Air pollution effects on myocardial infarction

Detalhes bibliográficos
Autor(a) principal: Cendon Filha, Sônia Perez [UNIFESP]
Data de Publicação: 2006
Outros Autores: Pereira, Luiz Alberto Amador [UNIFESP], Braga, Alfésio Luís Ferreira [UNIFESP], Conceição, Gleice Margarete de Souza [UNIFESP], Cury Junior, Abraão [UNIFESP], Romaldini, Hélio [UNIFESP], Lopes, Antonio Carlos [UNIFESP], Saldiva, Paulo Hilário Nascimento
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0034-89102006000300008
http://repositorio.unifesp.br/handle/11600/3070
Resumo: OBJECTIVE: Myocardial infarction is an acute and severe cardiovascular disease that generally leads to patient admissions to intensive care units and few cases are initially admitted to infirmaries. The objective of the study was to assess whether estimates of air pollution effects on myocardial infarction morbidity are modified by the source of health information. METHODS: The study was carried out in hospitals of the Brazilian Health System in the city of São Paulo, Southern Brazil. A time series study (1998-1999) was performed using two outcomes: infarction admissions to infirmaries and to intensive care units, both for people older than 64 years of age. Generalized linear models controlling for seasonality (long and short-term trends) and weather were used. The eight-day cumulative effects of air pollutants were assessed using third degree polynomial distributed lag models. RESULTS: Almost 70% of daily hospital admissions due to myocardial infarction were to infirmaries. Despite that, the effects of air pollutants on infarction were higher for intensive care units admissions. All pollutants were positively associated with the study outcomes but SO2 presented the strongest statistically significant association. An interquartile range increase on SO2 concentration was associated with increases of 13% (95% CI: 6-19) and 8% (95% CI: 2-13) of intensive care units and infirmary infarction admissions, respectively. CONCLUSIONS: It may be assumed there is a misclassification of myocardial infarction admissions to infirmaries leading to overestimation. Also, despite the absolute number of events, admissions to intensive care units data provides a more adequate estimate of the magnitude of air pollution effects on infarction admissions.
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spelling Air pollution effects on myocardial infarctionEfeitos da poluição do ar no infarto do miocárdioAir pollutionCardiovascular diseasesTime-series studyPoluição do arDoenças cardiovascularesOBJECTIVE: Myocardial infarction is an acute and severe cardiovascular disease that generally leads to patient admissions to intensive care units and few cases are initially admitted to infirmaries. The objective of the study was to assess whether estimates of air pollution effects on myocardial infarction morbidity are modified by the source of health information. METHODS: The study was carried out in hospitals of the Brazilian Health System in the city of São Paulo, Southern Brazil. A time series study (1998-1999) was performed using two outcomes: infarction admissions to infirmaries and to intensive care units, both for people older than 64 years of age. Generalized linear models controlling for seasonality (long and short-term trends) and weather were used. The eight-day cumulative effects of air pollutants were assessed using third degree polynomial distributed lag models. RESULTS: Almost 70% of daily hospital admissions due to myocardial infarction were to infirmaries. Despite that, the effects of air pollutants on infarction were higher for intensive care units admissions. All pollutants were positively associated with the study outcomes but SO2 presented the strongest statistically significant association. An interquartile range increase on SO2 concentration was associated with increases of 13% (95% CI: 6-19) and 8% (95% CI: 2-13) of intensive care units and infirmary infarction admissions, respectively. CONCLUSIONS: It may be assumed there is a misclassification of myocardial infarction admissions to