Associação entre poluição atmosférica e doenças respiratórias e cardiovasculares na cidade de Itabira, Minas Gerais, Brasil

Ambient air pollution and mortality: The role of socioeconomic conditions

Background

There is a vast body of literature covering the association between air pollution exposure and nonaccidental mortality. However, the role of socioeconomic status (SES) in this relationship is still not fully understood.

Objectives

We investigated if individual and contextual SES modified the relationship between short-term exposure to ozone (O3), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameter <10 µm (PM10) on cardiovascular, respiratory, and all nonaccidental mortality.

Methods

We conducted a time-stratified case-crossover study. Analyses were based on information on 280,685 deaths from 2011 to 2015 in the city of São Paulo. Education was used as an individual SES, and information on the district of residence was used to build a contextual SES. Exposure to PM10, NO2, and O3 was accessed from monitoring stations and linked to each case based on the date of death. Conditional logistic regression models were used to estimate the effects of air pollutants, and interaction terms were added to access the effect modification of SES.

Results

Individuals with lower education had an increased chance of dying for all nonaccidental outcomes (1.54% [0.91%, 2.14%]) associated with exposure to PM10. Individuals living in lower SES areas had an increased chance of dying for nonaccidental (0.52% [0.16%, 0.88%]), cardiovascular (1.17% [0.88%, 1.46%]), and respiratory (1.70% [0.47%, 2.93%]) causes owing to NO2 exposure.

Conclusion

Exposure to air pollutants increases the chance of dying by nonaccidental, cardiovascular, and respiratory causes. Lower educational levels and living on lower contextual SES increased the risk of mortality associated with air pollution exposure.

Micronuclei frequency and exposure to chemical mixtures in three Colombian mining populations

The Colombian mining industry has witnessed significant growth. Depending on the scale and mineral extracted, complex chemical mixtures are generated, impacting the health of occupationally exposed populations and communities near mining projects. Increasing evidence suggests that chromosomal instability (CIN) is an important link between the development of certain diseases and exposure to complex mixtures. To better understand the effects of exposure to complex mixtures we performed a biomonitoring study on 407 healthy individuals from four areas: three located in municipalities exploiting different-scale mining systems and a reference area with no mining activity. Large, medium, and small-scale mining systems were analyzed in Montelibano (Córdoba), artisanal and small-scale mining (ASGM) in Nechí (Antioquia), and a closed mining system in Aranzazu (Caldas). The reference area with no mining activity was established in Montería (Córdoba). ICP-MS measured multi-elemental exposure in hair, and CIN was evaluated using the cytokinesis-block micronucleus technique (MNBN). Exposure to mixtures of chemical elements was comparable in workers and residents of the mining areas but significantly higher compared to reference individuals. In Montelibano, increased MNBN frequencies were associated with combined exposure to Se, Hg, Mn, Pb, and Mg. This distinct pattern significantly differed from other areas. Specifically, in Nechí, Cr, Ni, Hg, Se, and Mg emerged as the primary contributors to elevated frequencies of MNBN. In contrast, a combination of Hg and Ni played a role in increasing MNBN in Aranzazu. Interestingly, Se consistently correlated with increased MNBN frequencies across all active mining areas. Chemical elements in Montelibano exhibit a broader range compared to other mining zones, reflecting the characteristics of the high-impact and large-scale mining in the area. This research provides valuable insights into the effects of exposure to chemical mixtures, underscoring the importance of employing this approach in the risk assessment of communities, especially those from residential areas.

Spatio-temporal visualization and forecasting of [Formula: see text] in the Brazilian state of Minas Gerais

Air pollution due to air contamination by gases, liquids, and solid particles in suspension, is a great environmental and public health concern nowadays. An important type of air pollution is particulate matter with a diameter of 10 microns or less ([Formula: see text]) because one of the determining factors that affect human health is the size of particles in the atmosphere due to the degree of permanence and penetration they have in the respiratory system. Therefore, it is extremely interesting to monitor and understand the behavior of [Formula: see text] concentrations so that they do not exceed the established critical levels. In this work, we will study the [Formula: see text] concentrations in all available monitoring stations in the Brazilian state of Minas Gerais. To better understand its behavior, we will provide a spatio-temporal visualization of the [Formula: see text] concentrations. Besides the descriptive and visualization analysis, we consider six standard and advanced time series models that will be used to fit and forecast [Formula: see text] concentrations, with application to three locations, one in Belo Horizonte, the Minas Gerais state capital, and the monitoring stations with the lowest and highest average [Formula: see text] concentration levels.

