{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:58:09Z","timestamp":1775645889790,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess whether access to saltwater chlorinated swimming pools in remote Aboriginal communities is beneficial in reducing levels of middle ear disease and hearing loss in school children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective 3\u2010year cohort study of children in 10 remote Aboriginal communities in South Australia with (n\u00a0=\u00a04) or without (n\u00a0=\u00a06) swimming pools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Outback Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Eight hundred and thirteen school\u2010age children residing in remote South Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Prevalence of open and closed middle ear disease and prevalence of hearing loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 2107 ear assessments were conducted during the study period. 70.7% of children in communities with pools failed a screening test of hearing compared with 68.6% of children in non\u2010pool communities (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.637). 32.3% of children had chronic otitis media (COM). There was no difference between pool and non\u2010pool communities in the frequency of either inactive (19.4% pool vs 22.6% non\u2010pool; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.232) or active (19.8% pool vs 17.8% non\u2010pool; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.383) COM. In children with bilateral intact tympanic membranes, 21.2% had unilateral and 20.6 had bilateral type B tympanograms. There was no difference between pool and non\u2010pool communities in the frequency of type B tympanometry (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.465).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hearing loss associated with both open and closed middle ear disease remains highly prevalent in children living in remote Aboriginal communities in South Australia. Access to swimming pools in this population does not appear to significantly reduce these high levels of middle ear disease or associated hearing loss.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13364","type":"journal-article","created":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T18:48:22Z","timestamp":1558032502000},"page":"736-742","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Does access to saltwater swimming pools reduce ear pathology and hearing loss in school children of remote arid zone aboriginal communities? A prospective 3\u2010year cohort study"],"prefix":"10.1111","volume":"44","author":[{"given":"Linnett","family":"Sanchez","sequence":"first","affiliation":[{"name":"College of Nursing &amp; Health Sciences Flinders University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7507-7983","authenticated-orcid":false,"given":"Andrew Simon","family":"Carney","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine and Public Health Flinders University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Esterman","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of South Australia Adelaide South Australia Australia"},{"name":"Australian Institute of Tropical Health and Medicine James Cook University Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Sparrow","sequence":"additional","affiliation":[{"name":"College of Nursing &amp; Health Sciences Flinders University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Turner","sequence":"additional","affiliation":[{"name":"College of Medicine &amp; Public Health Flinders University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459981014305S10"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113003083"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115003217"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116009294"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7412.415"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1201\/b15118-85"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.10533"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.01.023"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200010000-00014"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100122601"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(02)00253-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199904000-00003"},{"issue":"3","key":"e_1_2_8_14_1","first-page":"32","article-title":"Impact of swimming pools in remote Aboriginal communities in Western Australia","volume":"7","author":"Lehmann D","year":"2010","journal-title":"SA Public Health Bull"},{"issue":"3","key":"e_1_2_8_15_1","first-page":"27","article-title":"Whole\u2010of\u2010population studies of ear health and hearing in remote and urban indigenous school age children in South Australia","volume":"7","author":"Sanchez L","year":"2010","journal-title":"SA Public Health Bull"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2002.tb04727.x"},{"key":"e_1_2_8_17_1","volume-title":"Stronger Futures in the Northern Territory: Hearing Health Services 2012\u201013","author":"AIHW","year":"2014"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.13364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T05:53:46Z","timestamp":1693806826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,29]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1111\/coa.13364"],"URL":"https:\/\/doi.org\/10.1111\/coa.13364","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,29]]},"assertion":[{"value":"2018-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}