Skip to main content

Advertisement

SpringerLink
Log in

Avoiding hospital admissions for respiratory system diseases by complying to the final Brazilian air quality standard: an estimate for Brazilian southeast capitals

  • Urban Air Quality, Climate and Pollution: From Measurement to Modeling Applications
  • Published:
Environmental Science and Pollution Research Aims and scope Submit manuscript

Abstract

According to the World Health Organization (WHO), in 2016, 91% of the global population was living in places where guidelines on air quality were not met, which results in an estimated figure of seven million deaths annually. The new Brazilian air quality standards, CONAMA 491/2018, was the first revision in over two decades and has as final target the WHO guidelines for air quality, although no deadline has been established for implementation. The goal of this work was to quantify public health gains of this new policy based on hospitalizations due to respiratory diseases, the most studied outcome in Brazilian time series studies, in four Brazilian Southeast capitals: São Paulo (SP), Rio de Janeiro (RJ), Belo Horizonte (MG), and Vitória (ES) for PM10, PM2,5, SO2, CO, and O3. Population and hospitalizations data for all respiratory diseases for people under 5 years old, over 64 years old, most vulnerable populations, and all ages were analyzed. The air quality monitoring data was analyzed in two different periods: 2016 to 2018 for São Paulo and Vitória; and between 2015 and 2017 for Belo Horizonte and Rio de Janeiro, according to available monitoring data. A literature review was carried out to determine the appropriate relative risk to be used in the estimations, and the public health gains were calculated based on the selected relative risks for each city. The highest estimate was for São Paulo, with 3454 avoidable respiratory hospital admissions (all ages). In total, the four cities accounted for 4148 avoidable hospitalizations, which was associated to $1.1 million public health gains. Results considering the day of exposure (lag 0) were superior to those with the 5-day moving average (lag 5). The results highlighted the importance of adopting more restrictive standards and called for public policies, the necessity of expanding the air quality monitoring network, mapping emission sources, and improve the knowledge about the interaction between air pollution and health outcomes beyond respiratory disease for the region.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  • Agudelo-Castañeda DM, Teixeira EC, Alves L, Fernández-Niño JA, Rodríguez-Villamizar LA (2019) Monthly-term associations between air pollutants and respiratory morbidity in South Brazil 2013–2016: a multi-city, time-series analysis. Int J Environ Res Public Health 16:3787. https://doi.org/10.3390/ijerph16203787

    Article  CAS  Google Scholar 

  • Albuquerque TT, West J, Andrade MF et al (2019) Analysis of PM 2.5 concentrations under pollutant emission control strategies in the metropolitan area of São Paulo, Brazil. Environ Sci Pollut Res 26(32):33216–33227

    Google Scholar 

  • Andrade MF, Kumar P, de Freitas ED, Ynoue RY, Martins J, Martins LD et al (2017) Air quality in the megacity of São Paulo: evolution over the last 30 years and future perspectives. Atmos Environ 159:66–82

    CAS  Google Scholar 

  • Andreão WL, Albuquerque TT, Kumar P (2018) Excess deaths associated with fine particulate matter in Brazilian cities. Atmos Environ 194:71–81

    Google Scholar 

  • Araújo MRM, Oliveira JM, Jesus MS, Sá NR, Santos PAC, Lima TC (2011) Transporte público coletivo: discutindo acessibilidade, mobilidade e qualidade de vida. Psicologia & Sociedade 23(3):574–582

    Google Scholar 

  • Arbex MA, Santos UDP, Martins LC, Saldiva PHN, Pereira LAA, Braga ALF (2012) A poluição do ar e o sistema respiratório. J Bras Pneumol 38(5):643–655

    Google Scholar 

  • Bakonyi SMC, Danni-Oliveira IM, Martins LC, Braga ALF (2004) Poluição atmosférica e doenças respiratórias em crianças na cidade de Curitiba, PR. Rev Saude Publica 38:695–700

