ABSTRACT
ABSTRACT CONTEXT AND OBJECTIVE: Exposure to air pollutants is one of the factors responsible for hospitalizations due to respiratory diseases. The objective here was to estimate the effect of exposure to particulate matter (such as PM2.5) on hospitalizations due to certain respiratory diseases among residents in Volta Redonda (RJ). DESIGN AND SETTING: Ecological time series study using data from Volta Redonda (RJ). METHODS: Data on hospital admissions among residents of Volta Redonda (RJ), between January 1, 2012, and December 31, 2012, due to pneumonia, acute bronchitis, bronchiolitis and asthma, were analyzed. Daily data on PM2.5 concentrations were estimated through the CCATT-BRAMS model. The generalized additive Poisson regression model was used, taking the daily number of hospitalizations to be the dependent variable and the PM2.5 concentration to be the independent variable, with adjustment for temperature, relative humidity, seasonality and day of the week, and using lags of zero to seven days. Excess hospitalization and its cost were calculated in accordance with increases in PM2.5 concentration of 5 µg/m3. RESULTS: There were 752 hospitalizations in 2012; the average concentration of PM2.5 was 17.2 µg/m3; the effects of exposure were significant at lag 2 (RR = 1.017), lag 5 (RR = 1.022) and lag 7 (RR = 1,020). A decrease in PM2.5 concentration of 5 µg/m3 could reduce admissions by up to 76 cases, with a decrease in spending of R$ 84,000 a year. CONCLUSION: The findings from this study provide support for implementing public health policies in this municipality, which is an important steelmaking center.
RESUMO CONTEXTO E OBJETIVO: A exposição aos poluentes do ar é um dos fatores responsáveis por internações por doenças respiratórias; o objetivo foi estimar o efeito da exposição a material particulado (como PM2,5) sobre as hospitalizações devido a certas doenças respiratórias em moradores de Volta Redonda (RJ). TIPO DE ESTUDO E LOCAL: Estudo ecológico de séries temporais utilizando dados de Volta Redonda (RJ). MÉTODOS: Foram analisados dados de internação hospitalar, entre 1 de janeiro de 2012 e 31 de dezembro de 2012, devida a pneumonia, bronquite aguda, bronquiolite e asma, em residentes em Volta Redonda (RJ), e dados diários das concentrações de PM2,5 obtidos a partir do modelo CCATT-BRAMS. Utilizou-se o modelo aditivo generalizado de regressão de Poisson, sendo o número diário de internações a variável dependente e a concentração PM2,5 a variável independente, ajustado para temperatura, umidade relativa, sazonalidade e dia da semana e defasagens entre zero e sete dias. Excesso de internação hospitalar e seu custo, de acordo com o aumento de 5 ug/m3 na concentração de PM2,5, foram calculados. RESULTADOS: Ocorreram 752 internações em 2012; a concentração média de PM2,5 foi de 17,2 ug/m3; os efeitos da exposição foram significativos em lag 2 (RR = 1,017), lag 5 (RR = 1,022) e lag 7 (RR = 1,020). A redução em 5 ug/m3 na concentração de PM2,5 poderia reduzir até 76 casos as internações com diminuição nos gastos de R$ 84 mil/ano. CONCLUSÃO: Os achados deste estudo fornecem subsídios para implantar políticas públicas de saúde neste município, que é importante polo siderúrgico.
Subject(s)
Humans , Male , Female , Patient Admission/statistics & numerical data , Respiratory Tract Diseases/etiology , Inhalation Exposure/adverse effects , Air Pollutants/adverse effects , Patient Admission/economics , Reference Values , Respiratory Tract Diseases/economics , Time Factors , Weather , Brazil , Poisson Distribution , Risk Factors , Risk Assessment , Inhalation Exposure/economics , Air Pollutants/analysis , Air Pollutants/economics , Particulate Matter/analysis , Particulate Matter/economics , Particulate Matter/adverse effectsABSTRACT
Objetivo Estimar los beneficios en salud asociados a la reducción de la concentración promedioanual de material particulado PM10, entre el 2010 y el 2020 a 50 μg/m³, por Unidades de Planeamiento Zonal en Bogotá. Materiales y Métodos Se determinaron los casos de morbilidad y mortalidad atribuibles a la contaminación por PM10 y se estimó su valoración económica año por año usando BenMap®, consolidando los resultados por localidad y por Unidades de PlaneamientoZonal. Se utilizó funciones de concentración-respuesta para determinar los casos atribuibles en mortalidad y hospitalizaciones por causas respiratorias y cardiovasculares, mientras que para los demás servicios hospitalarios analizados, se usaron proporciones del servicio con respecto a la tasa de hospitalización. Resultados Podrían evitarse 21 000 muertes para mayores de 30 años y 900 muertes en menores de un año por exposición a largo plazo.Para menores de 5 años, podrían evitarse 1 2000 hospitalizaciones por causas respiratorias, 3800 atenciones en salas de urgencias, 34 000 visitas a salas ERA y 2 500 visitas a las unidades de cuidados intensivos. Para mayores de 5 años, se evitarían alrededor de 44 000 hospitalizaciones por causas respiratorias, 350 hospitalizaciones por causas cardiovasculares (en mayores de 65 años), y 155 000 atenciones en las salas de urgencias en todo el período. Conclusiones Se obtendrían beneficios económicos alrededor de 180 mil millones de pesos en los costos de enfermedad y un beneficio económico de más de 21 billones de pesos en mortalidad, entre el 2010 y 2020 para Bogotá.
Objective The health and economic benefits associated with the reduction of the annual average concentration of particulate matter PM10 to 50 μg/m³ between 2010 and 2020 were estimated and disaggregated in Zonal Planning Units in Bogotá. Materials and Methods BenMap® was used for determining attributable cases and their economic valuation year per year, and the results were represented spatially for every borough and zonal planning unit of the city. The study used concentration-response functions to determine the mortality cases attributable to PM10 pollution and hospitalizations related with respiratory and cardiovascular diseases. Results 21,000 deaths associated with long-term exposure could be prevented for people over 30 years old and 900 deaths associated with long-term exposure for children under one year old. For children under five years old, more than 12,000 preventable hospitalizations for respiratory diseases, about 3,800 emergency room visits, over 34,000 Acute Respiratory Diseases (ARD) cases and nearly 2,500 intensive care unit visits. For people over 5 years old, about 44000 hospitalizations for respiratory diseases, 350 hospitalizations for cardiovascular diseases (people over 65 years old), and nearly 155,000 emergency room visits would be prevented. Conclusion Economic benefits for 180 billion Colombian Pesos (95 million U.S. dollars) would be obtained and a benefit higher than 21 trillion Colombian pesos (11 billion U.S. dollars) in ten years, preventing attributable deaths.