Years of life lost due to premature deaths associated with air pollution
an ecological time-series study
Keywords:
Mortality, premature, Particulate matter, Air pollutants, Value of lifeAbstract
BACKGROUND: Exposure to air pollutants is associated with hospital admissions due to cardiovascular diseases and premature deaths. OBJECTIVE: To estimate years of life lost (YLL) due to premature deaths and their financial costs. DESIGN AND SETTING: Ecological time-series study carried out in São José dos Campos, Brazil, in 2016. METHODS: Data on deaths among residents of this city in 2016 were assessed to estimate the financial cost of premature deaths associated with air pollution. The diagnoses studied were ischemic heart disease, congestive heart failure and cerebrovascular disease, according to YLL. The fractions attributable to deaths associated with air pollutant exposure and to each potential year of life lost were calculated using negative binomial regression with lags of 0-7 days between exposure and outcome. Nitrogen dioxide, particulatematter (PM10) and ozone concentrations were included in the model and adjusted for tem perature, humidity and seasonality. RESULTS: Exposure to particulate matter was significant at lag 3 days. There were 2177 hospitalizations over the study period, with 201 deaths (9.2%). Premature deaths led to 2035.69 years of life lost. A 10 μg/m³ increase in PM10 concentrations was correlated with 8.0% of the hospitalizations, which corresponded to 152.67 YLL (81.67 for males and 71.00 for females). The cost generated was approximately US$ 9.1 million in 2016. CONCLUSION: In this first study conducted in a medium-sized Brazilian city, using the YLL methodology, we identified an excess expense attributable to air pollution.
Downloads
References
Brasil. Ministério da Saúde. Departamento de Informática do Sistema Único de Saúde - DATASUS. Available from: Available from http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sih/cnv/nrsp.def Accessed in 2020 (Jan 30).
Amancio CT, Nascimento LFC. Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study. Sao Paulo Med J. 2014;132(6):353-8. PMID: 25351756; https://doi.org/10.1590/1516-3180.2014.1326733.
Nascimento LFC, Francisco JB, Patto MBR, Antunes AM. Poluentes ambientais e internações devido a acidente vasculo encéfalico [Environmental pollutants and stroke-related hospital admissions]. Cad Saude Publica. 2012;28(7):1319-24. PMID: 22729262; https://doi.org/10.1590/S0102-311X2012000700010.
Johnson JY, Rowe BH, Villeneuve PJ. Ecological analysis of long-term exposure to ambient air pollution and the incidence of stroke in Edmonton, Alberta, Canada. Stroke. 2010;41(7):1319-25. PMID: 20538697; https://doi.org/10.1161/STROKEAHA.110.580571.
Pestana PRS, Braga ALF, Ramos EMC, et al. Effects of air pollution caused by sugarcane burning in Western São Paulo on the cardiovascular system. Rev Saúde Pública. 2017;51:13. PMID: 28273230; https://doi.org/10.1590/s1518-8787.2017051006495.
Mantovani KCC, Nascimento LFC, Moreira DS, Vieira LCPFS, Vargas NP. Poluentes do ar e internações devido a doenças cardiovasculares em São José do Rio Preto, Brasil [Air pollutants and hospital admissions due to cardiovascular diseases in São José do Rio Preto, Brazil]. Cien Saude Colet. 2016;21(2):509-15. PMID: 26910158; https://doi.org/10.1590/1413-81232015212.16102014.
Brook RD, Rajagopalan S, Pope 3rd CA, et al. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation. 2010;121(21):2331-78. PMID: 20458016; https://doi.org/10.1161/CIR.0b013e3181dbece1.
Bazyar J, Pourvakhshoori N, Khankeh H, et al. A comprehensive evaluation of the association between ambient air pollution and adverse health outcomes of major organ systems: a systematic review with a worldwide approach. Environ Sci Pollut Res. 2019;26(13):12648-61. PMID: 30903465; https://doi.org/10.1007/s11356-019-04874-z.
Achilleos S, Kioumourtzoglou MA, Wu CD, et al. Acute effects of fine particulate matter constituents on mortality: A systematic review and meta-regression analysis. Environ Int. 2017;109:89-100. PMID: 28988023; https://doi.org/10.1016/j.envint.2017.09.010.
