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Made available in DSpace on 2018-11-26T15:47:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01. Added 1 bitstream(s) on 2019-10-09T18:25:23Z : No. of bitstreams: 1 S0102-311X2018000305008.pdf: 594554 bytes, checksum: 9ae34bd84d4cdedde32a57b29fe1c409 (MD5) Exposure to air pollutants, usually measured by environmental agencies that are not present in all states, may be associated with respiratory admissions in children. An ecological time series study was conducted with data on hospitalizations due to selected respiratory diseases in children under 10 years of age in 2012 in the city of Cuiaba, Mato Grosso State, Brazil. Mean levels of fine particulate matter (PM2.5) were estimated with a mathematical model, data on low temperatures and relative humidity were obtained from the Brazilian National Institute of Meteorology, and the numbers of brush burnings were obtained from the Environmental Information System. The statistical approach used the Poisson regression generalized additive model with lags of 0 to 7 days. The financial costs and increases in hospitalizations due to increments in PM2.5 were estimated. There were 565 hospitalizations (mean 1.54 admissions/day; SD = 1.52), and mean PM2.5 concentration was 15.7 mu g/m(3) (SD = 3.2). Associations were observed between exposure and hospitalizations in the second semester at lags 2 and 3, and at lag 2 when the entire year was analyzed. An increment of 5 mu g/m(3) in PM2.5 was associated with an increase of 89 hospitalizations and costs exceeding BRL 95,000 (approximate to USD 38,000) for the Brazilian Unified National Health System. Data estimated by mathematical models can be used in locations where pollutants are not monitored. Univ Estadual Paulista, Guaratingueta, Brazil Univ Taubate, Taubate, Brazil Univ Estadual Paulista, Guaratingueta, Brazil

Submitted by ADRIAN BLANCO MACHIN null (adrianbmachin@gmail.com) on 2017-03-14T13:29:14Z No. of bitstreams: 1 Adrian Blanco Machín-Dissertação de Mestrado- final 14-03-2017.pdf: 1853025 bytes, checksum: 544dbb6da4b5dcfa7c906eb007faba28 (MD5) Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2017-03-20T22:11:28Z (GMT) No. of bitstreams: 1 machin_ab_me_guara.pdf: 1853025 bytes, checksum: 544dbb6da4b5dcfa7c906eb007faba28 (MD5) Made available in DSpace on 2017-03-20T22:11:28Z (GMT). No. of bitstreams: 1 machin_ab_me_guara.pdf: 1853025 bytes, checksum: 544dbb6da4b5dcfa7c906eb007faba28 (MD5) Previous issue date: 2017-02-06 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) A poluição do ar é uma das principais causas de internação por doenças do aparelho respiratório. Efeitos negativos na saúde devido à exposição aos poluentes atmosféricos vêm causando aumentos nas internações hospitalares. O objetivo desse estudo consiste em identificar a associação entre a exposição ao material particulado fino, ajustado pelo monóxido de carbono sobre as internações hospitalares da rede pública por algumas doenças respiratórias na população de Cuiabá, MT, no período de 01 de janeiro de 2012 a 31 de dezembro de 2013. A metodologia utilizada fundamenta-se na pesquisa de estudo ecológico de série temporal. A variável dependente considerada foi o número de internações hospitalares concernentes às doenças: traqueite e laringite (J04.0 - J04.9), pneumonia (J12.0 - J18.9), bronquite e bronquiolite (J20.0 - J21.9), doença pulmonar obstructiva cônica (J44.0 - J44.9) e asma (J45.0 - J45.9), que representam em torno de 75% do total das doenças respiratórias (J00.0 – J99.9) e cujos códigos correspondem à CID 10, esses dados foram obtidos do DATASUS. As variáveis independentes consideradas foram as concentrações diárias dos poluentes PM2,5 e CO, estimados pelo modelo matemático CCATT-BRAMS. Os dados temperatura mínima e umidade relativa do ar foram obtidos do Instituto Nacional de Meteorologia e número de focos de queimadas do Sistema de Informações Ambientais. A abordagem estatística utilizou o modelo linear generalizado da regressão de Poisson com defasagens de 0 a 7 dias. Foram estimados custos financeiros e aumentos no número de internações decorrentes de aumentos na concentração de PM2,5 no ar. Os coeficientes fornecidos pela regressão de Poisson foram convertidos em risco relativo de internação adotando alfa = 5%. Foram 4998 internações segundo diagnóstico J-00 a J99 no período estudado, sendo 3876 internações (76,8%) por doenças específicas. A exposição ao PM2,5 quando ajustado com o CO, constitui fator de risco de internação nos 7 lags considerados, com valores entre RR=1,09 (IC95% 1,06 - 1,12) no Lag 7 e RR=1,12 (IC95% 1,09 – 1,15) no Lag 0, devido a que o CO potencializou a ação do PM2,5. Um aumento de 5 µg/m3 na concentração de PM2,5 implicou num aumento de até 1670 internações e custos acima dos R$ 1,68 milhão para o Sistema de Saúde Pública. Verificou-se portanto a associação da exposição a poluentes do ar e internações por doenças respiratórias bem como a exeqüibilidade de uso de modelo matemático. Air pollution is one of the main causes of hospitalization for respiratory diseases. Negative health effects due to exposure to air pollutants are causing increases in hospital admissions. The objective of this study is to identify the association between exposure to fine particles, adjusted for carbon monoxide and hospitalizations in Public Health System by some respiratory diseases in the population of Cuiabá, MT, in the period of January 1, 2012 To December 31, 2013. The methodology used is based on the ecological study of time series. The dependent variable was the number of hospital admissions in relation to diseases: tracheitis and laryngitis (J04.0 - J04.9), pneumonia (J12.0 - J18.9), bronchitis and bronchiolitis (J20.0 - J21. 9), congestive pulmonary disease (J44.0 - J44.9), and asthma (J45.0 - J45.9), which account for about 75% of all respiratory diseases (J00.0 - J99.9) And whose codes correspond to ICD-10, these data were obtained from DATASUS. The independent variables were the daily concentration of pollutants PM2,5 and CO, estimated by the mathematical model CCATT-BRAMS. Data of minimum temperature and the relative humidity were obtained from the National Institute of Meteorology and the number of fires from the system of environmental information. The statistical approach used the linear model of Poisson regression with delay of 0 to 7 days (lag0 to lag7). Financial expenses and increases in the number of hospitalizations due to the increase in the PM2,5 concentration in the air were estimated. The coefficients provided by the Poisson regression became the relative risk of hospitalization considering alpha = 5%. There were 4998 hospitalizations according to J-00 to J99 diagnoses in the study period, with 3876 hospitalizations (76.8%) for the specific diseases. Exposure to PM2,5 when adjusted for CO, constitutes a risk factor for hospitalization in the 7 considered lags, ranging from RR = (CI 95%: 1.06 to 1.12) 1.09 in Lag 7 and RR = 1.12 (95% CI: 1.09 to 1.15) in Lag 0, because CO increases the action of PM2,5. An increase of 5 µg/m3 in the concentration of PM2,5 resulted in an increase up to 1670 hospitalizations and costs of R$ 1,68 million for the Public Health System. Therefore, the association of exposure to air pollutants and hospitalizations due to respiratory diseases, as well as the viability of the mathematical model in use, were verified. CNPq:190432/2014-4