Respiratory diseases in children and outdoor air pollution in São Paulo, Brazil: a time series analysis
Nelson Gouveiaa, Tony Fletcherb
a Departamento de
Medicina Preventiva, Faculdade de Medicina da Universidade de São
Paulo, Av Dr Arnaldo 455, Sao Paulo 01246-903, SP, Brazil, b London School of Hygiene and Tropical
Medicine, London, UK
Correspondence to: Dr Nelson Gouveia ngouveia{at}usp.br
Accepted 26 January
2000
OBJECTIVES
To
investigate the short term effects of air pollution on the respiratory
morbidity of children living in São Paulo, Brazil, one of the
largest cities in the developing world.
METHODSDaily counts
of hospital admissions due to respiratory diseases along with daily
levels of meteorological variables and air pollutants
(PM10, SO2, NO2, O3,
and CO) were analysed with Poisson regression. Final models were
adjusted for the effects of time trends, seasonal patterns, weekdays,
holidays, meteorological factors, and serial correlation.
RESULTSDaily
admissions of children to hospital for total respiratory disease and
pneumonia showed significant increases associated with O3
(5-8%), NO2 (9%), and with PM10 (9%)
(results are for an increase from the 10th to the 90th percentile of
pollution measurements). Consistently, effects for pneumonia were
greater than for all respiratory diseases combined. Also, effects on
infants (children <1 year old) presented higher estimates. Similar
associations were found for asthma admissions. Point estimates for most
pollutants were higher for asthma than for other diagnosed admissions.
However, these associations were not significant.
CONCLUSIONSThese
results agree with the limited publications on this subject but
indicate a rather smaller magnitude of effects. Nevertheless, given the
present concentrations of air pollution in São Paulo and the
large population potentially exposed attention should be directed to
minimise such effects.
Keywords: air pollution; hospital admissions; respiratory diseases in children
© 2000 by Occupational and Environmental Medicine
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