MICHELINE DE SOUSA ZANOTTI STAGLIORIO COELHO
Projetos de Pesquisa
Unidades Organizacionais
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Wildfire-related PM2.5 and health economic loss of mortality in Brazil(2023) WU, Yao; LI, Shanshan; XU, Rongbin; CHEN, Gongbo; YUE, Xu; YU, Pei; YE, Tingting; WEN, Bo; COELHO, Micheline de Sousa Zanotti Stagliorio; SALDIVA, Paulo Hilario Nascimento; GUO, YumingBackground: Wildfire imposes a high mortality burden on Brazil. However, there is a limited assessment of the health economic losses attributable to wildfire-related fine particulate matter (PM2.5). Methods: We collected daily time-series data on all-cause, cardiovascular, and respiratory mortality from 510 immediate regions in Brazil during 2000-2016. The chemical transport model GEOS-Chem driven with Global Fire Emissions Database (GFED), in combination with ground monitored data and machine learning was used to estimate wildfire-related PM2.5 data at a resolution of 0.25 degrees x 0.25 degrees. A time-series design was applied in each immediate region to assess the association between economic losses due to mortality and wildfire-related PM2.5 and the estimates were pooled at the national level using a random-effect meta-analysis. We used a metaregression model to explore the modification effect of GDP and its sectors (agriculture, industry, and service) on economic losses.Results: During 2000-2016, a total of US$81.08 billion economic losses (US$5.07 billion per year) due to mortality were attributable to wildfire-related PM2.5 in Brazil, accounting for 0.68% of economic losses and equivalent to approximately 0.14% of Brazil's GDP. The attributable fraction (AF) of economic losses due to wildfire-related PM2.5 was positively associated with the proportion of GDP from agriculture, while negatively associated with the proportion of GDP from service.Conclusion: Substantial economic losses due to mortality were associated with wildfires, which could be influenced by the agriculture and services share of GDP per capita. Our estimates of the economic losses of mortality could be used to determine optimal levels of investment and resources to mitigate the adverse health impacts of wildfires.
- A multi-country analysis on potential adaptive mechanisms to cold and heat in a changing climate(2018) VICEDO-CABRERA, Ana M.; SERA, Francesco; GUO, Yuming; CHUNG, Yeonseung; ARBUTHNOTT, Katherine; TONG, Shilu; TOBIAS, Aurelio; LAVIGNE, Eric; COELHO, Micheline de Sousa Zanotti Stagliorio; SALDIVA, Paulo Hilario Nascimento; GOODMAN, Patrick G.; ZEKA, Ariana; HASHIZUME, Masahiro; HONDA, Yasushi; KIM, Ho; RAGETTLI, Martina S.; ROEOESLI, Martin; ZANOBETTI, Antonella; SCHWARTZ, Joel; ARMSTRONG, Ben; GASPARRINI, AntonioBackground: Temporal variation of temperature-health associations depends on the combination of two pathways: pure adaptation to increasingly warmer temperatures due to climate change, and other attenuation mechanisms due to non-climate factors such as infrastructural changes and improved health care. Disentangling these pathways is critical for assessing climate change impacts and for planning public health and climate policies. We present evidence on this topic by assessing temporal trends in cold-and heat-attributable mortality risks in a multi-country investigation. Methods: Trends in country-specific attributable mortality fractions (AFs) for cold and heat (defined as below/above minimum mortality temperature, respectively) in 305 locations within 10 countries (1985-2012) were estimated using a two-stage time-series design with time-varying distributed lag non-linear models. To separate the contribution of pure adaptation to increasing temperatures and active changes in susceptibility (non-climate driven mechanisms) to heat and cold, we compared observed yearly-AFs with those predicted in two counterfactual scenarios: trends driven by either (1) changes in exposure-response function (assuming a constant temperature distribution), (2) or changes in temperature distribution (assuming constant exposure-response relationships). This comparison provides insights about the potential mechanisms and pace of adaptation in each population. Results: Heat-related AFs decreased in all countries (ranging from 0.45-1.66% to 0.15-0.93%, in the first and last 5-year periods, respectively) except in Australia, Ireland and UK. Different patterns were found for cold where AFs ranged from 5.57-15.43% to 2.16-8.91%), showing either decreasing (Brazil, Japan, Spain, Australia and Ireland), increasing (USA), or stable trends (Canada, South Korea and UK). Heat-AF trends were mostly driven by changes in exposure-response associations due to modified susceptibility to temperature, whereas no clear patterns were observed for cold. Conclusions: Our findings suggest a decrease in heat-mortality impacts over the past decades, well beyond those expected from a pure adaptation to changes in temperature due to the observed warming. This indicates that there is scope for the development of public health strategies to mitigate heat-related climate change impacts. In contrast, no clear conclusions were found for cold. Further investigations should focus on identification of factors defining these changes in susceptibility.
