LUIZ ALBERTO AMADOR PEREIRA

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  • article 12 Citação(ões) na Scopus
    Air pollution and low birth weight in an industrialized city in Southeastern Brazil, 2003-2006
    (2017) REIS, Marcelo Moreno dos; GUIMARÃES, Mariana Tavares; BRAGA, Alfésio Luís Ferreira; MARTINS, Lourdes Conceição; PEREIRA, Luiz Alberto Amador
    ABSTRACT: Introduction: Birth weight is an important indicator of several conditions that manifest earlier (as fetal and neonatal mortality and morbidity, inhibited growth and cognitive development) and later in life such as chronic diseases. Air pollution has been associated with adverse pregnancy outcomes. Objective: Retrospective cohort study investigated the association between low birth weight (LBW) and maternal exposure to air pollutants in Volta Redonda city, Rio de Janeiro, Brazil, from 2003 to 2006. Methods: Birth data was obtained from Brazilian Information System. Exposure information (O3, PM10, temperature and humidity) was provided by Governmental Air Quality Monitoring System. Linear and Logistic models, adjusted for sex, type of pregnancy, prenatal care, place of birth, maternal age, parity, education, congenital anomalies and weather variables were employed. Results: Low birth weight (LBW) represented 9.1% of all newborns (13,660). For an interquartile range increase in PM10 it was found OR2 ndTrimester = 1.06 (95%CI 1.02 - 1.10), OR3 rdTrimester = 1.06 (95%CI 1.02 - 1.10) and, in O3 it was found OR2 ndTrimester = 1.03 (95%CI 1.01 - 1.04), OR3 rdTrimester = 1.03 (95%CI 1.02 - 1.04). The dose-response relationship and a reduction in birth weight of 31.11 g (95%CI -56.64 - -5.58) was observed in the third trimester of pregnancy due to an interquartile increase of O3. Conclusion: This study suggests that exposures to PM10 and O3, even being below the Brazilian air quality standards, contribute to risks of low birth weight.
  • article 7 Citação(ões) na Scopus
    Influence of environmental contamination on pregnancy outcomes
    (2015) GUIMARAES, Mariana Tavares; CUNHA, Michele Granato; CARVALHO, Daniele Pena; RIBEIRO, Tatyana Sampaio; MARTINS, Lourdes Conceicao; BRAGA, Alfesio Luis Ferreira; PEREIRA, Luiz Alberto Amador
    This study aims to compare pregnancy outcomes in four contaminated areas to those observed in a non-contaminated area of similar socioeconomic status. A cross-sectional study was carried out. A structured and pre-tested questionnaire was administered to population-based samples of 788-920 families in each of the five studied areas. The exposure assessment used was an ecological measure. Using logistic regression, odds of several pregnancies outcomes (pregnancy occurrence, miscarriage, stillbirth, prematurity, low birth weight, congenital malformation, and multiple births) were estimated after adjustment for potential confounders such as socioeconomic, demographic, and substance abuse factors. We adopted a statistical significance level of 5 %. In three of the four exposed areas, pregnancy occurrence was reduced in comparison to the control area (Area 2, odds ratio (OR) = 0.68, 95 % CI = 0.54-0.86; Area 3, OR = 0.76, 95 % CI = 0.60-0.97; Area 4, OR = 0.71, 95 % CI = 0.56-0.90). Also, a significantly increased odds of miscarriage for living in Area 3 (OR = 1.83, 95 % CI = 1.07-3.12) was found. The other pregnancy outcomes were not significantly elevated in the exposed areas. In conclusion, this study shows evidence of reduced pregnancy occurrence and increased miscarriage occurrence in some of the contaminated areas, compared to the control area.
  • conferenceObject
    PERSONAL EXPOSURE TO AIR POLLUTION INFLUENCED DISEASE ACTIVITY AND EXHALED BREATH BIOMARKERS: A PROSPECTIVE STUDY IN A CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS POPULATION
    (2016) GOULART, M. F. G.; ALVES, A. G. F.; BRAGA, A. L. F.; SALUM, A. M. E.; PEREIRA, L. A. A.; COIMBRA, A. J. F.; CARVALHO, T. D. S.; NAKAGAWA, N. K.; SILVA, C. A.; FARHAT, S. C. L.
  • article 28 Citação(ões) na Scopus
    Suicide and meteorological factors in Sao Paulo, Brazil, 1996-2011: a time series analysis
    (2017) BANDO, Daniel H.; TENG, Chei T.; VOLPE, Fernando M.; MASI, Eduardo de; PEREIRA, Luiz A.; BRAGA, Alfesio L.
    Objective: Considering the scarcity of reports from intertropical latitudes and the Southern Hemisphere, we aimed to examine the association between meteorological factors and suicide in Sao Paulo. Method: Weekly suicide records stratified by sex were gathered. Weekly averages for minimum, mean, and maximum temperature (degrees C), insolation (hours), irradiation (MJ/m(2)), relative humidity (%), atmospheric pressure (mmHg), and rainfall (mm) were computed. The time structures of explanatory variables were modeled by polynomial distributed lag applied to the generalized additive model. The model controlled for long-term trends and selected meteorological factors. Results: The total number of suicides was 6,600 (5,073 for men), an average of 6.7 suicides per week (8.7 for men and 2.0 for women). For overall suicides and among men, effects were predominantly acute and statistically significant only at lag 0. Weekly average minimum temperature had the greatest effect on suicide; there was a 2.28% increase (95% CI 0.90-3.69) in total suicides and a 2.37% increase (95% CI 0.82-3.96) among male suicides with each 1 degrees C increase. Conclusion: This study suggests that an increase in weekly average minimum temperature has a short-term effect on suicide in Sao Paulo.
  • article 2 Citação(ões) na Scopus
    Air pollution influence on serum inflammatory interleukins: A prospective study in childhood-onset systemic lupus erythematous patients
    (2021) FARHAT, Sylvia Costa Lima; EJNISMAN, Carolina; ALVES, Andressa Guariento Ferreira; GOULART, Maria Fernanda Giacomin; LICHTENFELS, Ana Julia de Faria Coimbra; BRAGA, Alfesio Luis Ferreira; PEREIRA, Luiz Alberto Amador; ELIAS, Adriana Maluf; SILVA, Clovis A.
    Objective To assess the effect of individual exposure, in real-time, to traffic-related pollutants on serum interleukin levels of childhood-onset lupus erythematous systemic (c-SLE) patients. Methods A longitudinal and observational design was conducted in 12 repeated measures of serum samples and clinical evaluations (totaling 108 measurements) of c-SLE patients over 30 consecutive months. Real-time, individual exposure to fine particles (PM2.5) and nitrogen dioxide (NO2) was measured with portable monitors. Generalized estimating equation was used to evaluate the association between exposure to PM2.5 and NO2 and the following serum cytokine levels on the 7 days preceding clinical assessment and serum collection: MCP1, IL-6, IL-8, IL-10, IL-17, IFN-alpha, and TNF-alpha. Disease activity and other risk factors were also controlled. Results An interquartile range (IQR) increase in PM2.5 daily concentration was significantly associated with increased levels of TNF-alpha on the third, fourth, and seventh day after exposure; IL-10 on the third and fourth day after exposure; IL-17 on the third and seventh day after exposure; and INF-alpha on the third day after exposure (p < 0.05). An IQR increase in 7-day moving average of PM2.5 was associated with a 6.2 pg/mL (95% CI: 0.5; 11.8; p = 0.04) increase in serum IFN-alpha level. An unexpected significant association was observed between an IQR increase in NO(2)7-day cumulative concentration and a decrease of 1.6 pg/mL (95% CI: -2.6; -0.7; p < 0.001) in serum IL-17. Conclusion Real-time exposure to PM2.5 prospectively associated with increased serum TNF-alpha, INF-alpha, IL-10, and IL-17 levels in c-SLE patients.
