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巴西亚马逊南部地区因呼吸系统疾病住院的老年人接触细颗粒物的影响。

Effects of exposure to fine particulate matter in elderly hospitalizations due to respiratory diseases in the South of the Brazilian Amazon.

作者信息

Machin A B, Nascimento L F, Mantovani K, Machin E B

机构信息

Faculdade de Engenharia de Guaratinguetá, Universidade Estadual Paulista Júlio de Mesquita Filho, Guaratinguetá, SP, Brasil.

Programa de Pós-Graduação em Ciências Ambientais, Universidade de Taubaté, Taubaté, SP, Brasil.

出版信息

Braz J Med Biol Res. 2019 Jan 24;52(2):e8130. doi: 10.1590/1414-431X20188130.

Abstract

Exposure to air pollution is an important cause of hospital admissions due to respiratory diseases. Nevertheless, few studies use pollutant concentration data estimated by mathematical models. A time-series ecological study was developed, using data from hospitalizations due to respiratory diseases in people over 60 years of age, residents of Cuiabá, Brazil, during 2012, obtained from the Brazilian Ministry of Health. The independent variables were the concentrations of fine particulate matter (PM2.5) and carbon monoxide (CO) estimated by mathematical modeling, minimum temperature, and relative humidity (obtained from the Brazilian Meteorological Agency), and the number of forest fires. The generalized linear regression model of Poisson was used, with lags of 0 to 7 days. The coefficients obtained were transformed into relative risk of hospitalization, with respective 95% confidence intervals; alpha=5% was adopted. In that year, 591 hospitalizations were evaluated, with a daily average of 1.61 (SD=1.49), the PM2.5 average concentration was 15.7 µg/m3, and the CO average concentration was 144.2 ppb. Significant associations between exposure to these contaminants and hospitalizations in lags 3 and 4 in 2012 were observed. There was a hospitalization risk increase of 31.8%, with an increase of 3.5 µg/m3 of PM2.5 concentrations and an increase of 188 in the total number of hospitalizations, with an expense of more than ≈US$ 96,000 for the Brazilian Public Health System. This study provided information on the cost of air pollution to the health system and the feasibility of using a mathematical model to estimate environmental concentration of air pollutants.

摘要

接触空气污染是因呼吸系统疾病而住院的一个重要原因。然而,很少有研究使用通过数学模型估算的污染物浓度数据。开展了一项时间序列生态研究,使用了2012年巴西库亚巴60岁以上居民因呼吸系统疾病住院的数据,这些数据来自巴西卫生部。自变量包括通过数学建模估算的细颗粒物(PM2.5)和一氧化碳(CO)浓度、最低温度和相对湿度(从巴西气象局获取)以及森林火灾数量。使用了泊松广义线性回归模型,滞后时间为0至7天。将获得的系数转换为住院的相对风险,并给出各自的95%置信区间;采用α=5%。当年评估了591例住院病例,日平均为1.61例(标准差=1.49),PM2.5平均浓度为15.7微克/立方米,CO平均浓度为144.2 ppb。观察到2012年这些污染物暴露与滞后3天和4天的住院病例之间存在显著关联。PM2.5浓度每增加3.5微克/立方米,住院风险增加31.8%,住院总数增加188例,巴西公共卫生系统为此花费超过约9.6万美元。本研究提供了空气污染对卫生系统造成的成本信息以及使用数学模型估算空气污染物环境浓度的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd83/6345358/b29f75309b3e/1414-431X-bjmbr-52-2-e8130-gf001.jpg

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