Impact of outdoor biomass air pollution on hypertension hospital admissions.
BACKGROUND
This study aimed to evaluate the association between the total suspended particles (TSP) generated from burning sugar cane plantations and the incidence of hospital admissions from hypertension in the city of Araraquara.


METHODS
The study was an ecological time-series study. Total daily records of hypertension (ICD 10th I10-15) were obtained from admitted patients of all ages in a hospital in Araraquara, São Paulo State, Brazil, from 23 March 2003 to 27 July 2004. The daily concentration of TSP (microg/m(3)) was obtained using a Handi-Vol sampler placed in downtown Araraquara. The local airport provided daily measures of temperature and humidity. In generalised linear Poisson regression models, the daily number of hospital admissions for hypertension was considered to be the dependent variable and the daily TSP concentration the independent variable.


RESULTS
TSP presented a lagged effect on hypertension admissions, which was first observed 1 day after a TSP increase and remained almost unchanged for the following 2 days. A 10 microg/m(3) increase in the TSP 3 day moving average lagged in 1 day led to an increase in hypertension-related hospital admissions during the harvest period (12.5%, 95% CI 5.6% to 19.9%) that was almost 30% higher than during non-harvest periods (9.0%, 95% CI 4.0% to 14.3%).


CONCLUSIONS
Increases in TSP concentrations were associated with hypertension-related hospital admissions. Despite the benefits of reduced air pollution in urban cities achieved by using ethanol produced from sugar cane to power automobiles, areas where the sugar cane is produced and harvested were found to have increased public health risk.
Arbex
Marcos Abdo
MA
Internal Medicine Post-Graduation Program, São Paulo Federal University Medical School, São Paulo, Brazil. arbexma@techs.com.br
Saldiva
Paulo Hilário Nascimento
PH
Pereira
Luiz Alberto Amador
LA
Braga
Alfésio Luís Ferreira
AL
D000383:Agriculture; D000397:Air Pollution / Q000009:adverse effects*; D018533:Biomass; D001938:Brazil / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence