PAULO HILARIO NASCIMENTO SALDIVA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
Resultados de Busca
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- Effects of biomass burning on nasal mucociliary clearance and mucus properties after sugarcane harvesting(2011) GOTO, Danielle Miyuki; LANCA, Marina; OBUTI, Camila Akemi; BARBOSA, Cristiane Maria Galvao; SALDIVA, Paulo Hilario Nascimento; ZANETTA, Dirce Maria Trevisan; LORENZI-FILHO, Geraldo; SANTOS, Ubiratan de Paula; NAKAGAWA, Naomi KondoObjective: Biofuel from sugarcane is widely produced in developing countries and is a clean and renewable alternative source of energy. However, sugarcane harvesting is mostly performed after biomass burning. The aim of this study was to evaluate the effects of harvesting after biomass burning on nasal mucociliary clearance and the nasal mucus properties of farm workers. Methods: Twenty seven sugarcane workers (21-45 years old) were evaluated at the end of two successive time-periods: first at the end of a 6-month harvesting period (harvesting), and then at the end of a 3-month period without harvesting (non-harvesting). Nasal mucociliary clearance was evaluated by the saccharine transit test, and mucus properties were analyzed using in vitro mucus contact angle and mucus transportability by sneeze. Arterial blood pressure, heart rate, respiratory rate, pulse oximetry, body temperature, associated illness, and exhaled carbon monoxide were registered. Results: Data are presented as mean values (95% confidence interval). The multivariate model analysis adjusted for age, body-mass index, smoking status and years of working with this agricultural practice showed that harvesting yielded prolonged saccharine transit test in 7.83 min (1.88-13.78), increased mucus contact angle in 8.68 degrees (3.18-14.17) and decreased transportability by sneeze in 32.12 mm (-44.83 to -19.42) compared with the non-harvesting period. No significant differences were detected in any of the clinical parameter at either time-period. Conclusion: Sugarcane harvesting after biomass burning negatively affects the first barrier of the respiratory system in farm workers by impairing nasal mucociliary clearance and inducing abnormal mucus properties.
- Cashew nut roasting: Chemical characterization of particulate matter and genotoxicity analysis (vol 131, pg 145, 2014)(2015) GALVAO, M. F.; CABRAL, T. de M.; ANDRE, P. A. de; ANDRADE, M. de F.; MIRANDA, R. M. de; SALDIVA, P. H.; VASCONCELLOS, R. de C.; MEDEIROS, S. R. de
- Ambient levels of air pollution induce clinical worsening of blepharitis(2012) MALERBI, Fernando Korn; MARTINS, Lourdes Conceicao; SALDIVA, Paulo Hilario Nascimento; BRAGA, Alfesio Luis FerreiraBackground: Even though air pollutants exposure is associated with changes in the ocular surface and tear film, its relationship to the clinical course of blepharitis, a common eyelid disease, had not yet been investigated. Our objective was to investigate the correlation between air pollution and acute manifestations of blepharitis. Method: We recorded all cases of changes in the eyelids and ocular surface, and rated clinical findings on a scale from zero (normal) to two (severe alterations). Daily values of carbon monoxide, particulate matter smaller than 10 mu m in diameter and nitrogen dioxide concentrations and meteorological variables (temperature and relative humidity) in the vicinity of the medical service were obtained. Specific linear regression models for each outcome were constructed including pollutants as independent variables (single pollutant models). Temperature and humidity were included as confounding variables. Results: increases of 28.8 mu g/m(3) in the concentration of particulate matter and 1.1 ppm in the concentration of CO were associated with increases in cases of blepharitis on the day of exposure (5 cases, 95% CI: 1-10 and 6 cases, 95% CI: 1-12, respectively). Conclusion: Exposure to usual air pollutants concentrations present in large cities affects, in a consistent manner, the eyes of residents contributing to the increasing incidence of diseases of the eyelid margin.
