NELSON DA CRUZ GOUVEIA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
94 resultados
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- Maternal Exposure to Particulate Air Pollution and Term Birth Weight: A Multi-Country Evaluation of Effect and Heterogeneity(2013) DADVAND, Payam; PARKER, Jennifer; BELL, Michelle L.; BONZINI, Matteo; BRAUER, Michael; DARROW, Lyndsey A.; GEHRING, Ulrike; GLINIANAIA, Svetlana V.; GOUVEIA, Nelson; HA, Eun-hee; LEEM, Jong Han; HOOVEN, Edith H. van den; JALALUDIN, Bin; JESDALE, Bill M.; LEPEULE, Johanna; MORELLO-FROSCH, Rachel; MORGAN, Geoffrey G.; PESATORI, Angela Cecilia; PIERIK, Frank H.; PLESS-MULLOLI, Tanja; RICH, David Q.; SATHYANARAYANA, Sheela; SEO, Juhee; SLAMA, Remy; STRICKLAND, Matthew; TAMBURIC, Lillian; WARTENBERG, Daniel; NIEUWENHUIJSEN, Mark J.; WOODRUFF, Tracey J.BACKGROUND: A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent. OBJECTIVES: We aimed to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across 14 centers from 9 countries, and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association. METHODS: Using a common analytical protocol, International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) centers generated effect estimates for term LBW and continuous birth weight associated with PM10 and PM2.5 (particulate matter <= 10 and 2.5 mu m). We used meta-analysis to combine the estimates of effect across centers (similar to 3 million births) and used meta-regression to evaluate the influence of center characteristics and exposure assessment methods on between-center heterogeneity in reported effect estimates. RESULTS: In random-effects meta-analyses, term LBW was positively associated with a 10-mu g/m(3) increase in PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01, 1.05] and PM2.5 (OR = 1.10; 95% CI: 1.03, 1.18) exposure during the entire pregnancy, adjusted for maternal socioeconomic status. A 10-mu g/m(3) increase in PM10 exposure was also negatively associated with term birth weight as a continuous outcome in the fully adjusted random-effects meta-analyses (-8.9 g; 95% CI: -13.2, -4.6 g). Meta-regressions revealed that centers with higher median PM2.5 levels and PM2.5: PM10 ratios, and centers that used a temporal exposure assessment (compared with spatiotemporal), tended to report stronger associations. CONCLUSION: Maternal exposure to particulate pollution was associated with LBW at term across study populations. We detected three site characteristics and aspects of exposure assessment methodology that appeared to contribute to the variation in associations reported by centers.
- The International Collaboration on Air Pollution and Pregnancy Outcomes: Initial Results(2011) PARKER, Jennifer D.; RICH, David Q.; GLINIANAIA, Svetlana V.; LEEM, Jong Han; WARTENBERG, Daniel; BELL, Michelle L.; BONZINI, Matteo; BRAUER, Michael; DARROW, Lyndsey; GEHRING, Ulrike; GOUVEIA, Nelson; GRILLO, Paolo; HA, Eunhee; HOOVEN, Edith H. van den; JALALUDIN, Bin; JESDALE, Bill M.; LEPEULE, Johanna; MORELLO-FROSCH, Rachel; MORGAN, Geoffrey G.; SLAMA, Remy; PIERIK, Frank H.; PESATORI, Angela Cecilia; SATHYANARAYANA, Sheela; SEO, Juhee; STRICKLAND, Matthew; TAMBURIC, Lillian; WOODRUFF, Tracey J.BACKGROUND: The findings of prior studies of air pollution effects on adverse birth outcomes are difficult to synthesize because of differences in study design. OBJECTIVES: The International Collaboration on Air Pollution and Pregnancy Outcomes was formed to understand how differences in research methods contribute to variations in findings. We initiated a feasibility study to a) assess the ability of geographically diverse research groups to analyze their data sets using a common protocol and b) perform location-specific analyses of air pollution effects on birth weight using a standardized statistical approach. METHODS: Fourteen research groups from nine countries participated. We developed a protocol to estimate odds ratios (ORs) for the association between particulate matter <= 10 mu m in aerodynamic diameter (PM(10)) and low birth weight (LBW) among term births, adjusted first for socioeconomic status (SES) and second for additional location-specific variables. RESULTS: Among locations with data for the PM(10) analysis, ORs estimating the relative risk of term LBW associated with a 10-mu g/m(3) increase in average PM(10) concentration during pregnancy, adjusted for SES, ranged from 0.63 [95% confidence interval (CI), 0.30-1.35] for the Netherlands to 1.15 (95% CI, 0.61-2.18) for Vancouver, with six research groups reporting statistically significant adverse associations. We found evidence of statistically significant heterogeneity in estimated effects among locations. CONCLUSIONS: Variability in PM(10)-LBW relationships among study locations remained despite use of a common statistical approach. A more detailed meta-analysis and use of more complex protocols for future analysis may uncover reasons for heterogeneity across locations. However, our findings confirm the potential for a diverse group of researchers to analyze their data in a standardized way to improve understanding of air pollution effects on birth outcomes.
