Laboratório de Poluição Atmosférica Experimental, Departmento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2012;67(6):639-46. doi: 10.6061/clinics/2012(06)15.
Due to their toxicity, diesel emissions have been submitted to progressively more restrictive regulations in developed countries. However, in Brazil, the implementation of the Cleaner Diesel Technologies policy (Euro IV standards for vehicles produced in 2009 and low-sulfur diesel with 50 ppm of sulfur) was postponed until 2012 without a comprehensive analysis of the effect of this delay on public health parameters. We aimed to evaluate the impact of the delay in implementing the Cleaner Diesel Technologies policy on health indicators and monetary health costs in Brazil.
The primary estimator of exposure to air pollution was the concentration of ambient fine particulate matter (particles with aerodynamic diameters <2.5 μm, [PM2.5]). This parameter was measured daily in six Brazilian metropolitan areas during 2007-2008. We calculated 1) the projected reduction in the PM2.5 that would have been achieved if the Euro IV standards had been implemented in 2009 and 2) the expected reduction after implementation in 2012. The difference between these two time curves was transformed into health outcomes using previous dose-response curves. The economic valuation was performed based on the DALY (disability-adjusted life years) method.
The delay in implementing the Cleaner Diesel Technologies policy will result in an estimated excess of 13,984 deaths up to 2040. Health expenditures are projected to be increased by nearly US$ 11.5 billion for the same period.
The present results indicate that a significant health burden will occur because of the postponement in implementing the Cleaner Diesel Technologies policy. These results also reinforce the concept that health effects must be considered when revising fuel and emission policies.
由于毒性，发达国家对柴油机排放物的规定越来越严格。然而，在巴西，清洁柴油技术政策（2009 年生产的车辆执行欧四标准，低硫柴油含硫量 50ppm）的实施被推迟到 2012 年，而没有对这一延迟对公共健康参数的影响进行全面分析。我们旨在评估延迟实施清洁柴油技术政策对巴西健康指标和货币健康成本的影响。
暴露于空气污染的主要估算值是环境细颗粒物（空气动力学直径<2.5μm 的颗粒，[PM2.5]）的浓度。在 2007-2008 年期间，我们在六个巴西大都市地区每天测量这一参数。我们计算了 1）如果 2009 年实施欧四标准，预计 PM2.5 会减少多少，2）2012 年实施后预计会减少多少。将这两条时间曲线之间的差异用以前的剂量反应曲线转化为健康结果。经济估值是基于 DALY（伤残调整生命年）方法进行的。
清洁柴油技术政策的延迟实施将导致到 2040 年预计超过 13984 人死亡。同期预计健康支出将增加近 115 亿美元。
目前的结果表明，由于推迟实施清洁柴油技术政策，将出现重大的健康负担。这些结果还加强了在修订燃料和排放政策时必须考虑健康影响的概念。