infirmaries leading to overestimation. Also, despite the absolute number of events, admissions to intensive care units data provides a more adequate estimate of the magnitude of air pollution effects on infarction admissions.OBJETIVO: O infarto do miocárdio é uma doença cardiovascular grave que tem como indicação a internação em unidades de terapia intensiva, com poucos indicados para admissão em enfermarias. O objetivo do estudo foi investigar se as estimativas dos efeitos da poluição atmosférica nas internações por infarto do miocárdio são modificadas de acordo com a fonte de informações de saúde. MÉTODOS: Em hospitais do Sistema Único de Saúde (SUS), na cidade de São Paulo, foi realizado estudo de séries temporais (1998-1999) tendo como desfechos as internações por infarto em unidades de terapia intensiva e em enfermarias, em pessoas acima de 64 anos. Foram utilizados modelos lineares generalizados, controlados para sazonalidade (de longa e curta duração) e variáveis climáticas. Foram construídos modelos distribuídos de defasagem polinomial de terceiro grau, para avaliar os efeitos acumulados nos oito dias anteriores à exposição. RESULTADOS: Aproximadamente 70% das internações por infarto no miocárdio ocorreram em enfermarias. Apesar disso, os efeitos da poluição sobre os casos foram maiores nas internações em unidades de terapia intensiva. Todos os poluentes mostraram uma associação positiva com os desfechos, mas o SO2 apresentou uma associação mais robusta e estatisticamente significante. O aumento do intervalo interquartil para as concentrações observadas do SO2 foi associado ao aumento em 13% (IC 95%: 6-19) e 8% (IC 95%: 2-13) nas internações em unidade de terapia intensiva e enfermarias, respectivamente. CONCLUSÕES: Pode-se supor que exista um erro de classificação das internações por infarto nas enfermarias, superestimando o número de internações. No entanto, o menor número de internações por infarto do miocárdio em unidades de terapia intensiva, é o indicador mais adequado para estimar os efeitos da poluição atmosférica nas internações por infarto.Universidade Federal de São Paulo (UNIFESP) Faculdade de Medicina Departamento de Clínica MédicaUniversidade de São Paulo Faculdade de Medicina Laboratório de Poluição AtmosféricaUNIFESP, Faculdade de Medicina Depto. de Clínica MédicaSciELOFaculdade de Saúde Pública da Universidade de São PauloUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)Cendon Filha, Sônia Perez [UNIFESP]Pereira, Luiz Alberto Amador [UNIFESP]Braga, Alfésio Luís Ferreira [UNIFESP]Conceição, Gleice Margarete de Souza [UNIFESP]Cury Junior, Abraão [UNIFESP]Romaldini, Hélio [UNIFESP]Lopes, Antonio Carlos [UNIFESP]Saldiva, Paulo Hilário Nascimento2015-06-14T13:32:07Z2015-06-14T13:32:07Z2006-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion414-419application/pdfhttp://dx.doi.org/10.1590/S0034-89102006000300008Revista de Saúde Pública. Faculdade de Saúde Pública da Universidade de São Paulo, v. 40, n. 3, p. 414-419, 2006.10.1590/S0034-89102006000300008S0034-89102006000300008.pdf0034-8910S0034-89102006000300008http://repositorio.unifesp.br/handle/11600/3070engRevista de Saúde Públicainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-05T19:50:08Zoai:repositorio.unifesp.br/:11600/3070Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-05T19:50:08Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Air pollution effects on myocardial infarction
Efeitos da poluição do ar no infarto do miocárdio
title Air pollution effects on myocardial infarction
spellingShingle Air pollution effects on myocardial infarction
Cendon Filha, Sônia Perez [UNIFESP]
Air pollution
Cardiovascular diseases
Time-series study
Poluição do ar
Doenças cardiovasculares
title_short Air pollution effects on myocardial infarction
title_full Air pollution effects on myocardial infarction
title_fullStr Air pollution effects on myocardial infarction
title_full_unstemmed Air pollution effects on myocardial infarction
title_sort Air pollution effects on myocardial infarction
author Cendon Filha, Sônia Perez [UNIFESP]
