Respiratory diseases in children and outdoor air pollution in São Paulo, Brazil: a time series analysis.
OBJECTIVE
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.


METHODS
Daily counts of hospital admissions due to respiratory diseases along with daily levels of meteorological variables and air pollutants (PM(10), SO(2), NO(2), O(3), 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.


RESULTS
Daily admissions of children to hospital for total respiratory disease and pneumonia showed significant increases associated with O(3) (5-8%), NO(2) (9%), and with PM(10) (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.


CONCLUSIONS
These 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.
Gouveia
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N
Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, Av Dr Arnaldo 455, Sao Paulo 01246-903, SP, Brazil. ngouveia@usp.br
Fletcher
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T
D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis*; D001249:Asthma / Q000209:etiology; D001938:Brazil; D001991:Bronchitis / Q000209:etiology; D002675:Child, Preschool; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008171:Lung Diseases / Q000209:etiology*; D011014:Pneumonia / Q000209:etiology; D012111:Residence Characteristics; D014504:Urban Health
D000393:Air Pollutants