- Socioeconomic Position and Low Birth Weight among Mothers Exposed to Traffic-Related Air Pollution(2014) HABERMANN, Mateus; GOUVEIA, NelsonBackground: Atmospheric pollution is a major public health concern. It can affect placental function and restricts fetal growth. However, scientific knowledge remains too limited to make inferences regarding causal associations between maternal exposure to air pollution and adverse effects on pregnancy. This study evaluated the association between low birth weight (LBW) and maternal exposure during pregnancy to traffic related air pollutants (TRAP) in Sao Paulo, Brazil. Methods and findings: Analysis included 5,772 cases of term-LBW (<2,500 g) and 5,814 controls matched by sex and month of birth selected from the birth registration system. Mothers' addresses were geocoded to estimate exposure according to 3 indicators: distance from home to heavy traffic roads, distance-weighted traffic density (DWTD) and levels of particulate matter <= 10 mg/m(3) estimated through land use regression (LUR-PM10). Final models were evaluated using multiple logistic regression adjusting for birth, maternal and pregnancy characteristics. We found decreased odds in the risk of LBW associated with DWTD and LUR-PM10 in the highest quartiles of exposure with a significant linear trend of decrease in risk. The analysis with distance from heavy traffic roads was less consistent. It was also observed that mothers with higher education and neighborhood-level income were potentially more exposed to TRAP. Conclusions: This study found an unexpected decreased risk of LBW associated with traffic related air pollution. Mothers with advantaged socioeconomic position (SEP) although residing in areas of higher vehicular traffic might not in fact be more expose to air pollution. It can also be that the protection against LBW arising from a better SEP is stronger than the effect of exposure to air pollution, and this exposure may not be sufficient to increase the risk of LBW for these mothers.
- Ambient fine particulate matter in Latin American cities: Levels, population exposure, and associated urban factors(2021) GOUVEIA, Nelson; KEPHART, Josiah L.; DRONOVA, Iryna; MCCLURE, Leslie; GRANADOS, Jose Tapia; BETANCOURT, Ricardo Morales; O'RYAN, Andrea Cortinez; TEXCALAC-SANGRADOR, Jose Luis; MARTINEZ-FOLGAR, Kevin; RODRIGUEZ, Daniel; V, Ana Diez-RouxBackground: Exposure to particulate matter (PM2.5) is a major risk factor for morbidity and mortality. Yet few studies have examined patterns of population exposure and investigated the predictors of PM2.5 across the rap-idly growing cities in lower- and middle-income countries. Objectives: Characterize PM2.5 levels, describe patterns of population exposure, and investigate urban factors as predictors of PM2.5 levels. Methods: We used data from the Salud Urbana en America Latina/Urban Health in Latin America (SALURBAL) study, a multi-country assessment of the determinants of urban health in Latin America, to characterize PM2.5 levels in 366 cities comprising over 100,000 residents using satellite-derived estimates. Factors related to urban form and transportation were explored. Results: We found that about 172 million or 58% of the population studied lived in areas with air pollution levels above the defined WHO-AQG of 10 mu g/m(3) annual average. We also found that larger cities, cities with higher GDP, higher motorization rate and higher congestion tended to have higher PM2.5. In contrast cities with higher population density had lower levels of PM2.5. In addition, at the sub-city level, higher intersection density was associated with higher PM2.5 and more green space was associated with lower PM2.5. When all exposures were examined adjusted for each other, higher city per capita GDP and higher sub-city intersection density remained associated with higher PM2.5 levels, while higher city population density remained associated with lower levels. The presence of mass transit was also associated with lower PM2.5 after adjustment. The motorization rate also remained associated with PM2.5 and its inclusion attenuated the effect of population density. Discussion: These results show that PM2.5 exposures remain a major health risk in Latin American cities and suggest that urban planning and transportation policies could have a major impact on ambient levels. (C) 2021 The Author(s).
