Coarse particles and hospital admissions due to respiratory diseases in children. An ecological time series study
Keywords:
Air pollutants, Particulate matter, Child health, Respiration diseases, Coarse particlesAbstract
BACKGROUND: Exposure to particulate matter (PM) is associated with hospitalizations due to respiratory diseases among children. DESIGN AND SETTING: An ecological time series study was carried out to identify the role of coarse fractions of particulate matter (PM10-2.5) in hospitalizations among children up to 10 years of age, in Piracicaba (SP) in the year 2015. METHODS: A generalized additive model of Poisson regression was used to estimate the risk of hospitalization due to acute laryngitis and tracheitis, pneumonia, bronchitis, bronchiolitis and asthma. Lags of 0 to 7 days were considered, and the model was adjusted for the temperature and relative humidity of the air and controlled for short and long-term exposure. Proportional attributable ratios, population-attributable fractions and hospital costs were calculated with increasing concentrations of these pollutants. RESULTS: 638 hospitalizations were evaluated during this period, with a mean of 1.75 cases per day (standard deviation, SD = 1.86). The daily averages were 22.45 μg/m3 (SD = 13.25) for the coarse fraction (PM10-2.5) and 13.32 μg/m3 (SD = 6.38) for the fine fraction. Significant risks of PM10-2.5 exposure were only observed at lag 0, with relative risk (RR) = 1.012, and at lag 6, with RR = 1.011. An increase of 5 μg/m3 in the coarse fraction concentration implied an increase in the relative risk of hospitalizations of up to 4.8%, with an excess of 72 hospitalizations and excess expenditure of US$ 17,000 per year. CONCLUSIONS: This study showed the impact of coarse-fraction exposure on hospital admissions among children due to respiratory diseases.
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Chuang KJ, Yan YH, Chiu SY, Cheng TJ. Long-term air pollution exposure and risk factors for cardiovascular diseases among the elderly in Taiwan. Occup Environ Med. 2011;68(1):64-8. PMID: 20833756; doi: 10.1136/oem.2009.052704.
Adar SD, Filigrana PA, Clements N, Peel JL. Ambient Coarse Particulate Matter and Human Health: A Systematic Review and Meta-Analysis. Curr Envir Health Rep. 2014;1:258-74. PMID: 25152864; doi: 10.1007/s40572-014-0022-z.
Cesar AC, Nascimento LF, Carvalho JA Jr. Associação entre exposição ao material particulado e internações por doenças respiratórias em crianças [Association between exposure to particulate matter and hospital admissions for respiratory disease in children]. Rev Saude Publica. 2013;47(6):1209-12. PMID: 24626559.
César AC, Nascimento LF , Mantovani KC, Pompeo Vieira LC. Material particulado fino estimado por modelo matemático e internações por pneumonia e asma em crianças [Fine particulate matter estimated by mathematical model and hospitalizations for pneumonia and asthma in children]. Rev Paul Pediatr. 2016;34(1):18-23. PMID: 26522821; doi: 10.1016/j.rpped.2015.06.009.
Silva AM, Mattos IE, Ignotti E, Hacon S de S. Material particulado originário de queimadas e doenças respiratórias [Particulate matter originating from biomass burning and respiratory]. Rev Saude Publica. 2013;47(2):345-52. PMID: 24037362; doi: 10.1590/S0034-8910.2013047004410.
Xiong Q, Zhao W, Gong Z, Zhao W, Tang T. Fine Particulate Matter Pollution and Hospital Admissions for Respiratory Diseases in Beijing, China. Int J Environ Res Public Health. 2015;12(9):11880-92. PMID: 26402691; doi: 10.3390/ijerph120911880.
Nascimento LF , Vieira LC, Mantovani KC, Moreira DS. Air pollution and respiratory diseases: ecological time series. Sao Paulo Med J. 2016;134(4):315-21. PMID: 27581332; doi: 10.1590/1516-3180.2015.0237250216.
Ignotti E, Hacon S de S, Junger WL, et al. Air pollution and hospital admissions for respiratory diseases in the subequatorial Amazon: a time series approach. Cad Saude Publica. 2010;26(4):747-61. PMID: 20512215.
Fajersztajn L, Saldiva P, Pereira LAA, Leite VF, Buehler AM. Short-term effects of fine particulate matter pollution on daily health events in Latin America: a systematic review and meta-analysis. Int J Public Health. 2017;62(7):729-738. PMID: 28255648; doi: 10.1007/s00038-017-0960-y.