Martinez GS, Spadaro JV, Chapizanis D, et al. Health impacts and economic costs of air pollution in the metropolitan area of Skopje. Int J Environ Res Public Health. 2018;15(4):626. PMID: 29596347; https://doi.org/10.3390/ijerph15040626.
Miraglia SGK, Gouveia N. Custos da poluição atmosférica nas regiões metropolitanas brasileiras [Costs of air pollution in Brazilian metropolitan regions]. Cien Saude Colet. 2014;19(10):4141-7. PMID: 25272123; https://doi.org/10.1590/1413-812320141910.09232014.
Abe KC, Miraglia SG, El Khouri. Health Impact Assessment of Air Pollution in São Paulo, Brazil. Int J Environ Res Public Health. 2016;13(7):694. PMID: 27409629; https://doi.org/10.3390/ijerph13070694.
Brazil. Ministry of Health. SUS Department of Informatics (DATASUS). Available from: Available from: http://www2.datasus.gov.br/DATASUS/index.php?area=0901 Accessed in 2020 (Jan 30).
São Paulo. Environmental Agency of São Paulo State (CETESB). Available from: Available from: https://cetesb.sp.gov.br/ar/qualar/ Accessed in 2020 (Jan 30).
Murray CJL, Lopez AD. The Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Boston: Harvard School of Public Health; 1996.
Chen LH, Knutsen SF, Shavlik D, et al. The association between fatal coronary heart disease and ambient particulate air pollution: Are females at greater risk? Environ Health Perspect. 2005;113(12):1723-9. PMID: 16330354; https://doi.org/10.1289/ehp.8190. Erratum in: nviron Health Perspect. 2006 Jan;114(1):A21.
Tuan TS, Venâncio TS, Nascimento LF. Effects of Air Pollutant Exposure on Acute Myocardial Infarction, According to Gender. Arq Bras Cardiol. 2016;107(3):216-22. PMID: 27533257; https://doi.org/10.5935/abc.20160117.
Machin AB, Nascimento LFC. Efeitos da exposição a poluentes do ar na saúde das crianças de Cuiabá, Mato Grosso, Brasil [Effects of exposure to air pollutants on children’s health in Cuiabá, Mato Grosso State, Brazil]. Cad Saude Publica. 2018;34(3):e00006617. PMID: 29538512; https://doi.org/10.1590/0102-311x00006617.
Machin AB, Nascimento LF, Mantovani K, Machin EB. Effects of exposure to fine particulate matter in elderly hospitalizations due to respiratory diseases in the South of the Brazilian Amazon. Braz J Med Biol Res. 2019;52(2):e8130. PMID: 30698228; https://doi.org/10.1590/1414-431x20188130.
Ribeiro PC, Nascimento LFC, Almeida AA, Targa MS, Cesar ACG. Fine particulate matter and ischemic heart diseases in relation to sex. An ecological time series study. Sao Paulo Med J. 2019;137(1):60-5. PMID: 31116273; https://doi.org/10.1590/1516-3180.2018.0239040119.
Patto NV, Nascimento LFC, Mantovani KCC, Vieira LCPFS, Moreira DS. Exposure to fine particulate matter and hospital admissions due to pneumonia: Effects on the number of hospital admissions and its costs. Rev Assoc Med Bras. 2016;62(4):342-6 PMID: 27437680; https://doi.org/10.1590/1806-9282.62.04.342.
Al-Hemoud A, Gasana J, Al-Dabbous NA, Al-Shatti A, Al-Khayat A. Disability Adjusted Life Years (DALYs) in Terms of Years of Life Lost (YLL) Due to Premature Adult Mortalities and Postneonatal Infant Mortalities Attributed to PM2.5 and PM10 Exposures in Kuwait. Int J Environ Res Public Health. 2018;15(11):2609. PMID: 30469450; https://doi.org/10.3390/ijerph15112609.
Gao T, Wang XC, Chen R, Ngo HH, Guo W. Disability adjusted life year (DALY): a useful tool for quantitative assessment of environmental pollution. Sci. Total Environ. 2015;511:268-87. PMID: 25549348; https://doi.org/10.1016/j.scitotenv.2014.11.048.
Jun Yang, Chun-Quan Ou, Yu-Feng Song, et al. Estimating years of life lost from cardiovascular mortality related to air pollution in Guangzhou, China. Sci Total Environ. 2016;573(15):1566-72. PMID: 27613670; https://doi.org/10.1016/j.scitotenv.2016.09.014.