- Cashew nut roasting: Chemical characterization of particulate matter and genotocixity analysis(2014) GALVAO, Marcos Felipe de Oliveira; CABRAL, Thiago de Melo; ANDRE, Paulo Afonso de; ANDRADE, Maria de Fatima; MIRANDA, Regina Maura de; SALDIVA, Paulo Hilario Nascimento; VASCONCELLOS, Perola de Castro; MEDEIROS, Silvia Regina Batistuzzo deBackground: Particulate matter (PM) is potentially harmful to health and related to genotoxic events, an increase in the number of hospitalizations and mortality from respiratory and cardiovascular diseases. The present study conducted the first characterization of elemental composition and polycyclic aromatic hydrocarbon (PAH) analysis of PM, as well as the biomonitoring of genotoxic activity associated to artisanal cashew nut roasting, an important economic and social activity worldwide. Methods: The levels of PM2.5 and black carbon were also measured by gravimetric analysis and light reflectance. The elemental composition was determined using X-ray fluorescence spectrometry and PAH analysis was carried out by gas chromatography-mass spectrometry. Genotoxic activity was measured by the Tradescantia pallida micronucleus bioassay (Trad-MCN). Other biomarkers of DNA damage, such as nucleoplasmic bridges and nuclear fragments, were also quantified. Results: The mean amount of PM2.5 accumulated in the filters (January 2124.2 mu g/m(3); May 1022.2 mu g/m(3); September 1291.9 mu g/m(3)), black carbon (January 363.6 mu g/m(3); May 70 mu g/m(3); September 69.4 mu g/m(3)) and concentrations of Al, Si, P, S, Cl, K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn, Se, Br and Pb were significantly higher than the non-exposed area. Biomass burning tracers K, Cl, and S were the major inorganic compounds found. Benzo[k]fluoranthene, indene[1,2,3-c,d]pyrene, benzo[ghi]perylene, phenanthrene and benzo[b]fluoranthene were the most abundant PAHs. Mean benzo[a]pyrene-equivalent carcinogenic power values showed a significant cancer risk. The Trad-MCN bioassay revealed an increase in micronucleus frequency, 2-7 times higher than the negative control and significantly higher in all the months analyzed, possibly related to the mutagenic PAHs found. Conclusions: This study demonstrated that artisanal cashew nut roasting is a serious occupational problem, with harmful effects on workers' health. Those involved in this activity are exposed to higher PM2.5 concentrations and to 12 PAHs considered potentially mutagenic and/or carcinogenic. The Trad-MCN with T. pallida was sensitive and efficient in evaluating the genotoxicity of the components and other nuclear alterations may be used as effective biomarkers of DNA damage.
- Effects of ambient levels of traffic-derived air pollution on the ocular surface: Analysis of symptoms, conjunctival goblet cell count and mucin 5AC gene expression(2014) TORRICELLI, Andre Augusto Miranda; MATSUDA, Monique; NOVAES, Priscila; BRAGA, Alfesio Luiz Ferreira; SALDIVA, Paulo Hilario Nascimento; ALVES, Milton Ruiz; MONTEIRO, Mario Luiz RibeiroPurpose: To quantify ocular symptoms, goblet cells (GC) and mucin 5AC (MUC5AC) gene expression on the conjunctiva of healthy subjects exposed to ambient levels of traffic-derived air pollution and to estimate its correlation with NO2 and particulate matter smaller than 2.5 mu m (PM2.5) levels. Methods: Twenty-one taxi drivers or traffic controllers were assessed with the Ocular Surface Disease Index (OSDI) questionnaire and conjunctival impression cytology. MUC5AC mRNA levels were determined based on the cytology of the right eye, and GC density was assessed based on the cytology of the left eye. Mean individual levels of 24-h NO2 and PM2.5 exposure were assessed the day before examination. Possible associations between NO2 or PM2.5 levels, OSDI scores, GC densities and MUC5AC mRNA levels were verified. Results: The subjects were exposed to mean PM2.5 levels of 35 +/- 12 mu g/m(3) and mean NO2 levels of 189 +/- 47 mu g/m(3). OSDI scores were low (7.4 +/- 8) and GC densities were 521 +/- 257 and 782 +/- 322 cell/mm(2) on the bulbar and tarsal conjunctivas, respectively. The mean GC-derived MUC5AC mRNA expression was 14 +/- 7 fM/mu g of total RNA. A significant and positive correlation was observed between MUC5AC mRNA levels and tarsal GC density (p=0.018). A trend toward association between PM2.5 levels and tarsal GC cell density (p=0.052) was found. Conclusion: Exposure to ambient levels of air pollution impacts conjunctival GC density. An increase in MUC5AC mRNA levels may be part of an adaptive ocular surface response to long-term exposure to air pollution.
