Poluição veicular e saúde da população: uma revisão sobre o município de São Paulo (SP), Brasil

Assessment of human health risks associated with airborne arsenic, nickel and lead exposure in particulate matter from vehicular sources in Sao Paulo city

Air pollution is a critical public health concern. The present study assessed the risk to human health of airborne Potentially Toxic Elements (PTE) arsenic, nickel and lead exposure in particulate matter (PM10-2.5) in Sao Paulo, Brazil. Statistical analysis was performed using R Software and the risk assessment for human health was carried out according to the methods of the United States Environmental Protection Agency. The results for mean annual concentration of PTE (ng m-3) were within the limits stipulated for air-quality by international agencies (arsenic <6, nickel <20 and lead <150). Airborne arsenic and lead showed higher mean concentrations during the winter than the other seasons (p < 0.05). However, the results showed a greater health risk for the adult population and during the winter season. These findings highlight the importance of air pollution as a risk factor for population health.

A spatio-temporal analysis of cause-specific mortality in São Paulo State, Brazil

Abstract Using five cause-specific mortality data sourced by the Brazilian Ministry of Health, and over 17 years period, we applied Bayesian spatio-temporal models on 644 municipalities of the state of São Paulo, using logistic model to the binary outcome that specifies whether or not the death was from a specific cause. We modeled the temporal mortality effects using B-splines, while the spatial components were considered through Gaussian and Markov random field, and inference was based on Markov chain Monte Carlo simulation. The results demonstrate consistent downward trend in mortality from infectious and parasitic diseases and external causes, while those from neoplasms and respiratory are rising. Cardiovascular is the only cause-specific death that is kept constant in time. All the causes of death considered show heterogeneous spatial and temporal variations among the municipalities, which sometimes change considerably within successive years. Mortality from infectious diseases clustered around the Northwestern municipalities in 2000, but changes to the Southeastern part in 2016, a similar development as external death causes. The study identifies areas with increased and decreased odds mortality and could be useful in disease monitoring, especially if we consider small spatial units.

Air pollution and its impact on the concentration of airborne fungi in the megacity of São Paulo, Brazil

In the context of megacities in an urban environment, air quality is an important issue, due to the direct correlation to population's health. The biomonitoring of pollutants can indicate subtle environmental alterations, for that, anemophilous fungi can be monitored for changes in atmospheric conditions related to pollution. In the present study, the concentration of fungi and bacteria in the atmosphere was measured during a specific vehicle fleet reduction in the city of São Paulo, Brazil, from May 24 to 30, 2018, using impactor air samplers. The number of isolated developed colonies was related to atmospheric conditions and the concentration of other air pollutants constantly monitored. Aspergillus, Curvularia, Penicillium, Neurospora, Rhizopus and Trichoderma were identified. The number of colony-forming units increased by approximately 80% during the sampling period in response to environmental changes favored by the fleet reduction. This result implies the relation between fuel emissions, concentration of atmospheric pollutants, and the presence of viable fungal spores in the urban environment, which highlights the importance of combined public policies for air quality in large cities.

Incidence and mortality for respiratory cancer and traffic-related air pollution in São Paulo, Brazil

BACKGROUND

Multiple lines of evidence have associated exposure to ambient air pollution with an increased risk of respiratory malignancies. However, there is a dearth of evidence from low-middle income countries, including those within South America, where the social inequalities are more marked.

OBJECTIVES

To quantify the association between exposures to traffic related air pollution and respiratory cancer incidence and mortality within São Paulo, Brazil. Further, we aim to investigate the role of socioeconomic status (SES) upon these outcomes.

METHODS

Cancer incidence between 2002 and 2011 was derived from the population-based cancer registry. Mortality data (between 2002 and 2013) was derived from the Municipal Health Department. A traffic density database and an annual nitrogen dioxide (NO₂) land use regression model were used as markers of exposure. Age-adjusted Binomial Negative Regression models were developed, stratifying by SES and gender.