author_facet Cendon Filha, Sônia Perez [UNIFESP]
Pereira, Luiz Alberto Amador [UNIFESP]
Braga, Alfésio Luís Ferreira [UNIFESP]
Conceição, Gleice Margarete de Souza [UNIFESP]
Cury Junior, Abraão [UNIFESP]
Romaldini, Hélio [UNIFESP]
Lopes, Antonio Carlos [UNIFESP]
Saldiva, Paulo Hilário Nascimento
author_role author
author2 Pereira, Luiz Alberto Amador [UNIFESP]
Braga, Alfésio Luís Ferreira [UNIFESP]
Conceição, Gleice Margarete de Souza [UNIFESP]
Cury Junior, Abraão [UNIFESP]
Romaldini, Hélio [UNIFESP]
Lopes, Antonio Carlos [UNIFESP]
Saldiva, Paulo Hilário Nascimento
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
dc.contributor.author.fl_str_mv Cendon Filha, Sônia Perez [UNIFESP]
Pereira, Luiz Alberto Amador [UNIFESP]
Braga, Alfésio Luís Ferreira [UNIFESP]
Conceição, Gleice Margarete de Souza [UNIFESP]
Cury Junior, Abraão [UNIFESP]
Romaldini, Hélio [UNIFESP]
Lopes, Antonio Carlos [UNIFESP]
Saldiva, Paulo Hilário Nascimento
dc.subject.por.fl_str_mv Air pollution
Cardiovascular diseases
Time-series study
Poluição do ar
Doenças cardiovasculares
topic Air pollution
Cardiovascular diseases
Time-series study
Poluição do ar
Doenças cardiovasculares
description OBJECTIVE: Myocardial infarction is an acute and severe cardiovascular disease that generally leads to patient admissions to intensive care units and few cases are initially admitted to infirmaries. The objective of the study was to assess whether estimates of air pollution effects on myocardial infarction morbidity are modified by the source of health information. METHODS: The study was carried out in hospitals of the Brazilian Health System in the city of São Paulo, Southern Brazil. A time series study (1998-1999) was performed using two outcomes: infarction admissions to infirmaries and to intensive care units, both for people older than 64 years of age. Generalized linear models controlling for seasonality (long and short-term trends) and weather were used. The eight-day cumulative effects of air pollutants were assessed using third degree polynomial distributed lag models. RESULTS: Almost 70% of daily hospital admissions due to myocardial infarction were to infirmaries. Despite that, the effects of air pollutants on infarction were higher for intensive care units admissions. All pollutants were positively associated with the study outcomes but SO2 presented the strongest statistically significant association. An interquartile range increase on SO2 concentration was associated with increases of 13% (95% CI: 6-19) and 8% (95% CI: 2-13) of intensive care units and infirmary infarction admissions, respectively. CONCLUSIONS: It may be assumed there is a misclassification of myocardial infarction admissions to infirmaries leading to overestimation. Also, despite the absolute number of events, admissions to intensive care units data provides a more adequate estimate of the magnitude of air pollution effects on infarction admissions.
publishDate 2006
dc.date.none.fl_str_mv 2006-06-01
2015-06-14T13:32:07Z
2015-06-14T13:32:07Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0034-89102006000300008
Revista de Saúde Pública. Faculdade de Saúde Pública da Universidade de São Paulo, v. 40, n. 3, p. 414-419, 2006.
10.1590/S0034-89102006000300008
S0034-89102006000300008.pdf
0034-8910
S0034-89102006000300008
http://repositorio.unifesp.br/handle/11600/3070
url http://dx.doi.org/10.1590/S0034-89102006000300008
http://repositorio.unifesp.br/handle/11600/3070
identifier_str_mv Revista de Saúde Pública. Faculdade de Saúde Pública da Universidade de São Paulo, v. 40, n. 3, p. 414-419, 2006.
10.1590/S0034-89102006000300008
S0034-89102006000300008.pdf
0034-8910
S0034-89102006000300008
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Revista de Saúde Pública
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 414-419
application/pdf
dc.publisher.none.fl_str_mv Faculdade de Saúde Pública da Universidade de São Paulo
publisher.none.fl_str_mv Faculdade de Saúde Pública da Universidade de São Paulo
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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