- Pleural anthracosis as an indicator of lifetime exposure to urban air pollution: An autopsy-based study in Sao Paulo(2019) TAKANO, Ana Paula Cremasco; JUSTO, Lisie Tocci; SANTOS, Nathalia Villa dos; MARQUEZINI, Monica Valeria; ANDRE, Paulo Afonso de; ROCHA, Francisco Marcelo Monteiro da; PASQUALUCCI, Carlos Augusto; BARROZO, Ligia Vizeu; SINGER, Julio M.; ANDRE, Carmen Diva Saldiva De; SALDIVA, Paulo Hilario Nascimento; VERAS, Mariana MateraMany studies have been conducted to evaluate the association between air pollution and adverse health effects using a wide variety of methods to assess exposure. However, the assessment of individual long-term exposure to ambient air pollution is a challenging task and has not been evaluated in a large autopsy study. Our goal was to investigate whether exposure to urban air pollution is associated to the degree of lung anthracosis, considering modifying factors such as personal habits, mobility patterns and occupational activities. We conducted a study in Sao Paulo, Brazil from February 2017 to June 2018, combining epidemiological, spatial analysis and autopsybased approaches. Information about residential address, socio-demographic details, occupation, smoking status, time of residence in the city and time spent commuting was collected via questionnaires applied to the next-ofkin. Images of the pleura surface from upper and lower lobes were used to quantify anthracosis in the lungs. We used multiple regression models to assess the association between the amount of carbon deposits in human lungs, measured by the fraction of pleural anthracosis (FA), and potential explanatory variables. We analyzed 413 cases and our data showed that for each additional hour spent in daily commuting, the ratio FA/(1-FA) is multiplied by 1.05 (95% confidence interval: [1.02; 1.08]). The estimated coefficient for daily hours spent in traffic was not considerably affected by the inclusion of socio-demographic variables and smoking habits. We estimate a tobacco equivalent dose of 5 cigarettes per day in a city where annual PM2.5 concentration oscillates around 25 mu g/m(3). Pleural anthracosis is a potential index of lifetime exposure to traffic-derived air pollution.
- 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 ConceicaoBackground: 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.
- Atherosclerotic process in taxi drivers occupationally exposed to air pollution and co-morbidities(2014) BRUCKER, Natalia; CHARAO, Mariele F.; MORO, Angela M.; FERRARI, Pedro; BUBOLS, Guilherme; SAUER, Elisa; FRACASSO, Rafael; DURGANTE, Juliano; THIESEN, Flavia V.; DUARTE, Marta M.; GIODA, Adriana; CASTRO, Iran; SALDIVA, Paulo H.; GARCIA, Solange C.Consistent evidence has indicated that the exposure to environmental air pollution increases the risk of cardiovascular disease. This study aimed to evaluate the possible effects of occupational exposure to air pollution, especially to polycyclic aromatic hydrocarbons (PAHs), and the influence of co-morbidities on the atherosclerotic process and inflammation. For that, biomarkers of exposure such as 1-hydroxypyrene urinary, oxidative damage and markers of cardiovascular risk were determined in plasma, serum and blood. In addition, inflammation models such as carotid intima-media thickness and serum inflammatory cytokines were analyzed in 58 taxi drivers with and without co-morbidity. The results demonstrated that considering only taxi drivers without co-morbidities, 15% presented carotid intima-media thickness above reference values. For the first time it has been demonstrated that urinary 1-hydroxypyrene levels were associated with carotid intima-media thickness and with serum homocysteine levels. The multiple linear regression analysis showed that several factors may contribute to the increased carotid intima-media thickness, among which age, interleukin-6, fibrinogen and exposure to PAHs stand out. In summary, our results suggest that chronic occupational exposure to atmospheric pollution could be an additional contributor to the atherogenesis process, leading to impaired vascular health. Moreover, carotid intima-media thickness, serum homocysteine levels, fibrinogen and the total cholesterol/HDL-c ratio could be suggested as preventive measures to monitor drivers' health.
