Relação entre poluição do ar e interações por insuficiência cardíaca congestiva, em adultos e idosos, na cidade de São Paulo, estratificado por sexo, explorando estruturas de defasagens, para o período de 2000 a 2013.

• Autor(a) principal: Pamplona, Ysabely de Aguuiar Pontes
• Data de Publicação: 2016
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UNISANTOS
• Texto Completo: https://tede.unisantos.br/handle/tede/2401
• topic: insuficiência cardíaca congestiva; poluição do ar; adulto; idoso; congestive heart failure; air pollution; adult; elderly; CIENCIAS DA SAUDE::SAUDE COLETIVA

Although there are robust evidence on the effects of exposure to air pollution on cardiovascular disease, little has been studied about the modification of this relationship induced by age and sex. This study aims to evaluate the relationship between air pollution and hospital admissions for Congestive Heart Failure (CHF) in adults and elderly in the city of São Paulo, stratified by sex, exploiting gaps structures for the 2000-2013 period. This is an ecological time series study, which uses hospital admissions information obtained from the Brazilian Unified Database Health (DATASUS), information on the daily levels of PM10, SO2, O3, NO2, CO, minimum temperature and average relative humidity were obtained from the Environmental Agency of the State of São Paulo (CETESB). A descriptive analysis was performed and calculated the Pearson correlation coefficient. To assess the relationship between exposure to pollutants and the outcomes of interest was used linear polynomial models with generalized Poisson regression exploring lags structures of up to 7 days. The models were adjusted for short and long term, and weather variables seasonality. The significance level was 5%. Results showed that contaminants were directly correlated (p <0.001), and inversely correlated with weather variables (p < 0.001), except O3, which was directly correlated with temperature (p <0.001). For the increase of one interquartile (7.63¿g/m3) in the SO2 level among adults (45-60 years) was related to the increase in hospital admissions for CHF of 5.32% (CI95%: 5.29-5.36) for women and 7.75% (CI95%: 7.53-7.96) for men in the first two days after exposure. In the group of elderly (60 years old) this increase raised admissions for CHF in 6.69% (CI95%: 6.62-6.75) for women and 5.83% (CI95%: 5.75¿5.90) for men in the first two days after exposure. For PM10 in relation to adults (45-60 years) an increase of 24.28¿g/m3 increased hospitalizations for ICC in 11.38% (CI95%: 10.68-12.09) for women and 4.08% (CI95%: 4.04-4.12) for men in the first three days after exposure. In the group of elderly (60 years old) there was an increase of 6.92% (CI95%: 6.86-6.98) for women and 5.97% (CI95%: 5.90-6 04) for men in the first two days after exposure in hospitalizations for ICC. The adverse effects of SO2 on CHF admissions in adult were higher men than in women. However, in the elderly group the adverse effects of SO2 on CHF admissions were higher in the women's groups. As for PM10, women seem to be more susceptible than men due to the adverse effects of PM10 on admissions for CHF, especially in the younger age group. It is concluded that the effect of air pollutants in admissions for CHF differ by age and sex.