Blood markers among residents from a coal mining area

Coal extraction and processing generate environmental contamination, which has several negative impacts on human health. Hematological and biochemical parameters are effective biomarkers of the exposure of a population to air pollutants. Thus, this study aimed to evaluate hematological and biochemical parameters in adult residents in a coal mining region in the largest national reserve in Brazil, as well as to investigate their relations with air quality. The study included three cities in the south of Brazil, which are located near an important power plant and coal mine. The air quality was analyzed by PM10, NOx, and SO₂ at five air quality monitoring stations, socioeconomic and demographic characteristics were evaluated with a questionnaire, and biochemical parameters were assessed in blood samples. The mean PM10 in the study area was 19.18 μg/m³. The air quality varied among the five monitoring stations, and the Candiota station exceeded the reference limit by 63.3%. In general, participants had lived more than 10 years in the municipality and had hepatic and renal parameters within the reference values. A higher prevalence of alterations was found in hematological parameters (43.1%) and liver function (30%). Among the three cities, the population of Pedras Altas seems to have a greater impairment of the blood parameters evaluated. The only parameter that was correlated with PM10 was the hematocrit level (r = 0.33; P < 0.001).

Mining Waste Challenges: Environmental Risks of Gigatons of Mud, Dust and Sediment in Megadiverse Regions in Brazil

The management of long-lived mining wastes is a complex environmental challenge, but the subject is little discussed among the public, scientific community, and policymakers. The negative environmental impacts caused by mining wastes are severe and cause damage to human health and the loss and degradation of natural ecosystems. With the objective of stimulating discussion to advance the development of measures to contain threats to biodiversity and to mitigate negative impacts, we present an overview of total volumes of mining waste disposal in tailings dams and dump piles, discriminating them by ore type and biome. We highlight the major environmental risks and challenges associated with tropical forests, savannas, and freshwater ecosystems and possible limitations and advances in public policies and governance. The scale of this challenge is global, as some data show, for example, Brazil generated 3.6 billion tons of solid mining waste in dump piles in the period between 2008 and 2019. The volume is equivalent to 62% of the global mass of nonfuel minerals removed from the planet’s crust in 2006. Numerous socio-environmental disasters are caused by catastrophic mining dam failures, and over the last 34 years, an average of one failure has occurred every three years in Brazil.

Avoiding hospital admissions for respiratory system diseases by complying to the final Brazilian air quality standard: an estimate for Brazilian southeast capitals

According to the World Health Organization (WHO), in 2016, 91% of the global population was living in places where guidelines on air quality were not met, which results in an estimated figure of seven million deaths annually. The new Brazilian air quality standards, CONAMA 491/2018, was the first revision in over two decades and has as final target the WHO guidelines for air quality, although no deadline has been established for implementation. The goal of this work was to quantify public health gains of this new policy based on hospitalizations due to respiratory diseases, the most studied outcome in Brazilian time series studies, in four Brazilian Southeast capitals: São Paulo (SP), Rio de Janeiro (RJ), Belo Horizonte (MG), and Vitória (ES) for PM₁₀, PM_2,5, SO₂, CO, and O₃. Population and hospitalizations data for all respiratory diseases for people under 5 years old, over 64 years old, most vulnerable populations, and all ages were analyzed. The air quality monitoring data was analyzed in two different periods: 2016 to 2018 for São Paulo and Vitória; and between 2015 and 2017 for Belo Horizonte and Rio de Janeiro, according to available monitoring data. A literature review was carried out to determine the appropriate relative risk to be used in the estimations, and the public health gains were calculated based on the selected relative risks for each city. The highest estimate was for São Paulo, with 3454 avoidable respiratory hospital admissions (all ages). In total, the four cities accounted for 4148 avoidable hospitalizations, which was associated to $1.1 million public health gains. Results considering the day of exposure (lag 0) were superior to those with the 5-day moving average (lag 5). The results highlighted the importance of adopting more restrictive standards and called for public policies, the necessity of expanding the air quality monitoring network, mapping emission sources, and improve the knowledge about the interaction between air pollution and health outcomes beyond respiratory disease for the region.