- Impaired lung function in individuals chronically exposed to biomass combustion(2012) SILVA, Luiz Fernando Ferraz da; SALDIVA, Silvia Regina Dias Medici; SALDIVA, Paulo Hilario Nascimento; DOLHNIKOFF, MarisaBackground: The use of biomass for cooking and heating is considered an important factor associated with respiratory diseases. However, few studies evaluate the amount of particulate matter less than 2.5 mu in diameter (PM2.5), symptoms and lung function in the same population. Objectives: To evaluate the respiratory effects of biomass combustion and compare the results with those of individuals from the same community in Brazil using liquefied petroleum gas (Gas). Methods: 1402 individuals in 260 residences were divided into three groups according to exposure (Gas, Indoor-Biomass, Outside-Biomass). Respiratory symptoms were assessed using questionnaires. Reflectance of paper filters was used to assess particulate matter exposure. In 48 residences the amount of PM2.5 was also quantified. Pulmonary function tests were performed in 120 individuals. Results: Reflectance index correlated directly with PM2.5 (r=0.92) and was used to estimate exposure (ePM2.5). There was a significant increase in ePM2.5 in Indoor-Biomass and Outside-Biomass, compared to Gas. There was a significantly increased odds ratio (OR) for cough, wheezing and dyspnea in adults exposed to Indoor-Biomass (OR=2.93, 2.33, 2.59, respectively) and Outside-Biomass (OR=1.78, 1.78, 1.80, respectively) compared to Gas. Pulmonary function tests revealed both Non-Smoker-Biomass and Smoker-Gas individuals to have decreased %predicted-forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity (FVC) as compared to Non-Smoker-Gas. Pulmonary function tests data was inversely correlated with duration and ePM2.5. The prevalence of airway obstruction was 20% in both Non-Smoker-Biomass and Smoker-Gas subjects. Conclusion: Chronic exposure to biomass combustion is associated with increased prevalence of respiratory symptoms, reduced lung function and development of chronic obstructive pulmonary disease. These effects are associated with the duration and magnitude of exposure and are exacerbated by tobacco smoke.
- Association of pulmonary black carbon accumulation with cardiac fibrosis in residents of Sao Paulo, Brazil(2024) TAKANO, Ana Paula Cremasco; ANDRE, Carmen Diva Saldiva de; ALMEIDA, Raquel de; WAKED, Dunia; VERAS, Mariana Matera; SALDIVA, Paulo Hilario NascimentoEvidence suggests that myocardial interstitial fibrosis, resulting from cardiac remodeling, may possibly be influenced by mechanisms activated through the inhalation of airborne pollutants. However, limited studies have explored the relationship between lifetime exposure to carbon-based particles and cardiac fibrosis, specially using post -mortem samples. This study examined whether long -term exposure to air pollution (estimated by black carbon accumulated in the lungs) is associated with myocardial fibrosis in urban dwellers of megacity of Sao Paulo. Data collection included epidemiological and autopsy-based approaches. Information was obtained by interviewing the next of kin and through the pathologist's report. The individual index of exposure to carbonbased particles, which we designed as the fraction of black carbon (FBC), was estimated through quantification of particles on the macroscopic lung surface. Myocardium samples were collected for histopathological analysis to evaluate the fraction of cardiac fibrosis. The association between cardiac fibrosis and FBC, age, sex, smoking status and hypertension was assessed by means of multiple linear regression models. Our study demonstrated that the association of FBC with cardiac fibrosis is influenced by smoking status and hypertension. Among hypertensive individuals, the cardiac fibrosis fraction tended to increase with the increase of the FBC in both groups of smokers and non-smokers. In non-hypertensive individuals, the association between cardiac fibrosis fraction and FBC was observed primarily in smokers. Long -term exposure to tobacco smoke and environmental particles may contribute to the cardiac remodeling response in individuals with pre-existing hypertension. This highlights the importance of considering hypertension as an additional risk factor for the health effects of air pollution on the cardiovascular system. Moreover, the study endorses the role of autopsy to investigate the effects of urban environment and personal habits in determining human disease.