The effects of air pollution on cardiovascular diseases: lag structures.
OBJECTIVE
To assess the lag structure between air pollution exposure and elderly cardiovascular diseases hospital admissions, by gender.


METHODS
Health data of people aged 64 years or older was stratified by gender in São Paulo city, Southeastern Brazil, from 1996 to 2001. Daily levels of air pollutants (CO, PM10, O3, NO2, and SO2) , minimum temperature, and relative humidity were also analyzed. It were fitted generalized additive Poisson regressions and used constrained distributed lag models adjusted for long time trend, weekdays, weather and holidays to assess the lagged effects of air pollutants on hospital admissions up to 20 days after exposure.


RESULTS
Interquartile range increases in PM10 (26.21 microg/m(3)) and SO2 (10.73 microg/m(3)) were associated with 3.17% (95% CI: 2.09-4.25) increase in congestive heart failure and 0.89% (95% CI: 0.18-1.61) increase in total cardiovascular diseases at lag 0, respectively. Effects were higher among female group for most of the analyzed outcomes. Effects of air pollutants for different outcomes and gender groups were predominately acute and some "harvesting" were found.


CONCLUSIONS
The results show that cardiovascular diseases in São Paulo are strongly affected by air pollution.
Martins
Lourdes Conceição
LC
Desciplina de Saú da Coletiva, deFaculdade de Medicina do ABC, Santo André, SP, Brasil.
Pereira
Luiz A A
LA
Lin
Chin A
CA
Santos
Ubiratan P
UP
Prioli
Gildeoni
G
Luiz
Olinda do Carmo
Odo C
Saldiva
Paulo H N
PH
Braga
Alfésio Luís Ferreira
AL
D000368:Aged; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005740:Gases / Q000032:analysis; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013696:Temperature; D013997:Time Factors
D005740:Gases