Association between the incidence of acute respiratory diseases in children and ambient concentrations of SO2, PM10 and chemical elements in fine particles

The aim of this study consists of investigating the effects of the SO₂, PM₁₀, inorganic chemical elements and black carbon (BC) present in fine particulates on the acute outcomes of respiratory diseases in children up to 12 years of age living in Brazilian urban area in the southern hemisphere during the winter (2013) and summer (2013-2014) months. SO₂ and PM₁₀ concentration data were obtained from six air quality monitoring stations spatially distributed in the area. PM_2.5 samples were collected at the same locations with a MiniVol sampler over a 24-h period on alternating days. The PM_2.5 components were analysed using the energy dispersive X-ray fluorescence and reflectance techniques. Hospital care and admission events due to acute respiratory diseases (n = 8,987) of the coded groups JJ00-JJ99 of the International Code of Diseases (ICD-10) were obtained from three hospitals (one public and two private hospitals). To quantify the association of acute respiratory disease events with pollutant concentrations, a generalized additive model (GAM) with a Poisson distribution was applied. The results showed a greater risk of acute respiratory events due to exposure to SO₂ with a relative risk of 1.28 (95% CI: 1.22-1.34) and to PM₁₀ with a risk of 1.14 (95% CI: 1.09-1.20) on the day of exposure (lag 0). The chemical constituents present in the fine particles with the highest risk for acute respiratory diseases were Si with a risk of 1.22 (95% CI: 1.15-1.29), S with a risk of 1.09 (95% CI: 1.06-1.12), Ti with a risk of 1.09 (95% CI: 1.01-1.17), BC with a risk of 1.07 (95% CI: 1.03-1.11), Se with a risk of 1.03 (95% CI: 0.96-1.10) and Ni with a risk of 1.03 (95% CI: 0.96-1.10).

Atmospheric Pollution and Hospitalization for Cardiovascular and Respiratory Diseases in the City of Manaus from 2008 to 2012

Objective

To relate the levels of air pollution and hospital admissions for cardiovascular and respiratory diseases in the city of Manaus in Brazil from 2008 to 2012.

Method

This is an ecological time-series study among children (under 5 years of age) and elderly (above 60 years of age). Data on the daily number of hospitalizations for cardiovascular and respiratory diseases, pollutants (PM_2.5), temperature, and humidity were used. Poisson generalized additive models were used to estimate the association between variables. Increases in hospitalizations for cardiovascular and respiratory diseases were estimated for the interquartile range (IQR) daily mean level of each variable studied, with a confidence interval of 95%.

Results

Respiratory diseases and children: −0.40% (95% CI: −1.11, 0.30), 0.59% (95% CI: −0.35, 1.52), and 0.47% (95% CI: −3.28, 4.21) for PM_2.5, temperature, and humidity, respectively. Respiratory diseases and elderly: 0.19% (95% CI: −0.93, 1.31), −0.10% (95% CI: −1.85, 1.65), and −6.17% (95% CI: −13.08, 0.74) for PM_2.5, temperature, and humidity, respectively. Cardiovascular diseases and elderly: −0.18% (95% CI: −0.86, 0.50), −0.04% (95% CI: −1.10, 1.03), and −3.37% (95% CI: −7.59, 0.85) for PM_2.5, temperature, and humidity, respectively.

Conclusions

The time-series study found no significant association between PM_2.5, temperature, humidity, and hospitalization, unlike the evidences provided by the present academic literature. Since there is no air quality monitoring network in Manaus and the option available in the present study was to reproduce some information obtained from remote sensing, there is a need for implementation of ground monitoring stations for health and environmental studies in the region.