Brunekreef B, Forsberg B. Epidemiological evidence of effects of coarse airborne particles on health. Eur Respir J. 2005;26(2):309-18. PMID: 16055881; doi: 10.1183/09031936.05.00001805.
Gerlofs-Nijland ME, Rummelhard M, Boere AJ, et al. Particle induced toxicity in relation to transition metal and polycyclic aromatic hydrocarbon contents. Environ Sci Technol. 2009;43(13):4729-36. PMID: 19673258.
Tong H, Cheng WY, Samet JM, Gilmour MI, Devlin RB. Differential cardiopulmonary effects of size-fractionated ambient particulate matter in mice. Cardiovasc Toxicol. 2010;10(4):259-67. PMID: 20602262; doi: 10.1007/s12012-010-9082-y.
Happo MS, Salonen RO, Hälinen AI, et al. Inflammation and tissue damage in mouse lung by single and repeated dosing of urban air coarse and fine particles collected from six European cities. Inhal Toxicol. 2010;22(5):402-16. doi: 10.3109/08958370903527908. PMID: 20121583.
Brasil. Departamento de Informações e Informática do Sistema Único de Saúde. DATASUS. Available from: Available from: http://www2.datasus.gov.br/DATASUS/index.php Accessed in 2017 (Nov 14).
Brasil - Instituto Brasileiro de Geografia e Estatística [página na Internet]. IBGE Cidades@. Available from: Available from: https://cidades.ibge.gov.br/v4/brasil/sp/piracicaba/panorama Accessed in 2017 (Nov 14).
São Paulo. Environmental Sanitation Company of the State of São Paulo. CETESB. Available from: Available from: http://www.cetesb.sp.gov.br Accessed in 2017 (Nov 14).
Samoli E, Peng R, Ramsay T, et al. Acute effects of ambient particulate matter on mortality in Europe and North America: results from the APHENA Study. Environ Health Perspect. 2008;116(11):1480-6. PMID: 19057700; doi: 10.1289/ehp.11345.
Froes Asmus CI, Camara VM, Landrigan PJ, Claudio L. A Systematic Review of Children's Environmental Health in Brazil. Ann Glob Health. 2016;82(1):132-48. PMID: 27325071; doi: 10.1016/j.aogh.2016.02.007.
Riguera D, André PA, Zanetta DM. Poluição da queima de cana e sintomas respiratórios em escolares de Monte Aprazível, SP [Sugar cane burning pollution and respiratory symptoms in schoolchildren in Monte Aprazível, Southeastern Brazil]. Rev Saude Publica. 2011;45(5):878-86. PMID: 21829978.
Jacobson L da S, Hacon S de S, Castro HA, et al. Association between fine particulate matter and the peak expiratory flow of schoolchildren in the Brazilian subequatorial Amazon: a panel study. Environ Res. 2012;117:27-35. PMID: 22683314; doi: 10.1016/j.envres.2012.05.006.
Jacobson L da S, Hacon S de S, de Castro HA, et al. Acute effects of particulate matter and black carbon from seasonal fires on peak expiratory flow of schoolchildren in the Brazilian Amazon. PLoS One. 2014;9(8):e104177. PMID: 25118606; doi: 10.1371/journal.pone.0104177.
Souza LS, Nascimento LF . Air pollutants and hospital admission due to pneumonia in children: a time series analysis. Rev Assoc Med Bras (1992). 2016;62(2):151-6. doi: 10.1590/1806-9282.62.02.151.
Souza JB, Reisen VA, Santos JM, Franco GC. Principal components and generalized linear modeling in the correlation between hospital admissions and air pollution. Rev Saude Publica. 2014;48(3):451-8. PMID: 25119940.
Wilson WE, Suh HH. Fine particles and coarse particles: concentration relationships relevant to epidemiologic studies. J Air Waste Manag Assoc. 1997;47(12):1238-49. PMID: 9448515.
Souza PA, Mello WZ, Mariani RL, Sella SM. Variações temporais do material particulado inalável fino e grosso e íons inorgânicos solúveis em São José dos Campos, SP. Revista Brasileira de Geofísica. 2011;29(1):71-82. doi:10.1590/S0102-261X2011000100005.