    Google Scholar 

  • Boldo E, Linares C, Aragonés N, Lumbreras J, Borge R, de la Paz D, Pérez-Gómez B, Fernández-Navarro P, García-Pérez J, Pollán M, Ramis R, Moreno T, Karanasiou A, López-Abente G (2014) Air quality modeling and mortality impact of fine particles reduction policies in Spain. Environ Res 128:15–26

    CAS  Google Scholar 

  • Braga ALF, Conceição GM, Pereira LA, Kishi HS, Pereira JC, Andrade MF et al (1999) Air pollution and pediatric respiratory hospital admissions in São Paulo. Brazil J Environ Med 1:95–102

    Google Scholar 

  • Braga ALF, Pereira LAA, Procópio M, André PAD, Saldiva PHDN (2007) Association between air pollution and respiratory and cardiovascular diseases in Itabira, Minas Gerais State, Brazil. Cadernos de Saúde Pública 23:S570–S578

    Google Scholar 

  • Braga ALF, Saldiva PH, Pereira LA, Menezes JJ, Conceição GM, Lin CA, Zanobetti A, Schwartz J, Dockery DW (2001) Health effects of air pollution exposure on children and adolescents in São Paulo, Brazil. Pediatr Pulmonol 31:106–113

    CAS  Google Scholar 

  • Cançado JE, Saldiva PH, Pereira LA, Lara LB, Artaxo P, Martinelli LA, Arbex MA, Zanobetti A, Braga AL (2006) The impact of sugar cane–burning emissions on the respiratory system of children and the elderly. Environ Health Perspect 114(5):725–729

    Google Scholar 

  • Carmo CND, Hacon S, Longo KM, Freitas S, Ignotti E, Leon APD, Artaxo P (2010) Associação entre material particulado de queimadas e doenças respiratórias na região sul da Amazônia brasileira. Rev Panam Salud Publica 27:10–16

    Google Scholar 

  • Castro HAD, Cunha MFD, Mendonça GA, Junger WL, Cunha-Cruz J, Leon APD (2009) Effect of air pollution on lung function in schoolchildren in Rio de Janeiro, Brazil. Rev Saude Publica 43(1):26–34

    Google Scholar 

  • César ACG, Nascimento LFC, Carvalho JAD Jr (2013) Association between exposure to particulate matter and hospital admissions for respiratory disease in children. Rev Saude Publica 47(6):1209–1212

    Google Scholar 

  • CETESB – Environmental Company of the State of São Paulo (2017) Qualidade do Ar no Estado de São Paulo – 2016. São Paulo, Brazil

    Google Scholar 

  • CETESB – Environmental Company of the State of São Paulo (2018) Qualidade do Ar no Estado de São Paulo – 2017. São Paulo, Brazil

    Google Scholar 

  • CETESB – Environmental Company of the State of São Paulo (2019) Qualidade do Ar no Estado de São Paulo – 2018. São Paulo, Brazil

    Google Scholar 

  • Cortizo EC (2002) Mecanismos de avaliação ambiental: Estudo de caso Belvedere III, município de Belo Horizonte. Pontifícia Universidade Católica de MG, MSc Dissertation

    Google Scholar 

  • DATASUS (2019) Brasil (2019) "Departamento de Informática do SUS.". Ministério de Saúde do Brasil

  • Farhat SCL, Paulo RLP, Shimoda TM, Conceição GMDS, Lin CA, Braga ALF, Warth MPN, Saldiva PHN (2005) Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions. Braz J Med Biol Res 38(2):227–235

    CAS  Google Scholar 

  • Ferreira T, Forti M, de Freitas C, Nascimento F, Junger W, Gouveia N (2016) Effects of particulate matter and its chemical constituents on elderly hospital admissions due to circulatory and respiratory diseases. Int J Environ Res Public Health 13(10):947

    Google Scholar 

  • Franco JF, Gidhagen L, Morales R, Behrentz E (2019) Towards a better understanding of urban air quality management capabilities in Latin America. Environ Sci Pol 102:43–53