Space-time analysis of the effect of air pollution on children's health

The study aimed to investigate the short-term association between air pollution and emergency treatments for respiratory diseases in children 0 to 6 years of age. This was an ecological space-time study in Greater Metropolitan Vitória, Espírito Santo State, Brazil. A Poisson regression general additive model (GAM) used the number of daily treatments for respiratory diseases as the dependent variable, and the independent variables were daily concentrations of air pollutants (PM10, SO2, NO2, O3, and CO), temperature, humidity, and precipitation. Average daily concentrations were used to make estimates for the entire metropolitan area and in loco analyses considering children residing in a 2km radius around 8 air quality monitoring stations. An increase of 10μg/m3 in the concentration of air pollutants increased the risk of emergency treatment for respiratory disease. In the overall area, for PM10, the increase was 2.43%, 2.73%, and 3.29% in the cumulative values at 5, 6, and 7 days, respectively. For SO2, the increase was 4.47% on the day of exposure, 5.26% two days later, and 6.47%, 8.8%, 8.76%, and 7.09% for the cumulative values at days 2, 3, 4, and 5 days, respectively. CO showed a significant association for residents around two stations, and O3 for only one. Even within the limits set by the World Health Organization, the pollutants PM10, SO2, NO2, and O3 are associated with increased risk of treatment for respiratory diseases in children 0 to 6 years of age, and some effects were only identified when disaggregating by neighborhood, i.e., in loco, which allows capturing greater variation in the data.

Mean air temperature as a risk factor for stroke mortality in São Paulo, Brazil

In Brazil, chronic diseases account for the largest percentage of all deaths among men and women. Among the cardiovascular diseases, stroke is the leading cause of death, accounting for 10% of all deaths. We evaluated associations between stroke and mean air temperature using recorded mortality data and meteorological station data from 2002 to 2011. A time series analysis was applied to 55,633 mortality cases. Ischemic and hemorrhagic strokes (IS and HS, respectively) were divided to test different impact on which subgroup. Poisson regression with distributed lag non-linear model was used and adjusted for seasonality, pollutants, humidity, and days of the week. HS mortality was associated with low mean temperatures for men relative risk (RR) = 2.43 (95% CI, 1.12-5.28) and women RR = 1.39 (95% CI, 1.03-1.86). RR of IS mortality was not significant using a 21-day lag window. Analyzing the lag response separately, we observed that the effect of temperature is acute in stroke mortality (higher risk among lags 0-5). However, for IS, higher mean temperatures were significant for this subtype with more than 15-day lag. Our findings showed that mean air temperature is associated with stroke mortality in the city of São Paulo for men and women and IS and HS may have different triggers. Further studies are needed to evaluate physiologic differences between these two subtypes of stroke.

A Systematic Review of Children's Environmental Health in Brazil

In the region of the Americas, approximately 100,000 children under the age of 5 years die each year due to environmental hazards. Brazil, due to its large size and wide range of environmental challenges, presents numerous hazards to children's health. The aim of this study was to systematically review the scientific literature that describes children's exposures to environmental pollutants in Brazil and their effects on Brazilian children's health. A systematic review of the scientific literature was performed without language restrictions and time of publication (years). The literature search was conducted in the following key resources: PubMed (MEDLINE), Scopus and Web of Science with the MeSH Terms: Environmental exposure AND Brazil (filters: Human, Child [birth to 18 years] and Affiliation Author). The Virtual Health Library was also employed to access the databases Scielo and Lilacs. The search strategy was [DeCS Terms]: Child OR adolescent AND Environmental exposure AND Brazil. Health effects in children associated with exposure to environmental pollutants in Brazil were reported in 74 studies, during the period between 1995 and 2015. The most frequently cited effect was hospital admission for respiratory causes including wheezing, asthma, and pneumonia among children living in areas with high concentrations of air pollutants. A broad spectrum of other health effects possibly linked to pollutants also was found such as prematurity, low birth weight, congenital abnormality (cryptorchidism, hypospadia, micropenis), poor performance in tests of psychomotor and mental development, and behavioral problems. Exposure to pesticides in utero and postnatally was associated with a high risk for leukemia in children <2 years old. These results show that there is a need in Brazil for stricter monitoring of pollutant emissions and for health surveillance programs especially among vulnerable populations such as pregnant women and young children.

Effects of air pollution caused by sugarcane burning in Western São Paulo on the cardiovascular system

OBJECTIVE

To evaluate the effects of acute exposure to air pollutants (NO₂ and PM₁₀) on hospitalization of adults and older people with cardiovascular diseases in Western São Paulo.

METHODS

Daily cardiovascular-related hospitalization data (CID10 – I00 to I99) were acquired by the Department of Informatics of the Brazilian Unified Health System (DATASUS) from January 2009 to December 2012. Daily levels of NO₂ and PM₁₀ and weather data were obtained from Companhia Ambiental do Estado de São Paulo (CETESB – São Paulo State Environmental Agency). To estimate the effects of air pollutants exposure on hospital admissions, generalized linear Poisson regression models were used.

