title: Air pollution and children's health: sickle cell disease.
abstract: The hallmarks of sickle cell disease are anemia and vasculopathy. The aim of this study was to assess the association between air pollution and children's emergency room visits of sickle cell patients. We adopted a case-crossover design. Daily counts of children's and adolescents' sickle cell disease emergency room visits from the pediatric emergency unit in São Paulo, Brazil, were evaluated from September 1999 to December 2004, matching by temperature, humidity and controlling for day of the week. Interquartile range increases of the four-day moving averages of PM10, NO2, SO2, CO, and O3 were associated with increases of 18.9% (95%CI: 11.2-26.5), 19% (95%CI: 8.3-29.6), 14.4% (95%CI: 6.5-22.4), 16,5% (95%CI: 8.9-24.0), and 9.8% (95%CI: 1.1-18.6) in total sickle cell emergency room visits, respectively. When the analyses were stratified by pain, PM10 was found to be 40.3% higher than in sickle cell patients without pain symptoms. Exposure to air pollution can affect the cardiovascular health of children and may promote a significant health burden in a sensitive group.
authors.forename: Silvia Maria de Macedo
authors.initials: SM
authors.lastname: Barbosa
authors.forename: Sylvia Costa Lima
authors.initials: SC
authors.lastname: Farhat
authors.forename: Lourdes Conceição
authors.initials: LC
authors.lastname: Martins
authors.forename: Luiz Alberto Amador
authors.initials: LA
authors.lastname: Pereira
authors.forename: Paulo Hilário Nascimento
authors.initials: PH
authors.lastname: Saldiva
authors.forename: Antonella
authors.initials: A
authors.lastname: Zanobetti
authors.forename: Alfésio Luís Ferreira
authors.initials: AL
authors.lastname: Braga
mesh_terms: D000293:Adolescent; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D000755:Anemia, Sickle Cell / Q000150:complications*; D001938:Brazil; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male