  • article 32 Citação(ões) na Scopus
    Air pollution and pediatric hospital admissions due to respiratory diseases in Cubatao, Sao Paulo State, Brazil, from 1997 to 2004
    (2011) JASINSKI, Renata; PEREIRA, Luiz Alberto Amador; BRAGA, Alfesio Luis Ferreira
    The aim of this study was to evaluate the effects of air pollutants and their lag structures in relation to respiratory morbidity among children and adolescents in the city of Cubatao, Sao Paulo State, Brazil, from 1997 to 2004. An ecological time-series study was performed, analyzing respiratory hospital admissions of children and adolescents in National Health System hospitals in Cubatao. Generalized linear Poisson regression models were used to control for seasonality, temperature, humidity, and short-term trends. PM(10) and ozone were significantly associated with respiratory hospital admissions. Among children, inter-quartile range increases in the PM(10) 7-day moving average (56.5 mu g/m(3)) and in the ozone 5-day moving average (46.7 mu g/m(3)) led to increases of 9.6% (95%CI: 3.0%-16.1%) and 2.4% (95%CI: 0.1%-4.7%) in respiratory hospital admissions, respectively. Efforts to reduce air pollutants need to be adopted to minimize the adverse effects on children and adolescents in Cubatao.
  • article 15 Citação(ões) na Scopus
    Influence of air pollution on renal activity in patients with childhood-onset systemic lupus erythematosus
    (2020) GOULART, Maria Fernanda Giacomin; ALVES, Andressa Guariento Ferreira; FARHAT, Juliana; BRAGA, Alfesio Luis Ferreira; PEREIRA, Luiz Alberto Amador; LICHTENFELS, Ana Julia de Faria Coimbra; CAMPOS, Lucia Maria de Arruda; SILVA, Clovis Artur Almeida da; ELIAS, Adriana Maluf; FARHAT, Sylvia Costa Lima
    Background Childhood-onset systemic lupus erythematosus (cSLE) is an autoimmune and multifactorial disease that can affect the renal system. Exposure to air pollution can trigger systemic inflammation in cSLE patients and increase risk of disease activity. We evaluated effects of individual real-time exposure to air pollutants on renal activity in cSLE patients using the Systemic Lupus Erythematosus Disease Activity Index 2000. Methods Longitudinal panel study of 108 repetitive measures from 9 pediatric lupus patients. Over three consecutive weeks, daily individual levels of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were measured, as well as weekly clinical evaluation and laboratory tests. This was repeated every 10 weeks over a 1-year period. Specific generalized estimating equation models were used to evaluate the impact of these pollutants on risk of nephritis and anti-dsDNA > 20 UI/mL and on 24-h urine protein and serum complement (C3) levels. Results An interquartile range (IQR) increase of 18.12 mu g/m(3) in PM2.5 daily concentration was associated with increased risk of nephritis and positive results for anti-dsDNA. Moreover, increase in 24-h urine protein and decrease in C3 serum levels also associated with exposure to pollutants. An IQR increase in PM(2.5)7-day moving average was associated with increased risks of leukocyturia (3.4; 95% CI 2.6:4.3), positive anti-dsDNA (3.1; 95% CI 2.1:4.0), and 36.3-mg increase (95% IC 20.2:52.3) in 24-h urine protein. An IQR increase (63.1 mu g/m(3)) in 7-day cumulative NO2 levels was associated with decreased serum C3 levels. Conclusions This prospective study suggests exposure to air pollution can trigger renal activity in cSLE patients.
  • article 7 Citação(ões) na Scopus
    Seven-day cumulative effects of air pollutants increase respiratory ER visits up to threefold
    (2017) SCHVARTSMAN, Claudio; PEREIRA, Luiz Alberto Amador; BRAGA, Alfesio Luiz Ferreira; FARHAT, Sylvia Costa Lima
    Objective: Children are especially vulnerable to respiratory injury induced by exposure to air pollutants. In the present study, we investigate periods of up to 7 days, and evaluate the lagged effects of exposure to air pollutants on the daily number of children and adolescents visiting the emergency room (ER) for the treatment of lower respiratory obstructive diseases (LROD), in the city of SAo Paulo, Brazil. Methods: Daily records of LROD-related ER visits by children and adolescents under the age of 19, from January 2000 to December 2007 (2,922 days) were included in the study. Time-series regression models (generalized linear Poisson) were used to control for short- and long-term trends, as well as for temperature and relative humidity. Third-degree polynomial lag models were used to estimate both lag structures and the cumulative effects of air pollutants. Effects of air pollutants were expressed as the percentage increase in LROD-related ER visits. Results: We observed an acute effect at the same day of exposure to air pollutants; however, the cumulative effects of air pollutants on the number of LROD-related ER visits was almost threefold greater than the one observed at the same day of exposure to PM10, SO2, and NO2 mainly in children aged 5 years and under. The 7-day cumulative effect of SO2 reached 11.0% (95% CI: 5.0-16.7) increase in visits. Conclusion and Relevance: This study highlights the effects of intermediate-term exposure to air pollutants on LROD in children. Pediatr Pulmonol. 2017;52:205-212. (c) 2016 Wiley Periodicals, Inc.