    Google Scholar 

  • Freitas C, Bremner SA, Gouveia N, Pereira LA, Saldiva PH (2004) Internações e óbitos e sua relação com a poluição atmosférica em São Paulo, 1993 a 1997. Rev Saude Publica 38:751–757

    Google Scholar 

  • Freitas CUD, Junger W, Leon APD, Grimaldi R, Silva MAFR, Gouveia N (2013) Poluição do ar em cidades brasileiras: selecionando indicadores de impacto na saúde para fins de vigilância. Epidemiologia e Serviços de Saúde 22(3):445–454

    Google Scholar 

  • Freitas CUD, Leon APD, Juger W, Gouveia N (2016) Poluição do ar e impactos na saúde em Vitória. Espírito Santo Rev Saúde Pública 50:4

    Google Scholar 

  • Freitas ED, Rozoff CM, Cotton WR, Dias PLS (2007) Interactions of an urban heat island and sea-breeze circulations during winter over the metropolitan area of São Paulo, Brazil. Bound-Layer Meteorol 122:43–65

    Google Scholar 

  • Galvão ES, Reis NC Jr, Lima AT, Stuetz RM, MTD’A O, Santos JM (2019) Use of inorganic and organic markers associated with their directionality for the apportionment of highly correlated sources of particulate matter. Sci Total Environ 651:1332–1343

    Google Scholar 

  • Godoy MLDP, Godoy JM, Roldão LA, Soluri DS, Donagemma RA (2009) Coarse and fine aerosol source apportionment in Rio de Janeiro, Brazil. Atmos Environ 43:2366–2374

    CAS  Google Scholar 

  • Gonçalves KDS, Castro HAD, Hacon SDS (2012) As queimadas na região amazônica e o adoecimento respiratório. Ciência & Saúde Coletiva 17:1523–1532

    Google Scholar 

  • Gouveia N, Corrallo FP, de Leon ACP, Junger W, de Freitas CU (2017) Poluição do ar e hospitalizações na maior metrópole brasileira. Rev Saude Pública 51:1–10. https://doi.org/10.11606/S1518-8787.2017051000223

    Article  Google Scholar 

  • Gouveia N, Fletcher T (2000a) Time series analysis of air pollution and mortality: effects by cause, age and socioeconomic status. J Epidemiol Community Health 54(10):750–755

    CAS  Google Scholar 

  • Gouveia N, Fletcher T (2000b) Respiratory diseases in children and outdoor air pollution in Sao Paulo, Brazil: a time series analysis. Occup Environ Med 57(7):477–483

    CAS  Google Scholar 

  • Gouveia N, Freitas CUD, Martins LC, Marcilio IO (2006) Respiratory and cardiovascular hospitalizations associated with air pollution in the city of São Paulo, Brazil. Cadernos de Saúde Pública 22(12):2669–2677

    Google Scholar 

  • Gouveia N, Leon AP, Junger W, Lins JDF, Freitas CU (2019) Air pollution and the impacts on health in the Metropolitan Region of Belo Horizonte in the state of Minas Gerais, Brazil. Ciencia & Saude Coletiva 24(10):3773–3781. https://doi.org/10.1590/1413-812320182410.29432017

    Article  Google Scholar 

  • Gouveia N, Mendonça GA, Leon APD, Correia JEDM, Junger WL, Freitas CUD et al (2003) Air pollution and health effects in two Brazilian Metropolis. Epidemiologia e Serviços de Saúde 12(1):29–40

    Google Scholar 

  • IBGE – Brazilian Institute of Geography and Statistics (2018) Produto Interno Bruto – PIB https://www.ibge.gov.br/explica/pib.php. Accessed in 05 July 2019

  • IBGE – Brazilian Institute of Geography and Statistics (2019a) Cidades – São Paulo. https://cidades.ibge.gov.br/brasil/sp/sao-paulo/panorama. Accessed in 05 July 2019

  • IBGE – Brazilian Institute of Geography and Statistics (2019b) Cidades – Rio de Janeiro. https://cidades.ibge.gov.br/brasil/rj/rio-de-janeiro/panorama. Accessed in 05 July 2019

