Climatic variability and morbidity and mortality associated with particulate matter

Rodrigues, Poliany Cristiny de Oliveira; Pinheiro, Samya de Lara; Junger, Washington; Ignotti, Eliane; Hacon, Sandra de Souza

doi:10.11606/S1518-8787.2017051006952

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Sumário

Original Articles • Rev. Saúde Pública 51 • 2017 • https://doi.org/10.11606/S1518-8787.2017051006952 copy

Climatic variability and morbidity and mortality associated with particulate matter

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

The objective of this study has been to analyze whether fine particulate matter (PM_2.5), as well as its synergistic effect with maximum temperature, humidity, and seasons, is associated with morbidity and mortality from cardiovascular diseases.

METHODS

This is an ecological study of time series. We have used as outcomes the daily death and hospitalization records of adults aged 45 years and over from 2009 to 2011 of the municipalities of Cuiabá and Várzea Grande, State of Mato Grosso, Brazil. We have used Poisson regression using generalized additive models, assuming a significance level of 5%. The model has been controlled for temporal trend, seasonality, average temperature, humidity, and season effects. Daily concentrations of PM_2.5 (particulate material with aerodynamic diameter less than 2.5 micrometers) have been obtained by converting the values of optical aerosol thickness. Maximum temperature, humidity, and seasons have been separately included in the model as dummy variables for the analysis of the synergistic effect of PM_2.5 with morbidity and mortality from cardiovascular disease. We have calculated the percentage increase of relative risk (%RR) of deaths and hospitalizations for the linear increase of 10 μg/m³ of PM_2.5.

RESULTS

Between 2009 and 2011, the increase in PM_2.5 was associated with a %RR 2.28 (95%CI 0.53–4.06) for hospitalizations on the same day of exposure and RR% 3.57 (95%CI 0.82–6.38) for deaths with a lag of three days. On hot days, %RR 4.90 (95%CI -0.61–9.38) was observed for deaths. No modification of the effect of PM_2.5 was observed for maximum temperature in relation to hospitalizations. On days with low humidity, %RR was 5.35 (95%CI -0.20–11.22) for deaths and 2.71 (95%CI -0.39–5.92) for hospitalizations. In the dry season, %RR was 2.35 (95%CI 0.59–4.15) for hospitalizations and 3.43 (95%CI 0.58–6.35) for deaths.

CONCLUSIONS

The PM_2.5 is associated with morbidity and mortality from cardiovascular diseases and its effects may be potentiated by heat and low humidity and during the dry season.

Particulate Matter, adverse effects; Air Pollutants; Cardiovascular Diseases, epidemiology; Risk Factors; Seasons; Ecological Studies; Time Series Studies

Variable	Days with no information	Average	Standard deviation	Minimum	Maximum
Death from CD (n)	0	3.08	1.74	0.00	9.00
Hospitalization for CD (n)	0	8.76	3.55	1.00	20.00
PM_2.5 (μg/m³3. Bell ML, McDermott A, Zeger SL, Samet JM, Dominici F. Ozone and short-term mortality in 95 US urban communities, 1987-2000. JAMA. 2004;292(19):2372-8. https://doi.org/10.1001/jama.292.19.2372 https://doi.org/10.1001/jama.292.19.2372... )	55*	17.07	15.66	0.10	172.30
Average temperature (°C)	0	26.45	3.04	11.44	33.44
Maximum temperature (°C)	0	33.69	3.88	13.30	42.30
Relative humidity (%)	0	70.71	11.35	35.00	97.00

Variable	Deaths from CD	Hospitalizations for CD	PM_2.5	Average temperature	Maximum temperature	Humidity
Deaths from CD	1
Hospitalizations for CD	0.069*	1
PM_2.5	0.011	0.009	1
Average temperature	-0.097*	-0.057	0.262*	1
Maximum temperature	-0.066	-0.009	0.250*	0.850*	1
Humidity	-0.024	-0.039	-0.189*	-0.383*	-0.600*	1

Variable		Hospitalizations		Deaths

		%RR	95%CI	%RR	95%CI
Season	Dry	2.35*	0.59–4.15	3.43*	0.58–6.35
Season	Wet	1.05	-5.37–7.91	-4.53	-11.95–3.50
Maximum temperature	> 37.9°C	0.95	-1.85–3.82	4.90*	0.61–9.38
Maximum temperature	< 37.9°C	-1.80	-4.95–1.45	1.55	-3.49–6.86
Humidity	> 54.5%	0.57	-2.75–4.02	2.05	-3.68–8.14
Humidity	< 54.5%	2.71*	-0.39–5.92	5.35*	-0.20–11.22

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E-mail: revsp@usp.br

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[1] Correspondence: Poliany Cristiny de Oliveira Rodrigues. Departamento de Enfermagem – UNEMAT. Avenida São João, s/n. 78200-000 Cáceres, MT, Brazil. E-mail: polianyrodrigues@unemat.br