RESULTS

During the study period, 6,363 hospitalizations were analysed. On the day of NO₂ exposure, an increase of 1.12% (95%CI 0.05–2.20) was observed in the interquartile range along with an increase in hospital admissions. For PM₁₀, a pattern of similar effect was observed; however, results were not statistically significant.

CONCLUSIONS

Even though with values within established limits, NO₂ is an important short-term risk factor for cardiovascular morbidity.

Association between the concentration of fine particles in the atmosphere and acute respiratory diseases in children

OBJECTIVE

To analyze the association between fine particulate matter concentration in the atmosphere and hospital care by acute respiratory diseases in children.

METHODS

Ecological study, carried out in the region of Grande Vitória, Espírito Santo, in the winter (June 21 to September 21, 2013) and summer (December 21, 2013 to March 19, 2014). We assessed data of daily count for outpatient care and hospitalization by respiratory diseases (ICD-10) in children from zero to 12 years in three hospitals in the Region of Grande Vitória. For collecting fine particulate matter, we used portable samplers of particles installed in six locations in the studied region. The Generalized Additive Model with Poisson distribution, fitted for the effects of predictor covariates, was used to evaluate the relationship between respiratory outcomes and concentration of fine particulate matter.

RESULTS

The increase of 4.2 µg/m³ (interquartile range) in the concentration of fine particulate matter increased in 3.8% and 5.6% the risk of medical care or hospitalization, respectively, on the same day and with six-day lag from the exposure.

CONCLUSIONS

We identified positive association between outpatient care and hospitalizations of children under 12 years due to acute respiratory diseases and the concentration of fine particulate matter in the atmosphere.

Poluentes do ar e internações devido a doenças cardiovasculares em São José do Rio Preto, Brasil

Resumo O presente estudo teve como objetivo estimar os efeitos de poluentes ambientais sobre o número de internações por doenças cardiovasculares. Foi um estudo ecológico com dados de internações hospitalares de residentes em São José do Rio Preto, São Paulo, Brasil, com diagnóstico nas categorias de I-00 a I-99, entre 01/10/11 e 30/09/12. Os poluentes analisados foram partículas finas (PM2,5), ozônio, monóxido de carbono, óxido de nitrogênio e dióxido de nitrogênio. Foram estimados pelo modelo CCATT-BRAMS. O uso do modelo aditivo de regressão de Poisson foi utilizado para estimar associação entre a exposição ao PM2,5 e internação por doença cardiovascular. Foram calculados os excessos de internação e os gastos por estas doenças. Observou-se que a exposição ao PM2,5 no quinto dia após a exposição (lag 5) foi significativo para internação e aumentou em 15 ppts segundo incremento de 10µg /m3 na concentração de PM2,5. Foram identificadas 650 internações evitáveis com custos da ordem de R$ 1,9 milhão. Desse modo, foi possível identificar associação entre exposição ao PM2,5 e internações devido a doenças cardiovasculares em cidades de médio porte como São José do Rio Preto fornecendo subsídios aos gestores municipal e regional de Saúde.

Dialogues between social and natural sciences: contribution to the debate on socio-environmental conflicts

ABSTRACT In this article, I argue that attempting to solve real problems is a possible approach to bring social and natural sciences together, and suggest that - as Environmental Impact Assessment necessarily brings together social and environmental issues - this debate is a strong candidate for such a task. The argument is based on a general discussion about the possibilities and limitations of Environmental Impact Assessments, the social-environmental impacts of mining activities and three case studies. The analysis of the cases indicates possibilities and limitations of the dialogue between scientists from various areas - and of the collaboration with social movements and affected communities - in avoiding negative impacts of mining projects and, eventually, increasing their sustainability.

