Efeitos da exposição à poluição atmosférica nas internações por doenças do sistema osteomuscular e do tecido conjuntivo em crianças e adultos residentes na cidade de São Paulo

Abstract

Musculoskeletal diseases (ICD 10th Revision from M00 to M25 and M40 to M99) are epidemiological relevant and economically impact the Brazilian Public Health System (SUS). The systemic diseases of connective tissue (ICD 10 th Revision from M30 to M36), although considered rare, are diseases with complex, multifactorial traits with serious commitments. Beyond well-known risk factors for these diseases, air pollutants can trigger an oxidative stress response leading to systemic inflammation. The present study aimed to evaluate the correlation between exposure to air pollutants and the possible worsening of DMSCT (Diseases of the Musculoskeletal System and Connective Tissue) in children and adults admitted to hospitals of the SUS in the State of São Paulo, from 2011 to 2016. In this ecological time series study, the effects of air pollutants on the outcomes were assessed using generalized linear Poisson regression model with a third-degree polynomial distributed lag model, controlling for weather variables, seasonality and days of the week. During the studied period was contacted a total of 54,982 cases of hospitalization for DSOTC in the city of São Paulo, being the age groups of 20 to 59 years and 60 years or more prevalent and more vulnerable to the effects exposure to pollutants. The pollutants are within the limits imposed by State Decree No. 59,113 of 23/04/2013, except the ozone (O3) that exceeded the limit imposed to 296 times is 140 µ g/m3. And when compared to the standards imposed by the who, 3 of the 5 pollutants examined exceeded daily limits laid down, which are the O3, PM10 and NO2. The PM10 exceeded 288 times the daily permitted level during the period under examination. With acute and late effects to the total number of hospitalizations for DSOTC and for the tracks would be of 20 to 59 and 60 years or more, with an average increase of 1.31% (95% CI: 0.52-2.09) on the 13th day on the number of hospitalizations by DSOTC. Noting that the pollutant analyzed 5 4 showed significant effect on hospitalizations for DSOTC in total number and in at least one of the stipulated age groups, and that the standards set in the State of São Paulo cannot be considered safe in relation to human health, reinforcing the need for new parameters that minimize the adverse effects of air pollutants.