- Green Areas and PM2,5 exposure could be associated with Asthma and COPD?(2023) ALMEIDA, Francine Maria; MOREIRA, Tiana Carla Lopes; OLIVEIRA, Lucas Miranda; RIGHETTI, Renato Fraga; LOPES, Fernanda Degobbi Tenorio Quirino Santos; ALENCAR, Airlane P.; GOUVEIA, Nelson; MAUAD, Thais; LOTUFO, Paulo A.; BENSENOR, Isabela; SANTOS, Itamar Souza; TIBERIO, Iolanda Fatima Lopes Calvo
- Vehicular traffic density and cognitive performance in the ELSA-Brasil study(2020) ROCHA, Douglas; SUEMOTO, Claudia K.; SANTOS, Itamar Souza; LOTUFO, Paulo A.; BENSENOR, Isabela; GOUVEIA, NelsonBackground: Despite the knowledge about the deleterious effects of air pollutants and their influence on mortality and morbidity due to respiratory and cardiovascular diseases, little is known about the relationship between atmospheric pollutants and neurological diseases. Recently, studies from high-income countries have suggested an association between exposures to air pollutants with cognitive impairment. Thus, we investigated the association of air pollution with cognitive performance in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Cognitive function was evaluated using the word list, the verbal fluency, and the trail making tests (TMT). Pollutant exposure was evaluated indirectly using the distance-weighted traffic density (DWTD) of participants' residence and workplace. We investigated the cross-sectional association between DWTD and cognitive test scores using adjusted linear regression models for sociodemographic and clinical variables. Results: 3050 were included (mean age = 52.1 +/- 9.2 years old, 56.5% women, and 63.6% white). In the simple linear regression models, participants in the higher tertile of combined DWTD (residence and workplace) presented better cognitive performance in all tests when compared to participants in the lower tertile. The DWTD was not associated with cognitive performance in adjusted linear models especially when adjusted for socioeconomic variables (age, sex, education, and race). We found similar results when we investigated the association of cognitive performance with DTWD near participants' workplace and residence separately. Conclusion: Air pollutants were not associated with worse cognitive performance in a large sample of middle-aged and older adults.
- Health Effects of Pesticide Exposure in Latin American and the Caribbean Populations: A Scoping Review (vol 130, 096002, 2022)(2023) ZUNIGA-VENEGAS, Liliana A.; HYLAND, Carly; MUNOZ-QUEZADA, Maria Teresa; QUIROS-ALCALA, Lesliam; BUTINOF, Mariana; BURALLI, Rafael; CARDENAS, Andres; FERNANDEZ, Ricardo A.; FOERSTER, Claudia; GOUVEIA, Nelson; JARA, Juan P. Gutierrez; LUCERO, Boris A.; MUNOZ, Maria Pia; RAMIREZ-SANTANA, Muriel; SMITH, Anna R.; TIRADO, Noemi; JOODE, Berna van Wendel de; CALAF, Gloria M.; HANDAL, Alexis J.; SILVA, Agnes Soares da; CORTES, Sandra; MORA, Ana M.