Fuzzy model approach for estimating time of hospitalization due to cardiovascular diseases

A fuzzy linguistic model based on the Mamdani method with input variables, particulate matter, sulfur dioxide, temperature and wind obtained from CETESB with two membership functions each was built to predict the average hospitalization time due to cardiovascular diseases related to exposure to air pollutants in São José dos Campos in the State of São Paulo in 2009. The output variable is the average length of hospitalization obtained from DATASUS with six membership functions. The average time given by the model was compared to actual data using lags of 0 to 4 days. This model was built using the Matlab v. 7.5 fuzzy toolbox. Its accuracy was assessed with the ROC curve. Hospitalizations with a mean time of 7.9 days (SD = 4.9) were recorded in 1119 cases. The data provided revealed a significant correlation with the actual data according to the lags of 0 to 4 days. The pollutant that showed the greatest accuracy was sulfur dioxide. This model can be used as the basis of a specialized system to assist the city health authority in assessing the risk of hospitalizations due to air pollutants.

Epidemiologia de desfechos na saúde humana relacionados à poluição atmosférica no Brasil: uma revisão sistemática

ResumoO presente artigo revisa e discute aspectos da situação da pesquisa epidemiológica relacionados aos desfechos de saúde decorrentes da poluição atmosférica. Foi realizada uma revisão sistemática de estudos que avaliou os efeitos de poluentes do ar na saúde humana. A qualidade metodológica dos trabalhos também foi avaliada. A revisão identificou 432 estudos que abordaram a temática, dos quais 56 atendem aos critérios de inclusão previamente estabelecidos. Além de evidenciarem um cenário de pesquisa epidemiológica pautado na relação causa-efeito, os resultados apontam para a necessidade de revisão de parâmetros ambientais e expõem desafios e contribuições à pesquisa epidemiológica em saúde ambiental.

Low birth weight at term and the presence of fine particulate matter and carbon monoxide in the Brazilian Amazon: a population-based retrospective cohort study

BACKGROUND

Although studies have shown an association between air pollutants from anthropogenic sources and pregnancy outcomes, little is known regarding the association between low birth weight (LBW) and exposure to emissions of biomass burning.

METHODS

This population-based retrospective cohort study assessed the effect of exposure to particulate matter and carbon monoxide (CO) from biomass burning in the Amazon and cerrado (Brazilian savanna) biomes on term LBW (<2500 g) in cities of Mato Grosso, Brazil. Data on births were obtained from the Information System on Live Births of the Ministry of Health. The exclusion criteria were a twin pregnancy, gestational age of less than 37 weeks, and congenital malformation diagnosed at birth. For exposure variables, we used a historical series of daily average concentrations of particulate matter with a diameter less than 2.5 μm (PM2.5) and CO provided by Coupled Aerosol and Trace Gases Transport Model for the Brazilian Development of the Regional Atmospheric Modeling System developed at the National Institute for Space National Center for Weather Forecasts and Climate Studies, National Institute for Space Research. Maternal exposure was estimated by the average amount of pollutants for each trimester and for the entire period of gestation. The association between air pollutants and LBW was analyzed by multiple logistic regression, adjusting for the newborn's sex, mother's age and education, and prenatal care.

RESULTS

A total of 6147 full-term singleton live births were included in the study and 193 (3.1%) were LBW. In adjusted analysis, the number of prenatal visits and maternal education with 8 years or more were associated with LBW. The association between exposure to air pollutants and the risk of LBW was significant for the 4th quartile of PM2.5 concentrations in the 2nd trimester (OR = 1.51, 95% CI = 1.04 to 2.17) and in the 3rd trimester, and for the 4th quartile of CO concentrations in the 2nd trimester only, in adjusted analysis.

CONCLUSIONS

This study provides further evidence of the effect of smoke from biomass burning on the occurrence of LBW in cities of the Brazilian Amazon.

Association between air quality and quality of life

Air quality-or its converse, air pollution-is a significant risk factor for human health. Recent studies have reported association between air pollution and human health. There are numerous diseases that may be caused by air pollution such as respiratory infection, lung cancer, cardiovascular disease, chronic obstructive pulmonary disease, and asthma. In this study, the relationship between air quality and quality of life was examined by using canonical correlation analysis. Data of this study was collected from 27 countries. WHO statistics were used as the main source of quality of life data set (Y variables set). European Environment Agency statistics and (for outdoor air-PM10) WHO statistics were used as the main source of air quality data set (X variables set). It is found that there are significant positive correlation between air quality and quality of life.