- Loss of life expectancy from PM2.5 in Brazil: A national study from 2010 to 2018(2022) YU, Pei; XU, Rongbin; LI, Shanshan; COELHO, Micheline S. Z. S.; SALDIVA, Paulo H. N.; SIM, Malcolm R.; ABRAMSON, Michael J.; GUO, YumingBackground: Long-term exposure to PM2.5 is proved to be linked with mortality. However, limited studies have estimated the PM2.5 related loss of life expectancy (LLE) and its changing trends. How much life expectancy would be improved if PM2.5 pollution is reduced to the new WHO air quality guideline (AQG) level is unclear. Methods: Data on deaths from all-causes, cancer, cardiovascular and respiratory diseases were collected from 5,565 Brazilian municipalities during 2010-2018. A difference-in-differences approach with quasi-Poisson regression was applied to examine the PM2.5-years of life lost (YLL) associations and PM2.5 associated LLE. Results: The annual PM2.5 concentration in each municipality from 2010 to 2018 was 7.7 mu g/m3 in Brazil. Nationally, with each 10 mu g/m3 increase in five-year-average (current and previous four years) concentrations of PM2.5, the relative risks (RRs) were 1.18 (95% CI: 1.15-1.21) for YLL from all-causes, 1.22 (1.16-1.28) from cancer, 1.12 (1.08-1.17) from cardiovascular and 1.17 (1.10-1.25) from respiratory diseases. Life expectancy could be improved by 1.09 (95% CI: 0.92-1.25) years by limiting PM2.5 concentration to the national lowest level (2.9 mu g/m3), specifically, 0.20 (0.15-0.24) years for cancer, 0.16 (0.11-0.22) years for cardiovascular and 0.09 (0.05-0.13) years for respiratory diseases, with significant disparities across regions and municipalities. Life expectancy would be improved by 0.78 (0.66-0.90) years by setting the new WHO AQG PM2.5 concentration level of 5 mu g/m3 as an acceptable threshold. Conclusions: Using nationwide death records in Brazil, we found that long-term exposure to PM2.5 was associated with reduced life expectancy from all-causes, cancer, cardiovascular and respiratory diseases with regional inequalities and different trends. PM2.5 pollution abatement to below the WHO AQG level would improve this loss of life expectancy in Brazil.
- Joint effect of heat and air pollution on mortality in 620 cities of 36 countries(2023) STAFOGGIA, Massimo; MICHELOZZI, Paola; SCHNEIDER, Alexandra; ARMSTRONG, Ben; SCORTICHINI, Matteo; RAI, Masna; ACHILLEOS, Souzana; ALAHMAD, Barrak; ANALITIS, Antonis; ASTROM, Christofer; BELL, Michelle L.; CALLEJA, Neville; CARLSEN, Hanne Krage; CARRASCO, Gabriel; CAUCHI, John Paul; COELHO, Micheline D. S. Z. S.; CORREA, Patricia M.; DIAZ, Magali H.; ENTEZARI, Alireza; FORSBERG, Bertil; GARLAND, Rebecca M.; GUO, Yue Leon; GUO, Yuming; HASHIZUME, Masahiro; HOLOBACA, Iulian H.; INIGUEZ, Carmen; JAAKKOLA, Jouni J. K.; KAN, Haidong; KATSOUYANNI, Klea; KIM, Ho; KYSELY, Jan; LAVIGNE, Eric; LEE, Whanhee; LI, Shanshan; MAASIKMETS, Marek; MADUREIRA, Joana; MAYVANEH, Fatemeh; NG, Chris Fook Sheng; NUNES, Baltazar; ORRU, Hans; V, Nicolas Ortega; OSORIO, Samuel; PALOMARES, Alfonso D. L.; PAN, Shih-Chun; PASCAL, Mathilde; RAGETTLI, Martina S.; RAO, Shilpa; RAZ, Raanan; ROYE, Dominic; RYTI, Niilo; SALDIVA, Paulo H. N.; SAMOLI, Evangelia; SCHWARTZ, Joel; SCOVRONICK, Noah; SERA, Francesco; TOBIAS, Aurelio; TONG, Shilu; VALENCIA, Cesar D. L. C.; VICEDO-CABRERA, Ana Maria; URBAN, Ales; GASPARRINI, Antonio; BREITNER, Susanne; DONATO, Francesca K. deBackground: The epidemiological evidence on the interaction between heat and ambient air pollution on mor-tality is still inconsistent. Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. Methods: We used daily data on all-cause mortality, air temperature, particulate matter <= 10 mu m (PM10), PM <= 2.5 mu m (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. Results: We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 mu g/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 mu g/ m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 mu g/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. Conclusions: Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
- The impacts of long-term exposure to PM2.(5) on cancer hospitalizations in Brazil(2021) YU, Pei; XU, Rongbin; COELHO, Micheline S. Z. S.; SALDIVA, Paulo H. N.; LI, Shanshan; ZHAO, Qi; MAHAL, Ajay; SIM, Malcolm; ABRAMSON, Michael J.; GUO, YumingBackground: Long-term exposure to PM2.5 has been linked to cancer incidence and mortality. However, it was unknown whether there was an association with cancer hospitalizations. Methods: Data on cancer hospitalizations and annual PM2.5 concentrations were collected from 1,814 Brazilian cities during 2002-2015. A difference-in-difference approach with quasi-Poisson regression was applied to examine State-specific associations. The State-specific associations were pooled at a national level using randomeffect meta-analyses. PM2.5 attributable burden were estimated for cancer hospitalization admissions, inpatient days and costs. Results: We included 5,102,358 cancer hospitalizations (53.8% female). The mean annual concentration of PM2.5 was 7.0 mu g/m3 (standard deviation: 4.0 mu g/m3). With each 1 mu g/m3 increase in two-year-average (current year and previous one year) concentrations of PM2.5, the relative risks (RR) of hospitalization were 1.04 (95% confidence interval [CI]: 1.02 to 1.07) for all-site cancers from 2002 to 2015 without sex and age differences. We estimated that 33.82% (95%CI: 14.97% to 47.84%) of total cancer hospitalizations could be attributed to PM2.5 exposure in Brazil during the study time. For every 100,000 population, 1,190 (95%CI: 527 to 1,836) cancer hospitalizations, 8,191 (95%CI: 3,627 to 11,587) inpatient days and US$788,775 (95%CI: $349,272 to $1,115,825) cost were attributable to PM2.5 exposure. Conclusions: Long-term exposure to ambient PM2.5 was positively associated with hospitalization for many cancer types in Brazil. Inpatient days and cost would be saved if the annual PM2.5 exposure was reduced.