The indoor environment and otitis media among Australian children: a national cross-sectional study

David Veivers, Gail M. Williams, Brett G. Toelle, Adriana M. Cortés de Waterman, Yuming Guo, Lyn Denison, Bo-Yi Yang, Guang-Hui Dong, Bin Jalaludin, Guy B. Marks, Luke D. Knibbs

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The association between the indoor environment and lifetime prevalence of otitis media (OM) in Australian children was assessed. We analysed data from a cross-sectional study of children, aged 7–11 years, performed in twelve Australian cities during 2007–2008. The main outcome was a parental report of their child’s diagnosis with OM by a doctor. Information on the indoor environment (energy sources used for heating, cooling, and cooking, pets, and second-hand smoke exposure), in the first year of life and at present, was collected from parents by a questionnaire. Multi-level logistic regression models were used to adjust for individual- and area-level confounders. Our analysis comprised 2872 children (51% female, mean age: 10.0 (SD 1.2)). Of those, 1097 (39%) were reported to have OM. Exposure to gas heating in the first year of life was significantly associated with higher odds of OM in adjusted models (OR:1.22; 95% CI: 1.00,1.47), as was current exposure to reverse-cycle air conditioning (OR: 1.52, 95% CI: 1.27,1.82). Ownership of a cat or dog at any time was also associated with high odds of OM (OR: 1.50; 95% CI: 1.17,1.92). No other significant associations were observed. In this national study of Australian children, indoor environmental exposures associated with the lifetime prevalence of OM were gas heating, reverse-cycle air conditioning and pet ownership. Exposures in both early life and later childhood may both play a role in OM.
Original languageEnglish
Article number1551
Pages (from-to)1-9
Number of pages9
JournalInternational Journal of Environmental Research and Public Health
Issue number3
Publication statusPublished - 29 Jan 2022
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • otitis media
  • indoor air pollution
  • risk factor
  • glue ear


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