Association of sulfur dioxide exposure with circulatory system deaths in a medium-sized city in Brazil

There is a demonstrable association between exposure to air pollutants and deaths due to cardiovascular diseases. The objective of this study was to estimate the effects of exposure to sulfur dioxide on mortality due to circulatory diseases in individuals 50 years of age or older residing in São José dos Campos, SP. This was a time-series ecological study for the years 2003 to 2007 using information on deaths due to circulatory disease obtained from Datasus reports. Data on daily levels of pollutants, particulate matter, sulfur dioxide (SO2), ozone, temperature, and humidity were obtained from the São Paulo State Environmental Agency. Moving average models for 2 to 7 days were calculated by Poisson regression using the R software. Exposure to SO2 was analyzed using a unipollutant, bipollutant or multipollutant model adjusted for mean temperature and humidity. The relative risks with 95%CI were obtained and the percent decrease in risk was calculated. There were 1928 deaths with a daily mean (± SD) of 1.05 ± 1.03 (range: 0-6). Exposure to SO2 was significantly associated with mortality due to circulatory disease: RR = 1.04 (95%CI = 1.01 to 1.06) in the 7-day moving average, after adjusting for ozone. There was an 8.5% decrease in risk in the multipollutant model, proportional to a decrease of SO2 concentrations. The results of this study suggest that residents of medium-sized Brazilian cities with characteristics similar to those of São José dos Campos probably have health problems due to exposure to air pollutants.

Association between particulate matter air pollution and monthly inhalation and nebulization procedures in Ribeirão Preto, São Paulo State, Brazil

The study was designed to investigate the impact of air pollution on monthly inhalation/nebulization procedures in Ribeirão Preto, São Paulo State, Brazil, from 2004 to 2010. To assess the relationship between the procedures and particulate matter (PM10) a Bayesian Poisson regression model was used, including a random factor that captured extra-Poisson variability between counts. Particulate matter was associated with the monthly number of inhalation/nebulization procedures, but the inclusion of covariates (temperature, precipitation, and season of the year) suggests a possible confounding effect. Although other studies have linked particulate matter to an increasing number of visits due to respiratory morbidity, the results of this study suggest that such associations should be interpreted with caution.

A systematic review of the physical and chemical characteristics of pollutants from biomass burning and combustion of fossil fuels and health effects in Brazil

The aim of this study was to carry out a review of scientific literature published in Brazil between 2000 and 2009 on the characteristics of air pollutants from different emission sources, especially particulate matter (PM) and its effects on respiratory health. Using electronic databases, a systematic literature review was performed of all research related to air pollutant emissions. Publications were analyzed to identify the physical and chemical characteristics of pollutants from different emission sources and their related effects on the respiratory system. The PM2.5 is composed predominantly of organic compounds with 20% of inorganic elements. Higher concentrations of metals were detected in metropolitan areas than in biomass burning regions. The relative risk of hospital admissions due to respiratory diseases in children was higher than in the elderly population. The results of studies of health effects of air pollution are specific to the region where the emissions occurred and should not be used to depict the situation in other areas with different emission sources.

Poluição atmosférica e internações hospitalares por doenças respiratórias em crianças e adolescentes em Cubatão, São Paulo, Brasil, entre 1997 e 2004

O objetivo deste estudo foi avaliar os efeitos dos poluentes atmosféricos e suas estruturas de defasagem sobre a morbidade respiratória de crianças e adolescentes, na cidade de Cubatão, São Paulo, Brasil, entre 1997 e 2004. Um estudo ecológico de séries temporais foi realizado, analisando internações nos hospitais do Sistema Único de Saúde por doenças respiratórias de crianças e adolescentes residentes no município. Foram utilizados modelos lineares generalizados de regressão de Poisson, controlando-se para sazonalidade, temperatura, umidade e tendência de curta duração. PM10 e ozônio estiveram positiva e estatisticamente associados com as internações por doenças respiratórias. No grupo de crianças, aumentos de um interquartil nas médias móveis de sete dias do PM10 (56,5µg/m³) e de cinco dias do ozônio (46,7µg/m³) levaram a aumentos nas internações hospitalares de 9,6% (IC95%: 3,0%-16,1%) e 2,4% (IC95%: 0,1%-4,7%), respectivamente. Esforços para redução das concentrações dos poluentes do ar ainda precisam ser implementados para minimizar os seus efeitos adversos sobre crianças e adolescentes em Cubatão.

