Avaliação da função pulmonar de escolares na Cidade de Cubatão-SP e sua relação com a qualidade do ar

Abstract

This dissertation aimed to evaluate the influence of exposure to air pollution on the pulmonary function 78 of asthma and non-asthmatic schoolchildren in the city of Cubatão through a panel study, with a 9-month longitudinal evaluation of exposure to air pollutants and their effects on the respiratory function of children with and without asthma, between 5 and 15 years old, living in Cubatão. Patients diagnosed with asthma were evaluated and admitted and referred by the pulmonologist at the Cubatão Pediatric Specialties Center (CEP) in the city of Cubatão -SP. The non-asthmatic patients were evaluated and selected at the Padre José de Anchieta Municipal Education Unit. The data were obtained through monthly spirometry, nutritional assessment, self-administered questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) and the Asthma Control Test (C-ACT). Information on air quality was obtained from the Environmental Company of the State of São Paulo (CETESB). Equation models for generalized estimates were adopted for the analysis of the effects of variation in exposure to air pollution on respiratory function, controlled for temperature and humidity. Results: In spirometry, the main parameter for characterization of bronchial obstruction is VEF1/CVF. In the group of asthmatics it is observed that with the increase of 14.40 ¿g/m3 of PM10 there was a significant reduction of this parameter on the first, third, fourth and seventh day after exposure (lag 0 -44.02% (IC 95%): -2.94; -85.10); lag 1 -49.46% (IC 95%: -15.36; -83.57); lag 3 -47.22% (IC 95%: -18.14; -76.30); lag 4 -54.75% (IC 95%: -22.09; -87.41); lag 7 -49.05% (IC 95%: -12.75; -85.36)). In non-asthmatics, a significant reduction is observed on the second day after exposure -1.30% (95% CI: -0.35; -2.25). The increase of 5,75 ¿g/m3 of SO2 was associated with the reduction of VEF1/CVF of 27,81% (IC 95%: -12,93; -42,68) in the day, of 38,76% (IC 95%: -16,16; -61,37) in the second day, of 24,47% (IC 95%: -3,45; -45,49) on the third day, -24,7% (IC 95%: -6,39; -43,04) on the fourth day, and 33,92% (IC 95%: -8,64; -59,21) on the seventh day after the exhibition. With an increase of 25,25 ¿g/m3 of NO2 it is observed a reduction of 69,28% (IC 95%: -11,01; -127,55) in lag 2 and 93,04% (IC 95%: -19,44; -166,65) in lag 7. The increase of 43.25 ¿g/m3 of O3 was associated with the significant reduction of FEV1/CVF on the day and the seven days following the exposure ((lag 0 -132.17% (CI 95%: -49.02; -215.33); lag 1 -106.59% (CI 95%: -21.48; -191.71); lag 2 -133.76% (CI 95%: -41.94; -225.58); lag 3 -126.31% (IC 95%: -66.94; -185.68); lag 4 -108.21% (IC 95%: -51.07; -165.36); lag 5 -160.65% (IC 95%: -28,44; -292,86); lag 6 -137,66% (IC 95%: -39,41; -235,92); lag 7 -162,58% (IC 95%: -92,22; -232,94)). It also showed significant reduction in FEF 25-75% on the day, the first, third quarter, fifth, sixth and seventh days subsequent to exposure ((lag 0 -676.13% (95% CI: -257.48; -1094.79); lag 1 -836.01% (95% CI: -378.88; -1293.14);lag 3 -843.73% (CI 95%: -493.38; -1194.09); lag 4 -769.60% (CI 95%: -451.82; -1087.38); lag 5 -1450.66% (CI 95%: -2221,49; -679,83); lag 6 -1032,79% (IC 95%: -613,41; -1452,18); lag 7 -684,11% (IC 95%: -320,62; -1047,59)). We conclude that even with levels of atmospheric elevation considered within the quality standards obtained for the State of São Paulo, vulnerable people such as children with dissipated lung function cells with exposure to pollutants, there was no correlation between exposure to air exposure and decreased lung function seen in spirometry in children with asthma and non-asthmatics in the city and a strong association between the origins of O3 and the predicted decrease in FV1 / FVC and FEF 25-75% of children and adolescents with asthma.