Exposure to wildfire-related PM2.5 and sitespecific cancer mortality in Brazil from 2010 to 2016: A retrospective study
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Citações na Scopus
15
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Autores
YU, Pei
XU, Rongbin
LI, Shanshan
YUE, Xu
CHEN, Gongbo
YE, Tingting
SIM, Malcolm R.
ABRAMSON, Michael J.
Citação
PLOS MEDICINE, v.19, n.9, article ID e1004103, 21p, 2022
Resumo
Background Long-term exposure to fine particles <= 2.5 mu m in diameter (PM2.5) has been linked to cancer mortality. However, the effect of wildfire-related PM2.5 exposure on cancer mortality risk is unknown. This study evaluates the association between wildfire-related PM2.5 and site-specific cancer mortality in Brazil, from 2010 to 2016. Methods and findings Nationwide cancer death records were collected during 2010-2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and nonwildfire-related PM2.5 concentrations, at a resolution of 2.0 degrees latitude by 2.5 degrees longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age >= 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM2.5 concentration was 2.38 mu g/m(3), and the annual non-wildfire-related PM2.5 concentration was 8.20 mu g/m(3). The RR for mortality from all cancers was 1.02 (95% CI 1.01-1.03, p< 0.001) per mu g/m(3) increase of wildfire-related PM2.5 concentration, which was higher than the RR per 1-mu g/m(3) increase of non-wildfire-related PM2.5 (1.01 [95% CI 1.00-1.01], p = 0.007, with p for difference = 0.003). Wildfire-related PM2.5 was associated with mortality from cancers of the nasopharynx (1.10 [95% CI 1.04-1.16], p = 0.002), esophagus (1.05 [95% CI 1.01-1.08], p = 0.012), stomach (1.03 [95% CI 1.01-1.06], p = 0.017), colon/rectum (1.08 [95% CI 1.05-1.11], p < 0.001), larynx (1.06 [95% CI 1.02-1.11], p = 0.003), skin (1.06 [95% CI 1.001.12], p = 0.003), breast (1.04 [95% CI 1.01-1.06], p = 0.007), prostate (1.03 [95% CI 1.011.06], p = 0.019), and testis (1.10 [95% CI 1.03-1.17], p = 0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders. Conclusions Exposure to wildfire-related PM2.5 can increase the risks of cancer mcaoprttuarlietyyofourrmmeaannyincga:Infncoetr; pleaseprovidecorrectwording: sites, and the effect for wildfire-related PM2.5 was higher than for PM2.5 from non-wildfire sources.
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