Genotoxic potential generated by biomass burning in the Brazilian Legal Amazon by Tradescantia micronucleus bioassay: a toxicity assessment study

BACKGROUND

The Brazilian Amazon has suffered impacts from non-sustainable economic development, especially owing to the expansion of agricultural commodities into forest areas. The Tangará da Serra region, located in the southern of the Legal Amazon, is characterized by non-mechanized sugar cane production. In addition, it lies on the dispersion path of the pollution plume generated by biomass burning. The aim of this study was to assess the genotoxic potential of the atmosphere in the Tangará da Serra region, using Tradescantia pallida as in situ bioindicator.

METHODS

The study was conducted during the dry and rainy seasons, where the plants were exposed to two types of exposure, active and passive.

RESULTS

The results showed that in all the sampling seasons, irrespective of exposure type, there was an increase in micronucleus frequency, compared to control and that it was statistically significant in the dry season. A strong and significant relationship was also observed between the increase in micronucleus incidence and the rise in fine particulate matter, and hospital morbidity from respiratory diseases in children.

CONCLUSIONS

Based on the results, we demonstrated that pollutants generated by biomass burning in the Brazilian Amazon can induce genetic damage in test plants that was more prominent during dry season, and correlated with the level of particulates and elevated respiratory morbidity.

A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy

The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.

Material particulado (PM2.5) de queima de biomassa e doenças respiratórias no sul da Amazônia brasileira

OBJETIVOS: Analisar espacialmente o efeito da exposição ao material particulado (PM2.5) na ocorrência de doenças do aparelho respiratório de crianças de um a quatro anos e de idosos com sessenta e cinco anos ou mais nos municípios do Estado de Mato Grosso em 2004. MÉTODOS: Trata-se de um estudo ecológico em duas etapas. A primeira foi uma investigação da autocorrelação espacial global da prevalência de internações por doenças respiratórias e do percentual de horas críticas de concentração do material particulado nos municípios do estado de Mato Grosso, empregando-se o método bayesiano empírico para minimização das flutuações aleatórias dos indicadores e a estatística Moran "global". A segunda, uma regressão múltipla espacial, teve como variáveis resposta a prevalência de internações por doenças respiratórias, e como variável de exposição o percentual de horas críticas anuais. Para ajuste, foram utilizadas variáveis proxies de poluição do ar, variáveis de atenção à saúde e de condições de vida da população. RESULTADOS: Não foram observados padrões espaciais globais de prevalência de doenças respiratórias em grupos sensíveis nos municípios, mas evidenciou-se elevada dependência espacial do percentual de horas críticas anuais de concentração do material particulado. Na regressão múltipla, foram observadas associações estatisticamente significativas entre a prevalência de internações por doenças respiratórias e o percentual de horas críticas anuais de material particulado. CONCLUSÕES: As emissões de material particulado originadas de queimadas na Amazônia Legal estão relacionadas à prevalência de internações por doenças respiratórias em grupos populacionais sensíveis nos municípios do Estado de Mato Grosso.

Inserção da saúde nos estudos de impacto ambiental: o caso de uma termelétrica a carvão mineral no Ceará

Este texto objetiva discutir a inclusão da dimensão da saúde nos procedimentos de avaliação de impactos ambientais, para que os diversos atores (a serem) envolvidos no processo de tomada de decisão possam avaliar, antecipadamente à implementação, a necessidade e a adequação tecnológica e locacional do mesmo. O ponto de partida foi uma demanda do Ministério Público Federal à Universidade Federal do Ceará, para analisar o projeto de uma usina termelétrica a carvão mineral a ser implantada no Complexo Industrial e Portuário do Pecém (CE). A metodologia consistiu no reconhecimento do contexto sócio-histórico em que se insere o projeto, estudo bibliográfico sobre os impactos ambientais e à saúde gerados, diálogos com a comunidade atingida, para então analisar o documento preparado pelo órgão estadual de meio ambiente. Como resultados, são apresentados os eixos centrais de incidência da análise e as proposições de complementação do termo de referência para antecipar as inter-relações entre os processos de produção, o ambiente e a desigual distribuição dos impactos sobre a saúde; e avalia-se a necessidade de avançar nesta abordagem para alimentar processos de tomada de decisão mais próximos do real vivido ou a viver, e mais democráticos.