairly intensive care."

The problem doesn't appear to be bad water, Hennessy says. In fact the study found that areas where a high percentage of residents haul their own water did not show elevated rates of infectious diarrhea.

Instead, CDC researchers think the problem might be traced to a reluctance by some rural Alaskans to use water for hygienic purposes when they have to haul it to their homes -- sometimes over great distances -- one five-gallon container at a time.

"The inconvenience of not having water and not being able to clean your hands and body perhaps in the same way you would if you had running water -- and the negative consequences that has for the spread of infectious diseases in a household -- is really quite telling," Hennessy said.

Such living conditions are now rare in the U.S. By 2000, 99.4 percent of all U.S. homes provided basic sanitation services such as running water, flush toilets and kitchen sinks.

In Alaska, however, complete sanitation services were still lacking in 6.3 percent of households in 2000 -- a distinction that placed it last in the nation.

The CDC study, conducted in cooperation with the Indian Health Service and tribal health corporations in six regions of Alaska -- including the Arctic Slope, the Northwest Coast, Norton Sound, Bristol Bay, the Yukon-Kuskokwim region and Southeast Alaska -- surveyed more than 12,000 homes in 128 communities between 2000 and 2004.

Overall, 73 percent of the rural homes studied had in-home water services. In villages where less than 10 percent of the homes provided running water, the incidence of respiratory infections and skin infections were highest. Infants and the elderly were particularly vulnerable.

Hospitalization rates for infants with respiratory syncytial virus, or RSV, were five times higher than the national average.

The report suggests that better public health in the Bush might be as achievable as providing more villages with running water.

"What they're lacking," he said, "is something that 99.4 percent of the rest of us have."

Find George Bryson online at adn.com/contact/gbryson or call 257-4318.

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