Risk and burden of hospital admissions associated with wildfire-related PM2.5 in Brazil, 2000-15: a nationwide time-series study

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art_YE_Risk_and_burden_of_hospital_admissions_associated_with_2021.PDF (3.86 MB)
Citações na Scopus
41
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
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ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Autores
YE, Tingting
GUO, Yuming
CHEN, Gongbo
YUE, Xu
XU, Rongbin
ZHAO, Qi
LI, Shanshan
Citação
LANCET PLANETARY HEALTH, v.5, n.9, p.E599-E607, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background In the context of climate change and deforestation, Brazil is facing more frequent and unprecedented wildfires. Wildfire-related PM2.5 is associated with multiple adverse health outcomes; however, the magnitude of these associations in the Brazilian context is unclear. We aimed to estimate the association between daily exposure to wildfire-related PM2.5 and cause-specific hospital admission and attributable health burden in the Brazilian population using a nationwide dataset from 2000 to 2015. Methods In this nationwide time-series analysis, data for daily all-cause, cardiovascular, and respiratory hospital admissions were collected through the Brazilian Unified Health System from 1814 municipalities in Brazil between Jan 1, 2000, and Dec 31, 2015. Daily concentrations of wildfire-related PM2.5 were estimated using the 3D chemical transport model GEOS-Chem at a 2.0 degrees latitude by 2.5 degrees longitude resolution. A time-series analysis was fitted using quasi-Poisson regression to quantify municipality-specific effect estimates, which were then pooled at the regional and national levels using random-effects meta-analyses. Analyses were stratified by sex and ten age groups. The attributable fraction and attributable cases of hospital admissions due to wildfire-related PM2.5 were also calculated. Findings At the national level, a 10 mu g/m(3) increase in wildfire-related PM2.5 was associated with a 1.65% (95% CI 1.51-1.80) increase in all-cause hospital admissions, a 5.09% (4.73-5.44) increase in respiratory hospital admissions, and a 1.10% (0.78-1.42) increase in cardiovascular hospital admissions, over 0-1 days after the exposure. The effect estimates for all-cause hospital admission did not vary by sex, but were particularly high in children aged 4 years or younger (4.88% [95% CI 4.47-5.28]), children aged 5-9 years (2.33% [1.77-2.90]), and people aged 80 years and older (3.70% [3.20-4.20]) compared with other age groups. We estimated that 0.53% (95% CI 0.48-0.58) of allcause hospital admissions were attributable to wildfire-related PM2.5, corresponding to 35 cases (95% CI 32-38) per 100 000 residents annually. The attributable rate was greatest for municipalities in the north, south, and central-west regions, and lowest in the northeast region. Results were consistent for all-cause and respiratory diseases across regions, but remained inconsistent for cardiovascular diseases. Interpretation Short-term exposure to wildfire-related PM2.5 was associated with increased risks of all-cause, respiratory, and cardiovascular hospital admissions, particularly among children (0-9 years) and older people (>= 80 years). Greater attention should be paid to reducing exposure to wildfire smoke, particularly for the most susceptible populations.
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URI
https://observatorio.fm.usp.br/handle/OPI/42377
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/05
Artigos e Materiais de Revistas Científicas - ODS/03