RESULTS

We observed an increased rate of respiratory cancer incidence and mortality in association with increased traffic density and NO₂ concentrations, which was higher among those regions with the lowest SES. For cancer mortality and traffic exposure, those in the most deprived region, had an incidence rate ratio (IRR) of 2.19 (95% CI: 1.70, 2.82) when comparing the highest exposure centile (top 90%) to the lowest (lowest 25%). By contrast, in the least deprived area, the IRR for the same exposure contrast was.1.07 (95% CI: 0.95, 1.20). For NO₂ in the most deprived regions, the IRR for cancer mortality in the highest exposed group was 1.44 (95% CI: 1.10, 1.88) while in the least deprived area, the IRR for the highest exposed group was 1.11 (95% CI: 1.01, 1.23).

CONCLUSIONS

Traffic density and NO₂ were associated with an increased rate of respiratory cancer incidence and mortality in São Paulo. Residents from poor regions may suffer more from the impact of traffic air pollution.

[Influence of vehicular traffic density on hospital admissions due to respiratory tract cancer in the city of São Paulo, Brazil]

Pollution related to traffic is a major problem in urban centers and a large portion of the population is vulnerable to its health effects. This study sought to identify a potential association between hospital admissions due to respiratory tract cancer and vehicular traffic density in the city of São Paulo, Brazil. It is an ecological study of the public (Hospital Inpatient Authorization - AIH, in Portuguese) and private (Hospital Inpatient Communication - CIH, in Portuguese) health care systems, from 2004 to 2006, geocoded by individuals' residential addresses. Using a Besag-York-Mollié ecological model, we initially evaluated the relationship between number of cases of hospital admission due to respiratory tract cancer in each weighting area and the standardized co-variables: traffic density and Municipal Human Development Index (MHDI) as indicator of socioeconomic status. Using a classic Poisson model, we then evaluated the risk associated with growing traffic density categories. The Besag-York-Mollié model estimated a RR = 1.09 (95%CI: 1.02-1.15) and RR = 1.19 (95%CI: 1.10-1.29) of admission due to respiratory tract cancer for each increase of one standard deviation of traffic and MHDI, respectively. The Poisson model also showed a clear exposure-response gradient for admission due to respiratory tract cancer (IRR = 1.11; 95%CI: 1.07-1.15, for each 10 units of added traffic density). This study suggests that there is an association between residing in areas with high traffic density and hospital admissions due to respiratory tract cancer in the city of São Paulo.

Incidence and mortality risk for respiratory tract cancer in the city of São Paulo, Brazil: Bayesian analysis of the association with traffic density

BACKGROUND

There is evidence that exposure to traffic-related air pollution is related to the incidence of and mortality associated with lung cancer. The aim of this study was to perform a spatial analysis, with a Bayesian approach, to test the hypothesis that high traffic density is associated with increased respiratory tract cancer incidence and mortality risk among individuals over 20 years of age residing in the city of São Paulo, Brazil.

METHODS

We employed data from two different databases: the São Paulo Municipal Population-Based Cancer Registry (2002-2011 cancer incidence data); and the Mortality Database of the São Paulo Municipal Health Department (2002-2013 cancer mortality data). The relationships between the number of cases of respiratory tract cancer in each area analyzed and the standardized covariates-traffic density and the Municipal Human Development Index (MHDI)-were evaluated with a Besag-York-Mollié ecological model with relative risks (RRs) estimates.

RESULTS

Per 1-unit standard-deviation increase in traffic density and in the MHDI, the RR for respiratory tract cancer incidence was 1.07 (95% CI: 1.02-1.13) and 1.25 (95% CI: 1.18-1.32), respectively, whereas the RR for mortality was 1.04 (95% CI: 0.99-1.09) and 1.23 (95% CI: 1.16-1.30), respectively.

CONCLUSION

Our findings support the hypothesis that residing in areas with high traffic density is associated with increased respiratory tract cancer incidence and mortality risk in the city of São Paulo.

Air pollution and its relationship to lung function among adolescents from Taubate, São Paulo, Brazil

BACKGROUND

This paper sought to evaluate individual exposure to air pollution by quantifying the carbon in alveolar macrophages (AMs) and its relationship to lung function. We also examined the proximity of participants' residences to the Presidente Dutra highway (PDH) in adolescents with asthma from Taubaté, São Paulo, Brazil.