  • article 48 Citação(ões) na Scopus
    The association between air pollution and blood pressure in traffic controllers in Santo Andre, Sao Paulo, Brazil
    (2011) CHIARELLI, Paulo Sergio; PEREIRA, Luiz Alberto Amador; SALDIVA, Paulo Hilario do Nascimento; FERREIRA FILHO, Celso; GARCIA, Maria Lucia Bueno; BRAGA, Alfesio Luis Ferreira; MARTINS, Lourdes Conceicao
    Background: Urban air pollutants are associated with cardiovascular events. Traffic controllers are at high risk for pollution exposure during outdoor work shifts. Objective: The purpose of this study was to evaluate the relationship between air pollution and systemic blood pressure in traffic controllers during their work shifts. Methods: This cross-sectional study enrolled 19 male traffic controllers from Santo Andre city (Sao Paulo, Brazil) who were 30-60 years old and exposed to ambient air during outdoor work shifts. Systolic and diastolic blood pressure readings were measured every 15 min by an Ambulatory Arterial Blood Pressure Monitoring device. Hourly measurements (lags of 0-5 h) and the moving averages (2-5 h) of particulate matter (PM(10)), ozone (O(3)) ambient concentrations and the acquired daily minimum temperature and humidity means from the Sao Paulo State Environmental Agency were correlated with both systolic and diastolic blood pressures. Statistical methods included descriptive analysis and linear mixed effect models adjusted for temperature, humidity, work periods and time of day. Results: Interquartile increases of PM(10) (33 mu g/m(3)) and O(3) (49 mu g/m(3)) levels were associated with increases in all arterial pressure parameters, ranging from 1.06 to 2.53 mmHg. PM(10) concentration was associated with early effects (lag 0), mainly on systolic blood pressure. However, O(3) was weakly associated most consistently with diastolic blood pressure and with late cumulative effects. Conclusions: Santo Andre traffic controllers presented higher blood pressure readings while working their outdoor shifts during periods of exposure to ambient pollutant fluctuations. However, PM(10) and O(3) induced cardiovascular effects demonstrated different time courses and end-point behaviors and probably acted through different mechanisms.
  • article 5 Citação(ões) na Scopus
    Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city
    (2018) MISSAGIA, Suelem; AMARAL, Camila Alves Silva do; JESUS, Alessandra Santos de; ARBEX, Marcos Abdo; SANTOS, Ubiratan de Paula; ANDRÉ, Carmem Diva Saldiva de; ANDRÉ, Paulo Afonso de; SALDIVA, Paulo Hilário do Nascimento; MARTINS, Lourdes Conceição; BRAGA, Alfésio Luís Ferreira; PEREIRA, Luiz Alberto Amador
    ABSTRACT: Introduction: High particulate matter (PM10) concentrations are associated with increased incidence of respiratory symptoms and decreased lung function. This study evaluates the air pollution effects in children’s and adolescents’ lung function using peak expiratory flow (PEF) measurements over a given period, in an area exposed to industrial emissions. Methodology: This was a panel study. The effects of air pollution on respiratory symptoms and PEF were investigated in 117 children and adolescents from three public schools in areas of exposure to air pollution from a mining company in a Brazilian medium-sized city, from 2008 to 2009. The average daily PM10, temperature and humidity were recorded by the monitoring network in the region. Association between daily records of PEF and PM10 was assessed in mixed-effect regression models, controlling for temperature, humidity, and body mass index. Results: About 60,000 PEF measurements were performed. Increases of 14µg/m3 in PM10 were associated with decreased PEF in the morning (-1.04%, 95%CI -1.32; -0.77) and evening (-1.2%, 95%CI -1.49, -0.92). Discussion: We found a significant negative association between particulate matter and peak expiratory flow rate in this population, and these remained significant even after adjusted for temperature, humidity, body mass index, coughing, wheezing and coryza. Conclusion: Adverse effects were found and it suggests an association between increase in PM10 and reduced lung function.