Relação entre poluição do ar e internações por doenças respiratórias em crianças no Município de São Paulo.

Abstract

This study was designed to evaluate the relationship between exposure to air pollution and children hospitalizations in the public health system (Sistema Único de Saúde-SUS) due to respiratory diseases in São Paulo city, from 2000 to 2012, stratified by sex. This is an ecological time series study. Daily records of O3, PM10, CO, SO2, NO2, minimum temperature and humidity average were obtained from the São Paulo State Environmental Agency (CETESB). Hospital admissions were obtained from SUS database. A descriptive analysis and Pearson correlation were performed. Generalized linear polynomial distributed lag model was used to assess the effect of pollutants on the outcome. In São Paulo, all primary pollutants were associated with the outcome, being evaluated hospitalizations for respiratory diseases and asthma. For respiratory diseases, an interquartile range increase in O3 (52.17 ug / m3) increases by 1.30% ( 95% CI : 0.43%; 2.17 % ) total hospitalizations , 1.53 % ( 95% CI: 0.32%; 2.74 %) for girls and 1.26 % (95% CI: 0.16%; 2.36 %) for boys. An interquartile range increase in PM10 (24.42 ¿g/m3) was associated with a 3.34% (95% CI: 2.35%; 4.34%) increase in total, 2.71% (95% CI: 1.32%; 4.10%) for girls and a 3.72% (95% CI: 2.45%; 4.98%) for boys. An interquartile range increase of 7.48 ¿g/m3 in SO2 was observed increase of 2.06% (95% CI: 1.06%; 3.06%) in total hospitalizations, 1.80% (95%CI: 0.40%; 3.17%) for girls and 1.95% (95%CI: 0.68%; 3.22%) for boys. For NO2, an interquartile range (51.89 ¿g/m3) increases in 2.44% (95%CI: 1.50%; 3.79%) in children total respiratory admissions, 1.52% (95%CI: 0.22%; 2.82%) for girls, and 3.22% (95%CI: 2.04%; 4.40%) for boys. For each increase of interquartile 1,33ppm in CO concentrations there was an increase in total admissions of 1.13 % (95% CI: 0.23; 2.02); 0.76% (95% CI: 0.10; 1.41) for girls and 1.56 (95% CI: 0.42; 2.70) for boys. For admissions for asthma increased an interquartile of all pollutants revealed statistically significant increase in total hospitalizations, for girls and boys, except NO2, which revealed no effect on total and boys admissions. When analyzing the multi pollutants proved effect of the PM10 in morbidity for respiratory diseases and asthma among children. The automotive fleet predominantly generates air pollution in São Paulo which affect the children´s health, besides the pollution was bellow the air quality standard.