METHODS

This descriptive study examined fifty 13- to 14-year-old adolescents with asthma identified by the International Study of Asthma and Allergies in Childhood (ISAAC) in Taubaté. These adolescents underwent spirometry and sputum induction via the inhalation of 3% hypertonic saline (HSS). Sputum was collected after each nebulisation, and forced expiratory flow in one second (FEV₁) was measured. The collected sputum was stored and transported to the laboratory; it was then processed and analysed for ultrafine particles (≤100nm). This analysis was correlated with the residence location and FEV₁ of each adolescent.

RESULTS

A total of 39 adolescents completed the study. The comparison of the carbon fraction within macrophages (CA/MA) showed no differences according to residence in relation to the PDH (p=0.758). After adjustment, a mixed linear model with FEV₁ as the dependent variable and CA/MA, location, and evaluation condition as the predictors found that the interactions among the variables were not significant.

CONCLUSIONS

The amount of carbon present within the AMs of adolescents with asthma was not correlated with either lung function or residence location. Evaluations of the topography and local climatic conditions in Taubaté should be considered in future studies.

Lacrimal Cytokines Assessment in Subjects Exposed to Different Levels of Ambient Air Pollution in a Large Metropolitan Area

Background

Air pollution is one of the most environmental health concerns in the world and has serious impact on human health, particularly in the mucous membranes of the respiratory tract and eyes. However, ocular hazardous effects to air pollutants are scarcely found in the literature.

Design

Panel study to evaluate the effect of different levels of ambient air pollution on lacrimal film cytokine levels of outdoor workers from a large metropolitan area.

Methods

Thirty healthy male workers, among them nineteen professionals who work on streets (taxi drivers and traffic controllers, high pollutants exposure, Group 1) and eleven workers of a Forest Institute (Group 2, lower pollutants exposure compared to group 1) were evaluated twice, 15 days apart. Exposure to ambient PM_2.5 (particulate matter equal or smaller than 2.5 μm) was 24 hour individually collected and the collection of tears was performed to measure interleukins (IL) 2, 4, 5 and 10 and interferon gamma (IFN-γ) levels. Data from both groups were compared using Student’s t test or Mann- Whitney test for cytokines. Individual PM_2.5 levels were categorized in tertiles (lower, middle and upper) and compared using one-way ANOVA. Relationship between PM_2.5 and cytokine levels was evaluated using generalized estimating equations (GEE).

Results

PM_2.5 levels in the three categories differed significantly (lower: ≤22 μg/m³; middle: 23–37.5 μg/m³; upper: >37.5 μg/m³; p<0.001). The subjects from the two groups were distributed unevenly in the lower category (Group 1 = 8%; Group 2 = 92%), the middle category (Group 1 = 89%; Group 2 = 11%) and the upper category (Group 1 = 100%). A significant relationship was found between IL-5 and IL-10 and PM_2.5 levels of the group 1, with an average decrease of 1.65 pg/mL of IL-5 level and of 0.78 pg/mL of IL-10 level in tear samples for each increment of 50 μg/m3 of PM_2.5 (p = 0.01 and p = 0.003, respectively).

Conclusion

High levels of PM_2.5 exposure is associated with decrease of IL-5 and IL-10 levels suggesting a possible modulatory action of ambient air pollution on ocular surface immune response.

Custos da poluição atmosférica nas regiões metropolitanas brasileiras

O presente estudo avaliou o impacto econômico de eventos de saúde associados com a poluição do ar em regiões metropolitanas brasileiras. A partir de estimativa da mortalidade atribuível às concentrações de Material Particulado (MP) em 29 Regiões Metropolitanas, que totalizaram 20.050 óbitos, foram calculados os custos associados a essa mortalidade por meio da metodologia DALY (Disability Adjusted Life Years). O custo das mortes prematuras no Brasil resultou em US$ 1,7 bilhão anualmente. A tradução de perdas em saúde pública para valores econômicos serviu para comparar com o orçamento de gastos do Ministério da Saúde e evidenciar as prioridades na tomada de decisão de políticas públicas que minimizem a magnitude desses impactos.