Time series analysis of air pollution and mortality: effects by cause, age and socioeconomic status.
OBJECTIVE
To investigate the association between outdoor air pollution and mortality in São Paulo, Brazil.


METHODS
Time series study


METHODS
All causes, respiratory and cardiovascular mortality were analysed and the role of age and socioeconomic status in modifying associations between mortality and air pollution were investigated. Models used Poisson regression and included terms for temporal patterns, meteorology, and autocorrelation.


RESULTS
All causes all ages mortality showed much smaller associations with air pollution than mortality for specific causes and age groups. In the elderly, a 3-4% increase in daily deaths for all causes and for cardiovascular diseases was associated with an increase in fine particulate matter and in sulphur dioxide from the 10th to the 90th percentile. For respiratory deaths the increase in mortality was higher (6%). Cardiovascular deaths were additionally associated with levels of carbon monoxide (4% increase in daily deaths). The associations between air pollutants and mortality in children under 5 years of age were not statistically significant. There was a significant trend of increasing risk of death according to age with effects most evident for subjects over 65 years old. The effect of air pollution was also larger in areas of higher socioeconomic level.


CONCLUSIONS
These results show further evidence of an association between air pollution and mortality but of smaller magnitude than found in other similar studies. In addition, it seems that older age groups are at a higher risk of mortality associated with air pollution. Such complexity should be taken into account in health risk assessment based on time series studies.
Gouveia
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N
Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo-FMUSP, Av Dr Arnaldo 455, Sao Paulo, 01246-903-SP, Brazil. ngouveia@usp.br
Fletcher
T
T
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016012:Poisson Distribution; D012959:Socioeconomic Factors; D013458:Sulfur Dioxide / Q000032:analysis; D014504:Urban Health / Q000592:standards
D013458:Sulfur Dioxide