1. Pleural anthracosis as an indicator of lifetime exposure to urban air pollution: An autopsy-based study in Sao Paulo
- Author
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Lisie Tocci Justo, Julio M. Singer, Carmen Diva Saldiva de André, Mônica V. Marquezini, Carlos Augusto Pasqualucci, Ligia Vizeu Barrozo, Paulo Hilário Nascimento Saldiva, Francisco Marcelo Monteiro da Rocha, Paulo Afonso de André, Ana Paula Cremasco Takano, Nathalia Villa dos Santos, and Mariana Matera Veras
- Subjects
medicine.medical_specialty ,Air pollution ,Autopsy ,010501 environmental sciences ,medicine.disease_cause ,01 natural sciences ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Air Pollution ,Environmental health ,Linear regression ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Anthracosis ,0105 earth and related environmental sciences ,General Environmental Science ,Lifetime exposure ,Air Pollutants ,business.industry ,Environmental Exposure ,Confidence interval ,POLUIÇÃO ATMOSFÉRICA ,Pleura ,Smoking status ,business ,Brazil - Abstract
Many 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 autopsy-based 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-of-kin. 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 μg/m3. Pleural anthracosis is a potential index of lifetime exposure to traffic-derived air pollution.
- Published
- 2019