- Health impact modelling of different travel patterns on physical activity, air pollution and road injuries for Sao Paulo, Brazil(2017) SA, Thiago Herick de; TAINIO, Marko; GOODMAN, Anna; EDWARDS, Phil; HAINES, Andy; GOUVEIA, Nelson; MONTEIRO, Carlos; WOODCOCK, JamesBackground: Sao Paulo city, Brazil, faces challenges caused by rapid urbanization. We illustrate how future travel patterns could lead to different health consequences in the city. Methods: We evaluated the health impacts of different travel pattern scenarios for the Sao Paulo adult population by comparing the travel patterns of Sao Paulo in 2012 with counterfactual scenarios in which the city adopted travel patterns of i) those living in the city's expanded centre; ii) London (2012); iii) a highly motorized Sao Paulo (SP California); and iv) a visionary Sao Paulo (SP 2040), with high levels of walking and cycling and low levels of car and motorcycle use. For each scenario we estimated changes in exposure to air pollution, road injury risk, and physical activity. Health outcomes were estimated using disability adjusted life years (DALYs) and premature deaths averted. Sensitivity analyses were performed to identify the main sources of uncertainty. Results: We found considerable health gains in the SP 2040 scenario (total 63.6 k DALYs avoided), with 4.7% of premature deaths from ischemic heart disease avoided from increases in physical activity alone. Conversely, we found substantial health losses in the scenario favouring private transport (SP California, total increase of 54.9 k DALYs), with an increase in road traffic deaths and injuries among pedestrians and motorized vehicles. Parameters related to air pollution had the largest impact on uncertainty. Conclusions: Shifting travel patterns towards more sustainable transport can provide major health benefits in Sao Paulo. Reducing the uncertainties in the findings should be a priority for empirical and modelling research on the health impacts of such shifts.
- Aplicação de regressão baseada no uso do solo para predizer a concentração de material particulado inalável no município de São Paulo, Brasil(2013) HABERMANN, Mateus; GOUVEIA, NelsonThe study intended to develop a land use regression model to predict inhalable particulate matter (PM10) concentrations in Sao Paulo, Brazil. The model was based on the 2007 average of PM10 available from 9 monitoring stations and demographic, roads and land use data in buffers of 250 to 1,000 m. Simple linear regression were used to select the more robust independent variables and those without collinearity. Four variables were selected for the multiple regression analysis. Only light traffic in buffers <= 250 m remained in the final model which explained 63.8% of the PM(10)variance. The land use regression approach is a quick and easy method to predict air pollution levels. However, our model was based on measurements of only a few sites.
- Ambient air pollution and mortality: The role of socioeconomic conditions(2024) NASCIMENTO, Felipe Parra do; GOUVEIA, NelsonBackground: There is a vast body of literature covering the association between air pollution exposure and nonaccidental mortality. However, the role of socioeconomic status (SES) in this relationship is still not fully understood. Objectives: We investigated if individual and contextual SES modified the relationship between short-term exposure to ozone (O-3), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameter <10 m (PM10) on cardiovascular, respiratory, and all nonaccidental mortality. Methods: We conducted a time-stratified case-crossover study. Analyses were based on information on 280,685 deaths from 2011 to 2015 in the city of S & atilde;o Paulo. Education was used as an individual SES, and information on the district of residence was used to build a contextual SES. Exposure to PM10, NO2, and O-3 was accessed from monitoring stations and linked to each case based on the date of death. Conditional logistic regression models were used to estimate the effects of air pollutants, and interaction terms were added to access the effect modification of SES. Results: Individuals with lower education had an increased chance of dying for all nonaccidental outcomes (1.54% [0.91%, 2.14%]) associated with exposure to PM10. Individuals living in lower SES areas had an increased chance of dying for nonaccidental (0.52% [0.16%, 0.88%]), cardiovascular (1.17% [0.88%, 1.46%]), and respiratory (1.70% [0.47%, 2.93%]) causes owing to NO2 exposure. Conclusion: Exposure to air pollutants increases the chance of dying by nonaccidental, cardiovascular, and respiratory causes. Lower educational levels and living on lower contextual SES increased the risk of mortality associated with air pollution exposure.