Estudo dos poluentes do ar em um município de médio porte por meio dos dados estimados pelo Modelo CCATT-BRAMS
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Data
2016-06-27
Autores
Mantovani, Katia Cristina Cota [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Uma das principais causas de internação por infarto agudo do miocárdio é a poluição do ar. Os efeitos na saúde devido à exposição aos poluentes atmosféricos e à baixa qualidade do ar vêm causando um aumento nas internações hospitalares. Esse estudo teve como objetivo estimar a associação entre o Infarto Agudo do Miocárdio (IAM) e outras doenças isquêmicas do coração (DIC) e a exposição de PM2,5 ajustados pelos poluentes O3, CO e NO2 sobre as internações hospitalares da rede pública no município de São José do Rio Preto – SP, em todas as faixas etárias, estratificado por sexos, no período de 01 de janeiro de 2012 a 31 de dezembro de 2012, de acordo com a estrutura de defasagens (lags). A metodologia utilizada fundamenta-se na pesquisa de estudo ecológico de série temporal. A variável dependente considerada foi o número de internações hospitalares por IAM e outras DIC, CID 10, correspondentes aos códigos I20 a I 25.9, cujos dados foram obtidos pelo DATASUS. As variáveis independentes consideradas foram a concentração diária de poluentes PM2,5, O3, CO e NO2, temperatura e umidade relativa (CCATT-BRAMS). Ajustes por tendência temporal e efeitos do calendário foram incluídos no modelo. Foi calculado o Risco Relativo de internação utilizando Modelo de Regressão de Poisson. Na análise unipoluente, devido a um incremento interquartil (25%-75%) para o PM2,5 (3,1 μg/m3), observou-se, respectivamente, um aumento de 9,5% e 11,1% no aumento de internações para a o sexo masculino e sexo feminino, respectivamente. E na análise multipoluente (PM2,5, O3, CO e NO2), também com incremento interquartil, observou-se um aumento de 21% para o conjunto de ambos os sexos. Os gastos com o excesso de internações por IAM e DICs chega a cerca a mais de R$ 1,1 milhão, verificou-se portanto que é possível estudar a associação entre algumas das doenças cardiovasculares e poluentes estimados do modelo matemático CATT-BRAMS.
One of the main causes of hospitalization for acute myocardial infarction is air pollution. The health effects due to exposure to air pollution and poor air quality are causing hospital admission increase. This study aimed to estimate the association between PM2.5 exposure adjusted by pollutants O3, CO and NO2 and hospital admissions for Acute Myocardial Infarction (AMI) and other ischemic heart disease ( IHD ) in public in the city of Sao Jose do Rio Preto, in all age groups stratified by gender in the period of January 1st 2012 to December 31st 2012 according to the lag structure (lags). The methodology is based on ecological research study of temporal series. The dependent variable was considered the number of hospital admissions for Acute Myocardial Infarction and other ischemic heart disease ICD-10 codes I20 at I25.9, whose data were obtained by DATASUS. The independent variables were the daily concentration of PM2.5 pollutants, O3, CO and NO2, extracted temperature and relative humidity of CCATT-BRAMS. Adjustments for time trend and calendar effects were included in model. It calculated the relative risk of hospitalization using Poisson regression model. In unipollutant analysis due to a interquartile increase (25% -75%) to the PM2.5 (3.1 µg/m3) were observed respectively, an increase of 9.5% and 11.1% increase admissions for males and females, respectively. And in multipollutant analysis (PM2.5, O3, CO and NO2) with interquartile also increased, there was an increase of 13.8% to the whole of both sexes. Spending on excess hospitalizations for AMI and DICs reaches about more than R$ 1.1 million, so it is possible to study the association between cardiovascular disease and estimated pollutants mathematical model CATTBRAMS.
One of the main causes of hospitalization for acute myocardial infarction is air pollution. The health effects due to exposure to air pollution and poor air quality are causing hospital admission increase. This study aimed to estimate the association between PM2.5 exposure adjusted by pollutants O3, CO and NO2 and hospital admissions for Acute Myocardial Infarction (AMI) and other ischemic heart disease ( IHD ) in public in the city of Sao Jose do Rio Preto, in all age groups stratified by gender in the period of January 1st 2012 to December 31st 2012 according to the lag structure (lags). The methodology is based on ecological research study of temporal series. The dependent variable was considered the number of hospital admissions for Acute Myocardial Infarction and other ischemic heart disease ICD-10 codes I20 at I25.9, whose data were obtained by DATASUS. The independent variables were the daily concentration of PM2.5 pollutants, O3, CO and NO2, extracted temperature and relative humidity of CCATT-BRAMS. Adjustments for time trend and calendar effects were included in model. It calculated the relative risk of hospitalization using Poisson regression model. In unipollutant analysis due to a interquartile increase (25% -75%) to the PM2.5 (3.1 µg/m3) were observed respectively, an increase of 9.5% and 11.1% increase admissions for males and females, respectively. And in multipollutant analysis (PM2.5, O3, CO and NO2) with interquartile also increased, there was an increase of 13.8% to the whole of both sexes. Spending on excess hospitalizations for AMI and DICs reaches about more than R$ 1.1 million, so it is possible to study the association between cardiovascular disease and estimated pollutants mathematical model CATTBRAMS.
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Palavras-chave
Poluição do ar, Material particulado, Monóxido de carbono, Ozônio, Dióxido de nitrogênio, Doenças do aparelho circulatório, Infarto agudo do miocárdio, Regressão de Poisson