  • IBGE – Brazilian Institute of Geography and Statistics (2019c) Cidades – Belo Horizonte. https://cidades.ibge.gov.br/brasil/mg/belo-horizonte/panorama. Accessed in 05 July 2019

  • IBGE – Brazilian Institute of Geography and Statistics (2019d) Cidades – Vitória. https://cidades.ibge.gov.br/brasil/es/vitoria/panorama. Accessed in 05 July 2019

  • IEMA – Energy and Environment Institute (2014) 1o Diagnóstico da rede de monitoramento da qualidade do ar no Brasil. São Paulo: Instituto de Energia e Meio Ambiente

  • IEMA – Environmental Company of the state of Espírito Santo (2019) Inventário de emissões atmosféricas Região da Grande Vitória ano-base 2015. Vitória: IEMA/EcoSoft

  • INEA - State Institute of the Environment (2016) Relatório da Qualidade do Ar do Estado do Rio de Janeiro - Ano Base 2015. Rio de Janeiro, Brazil, 1, http://www.inea.rj.gov.br/wp-content/uploads/2019/01/RQAr_2015.pdf (2016).

  • Ignotti E, Hacon SDS, Junger WL, Mourão D, Longo K, Freitas S et al (2010) Air pollution and hospital admissions for respiratory diseases in the subequatorial Amazon: a time series approach. Cadernos de Saúde Pública 26:747–761

    Google Scholar 

  • Jasinski R, Pereira LAA, Braga ALF (2011) Air pollution and pediatric hospital admissions due to respiratory diseases in Cubatão, São Paulo State, Brazil, from 1997 to 2004. Cadernos de Saúde Pública 27(11):2242–2252

    Google Scholar 

  • Lessa DA, Miranda GC, Lobo C, Cardoso L (2019) A mobilidade urbana em Belo Horizonte/Minas Gerais/Brasil: indicadores e projeções para as viagens por automóveis. Revista Transporte y Territorio 20:288–306

    Google Scholar 

  • Machin AB, Nascimento LFC (2018) Efeitos da exposição a poluentes do ar na saúde das crianças de Cuiabá, Mato Grosso, Brasil. Cadernos de Saúde Pública 34:3

    Google Scholar 

  • Martins LC, Latorre MDRDD, Cardoso MRA, Gonçalves FLT, Saldiva PHN, Braga ALF (2002) Air pollution and emergency room visits due to pneumonia and influenza in Sao Paulo, Brazil. Rev Saude Publica 36(1):88–94

    Google Scholar 

  • Miranda RM, Andrade MF, Fornaro A, Astolfo R, Andre PA, Saldiva P (2012) Urban air pollution: a representative survey of PM2.5 mass concentrations in six Brazilian cities. Air Qual. Atmos. Health 5:63–77

    Google Scholar 

  • Moura M, Junger WL, Leon APD (2009) Air quality and emergency pediatric care for symptoms of bronchial obstruction categorized by age bracket in Rio de Janeiro, Brazil. Cadernos de Saúde Pública 25:635–644

    Google Scholar 

  • Nardocci AC, Freitas CUD, de Leon P, Monteiro AC, Junger WL, Gouveia NDC (2013) Air pollution and respiratory and cardiovascular diseases: a time series study in Cubatão, São Paulo State, Brazil. Cadernos de Saúde Pública 29(9):1867–1876

    Google Scholar 

  • Nascimento AP, Santos JM, Mill JG, de Souza JB, Júnior NCR, Reisen VA (2017) Associação entre concentração de partículas finas na atmosfera e doenças respiratórias agudas em crianças. Rev Saude Publica 51:3–3

    Google Scholar 

  • Nascimento LFC, Pereira LAA, Braga AL, Módolo MCC, Carvalho JA Jr (2006) Efeitos da poluição atmosférica na saúde infantil em São José dos Campos, SP. Rev Saude Publica 40:77–82

    Google Scholar 

  • Negrisoli J, Nascimento LFC (2013) Atmospheric pollutants and hospital admissions due to pneumonia in children. Rev Paul Pediatr 31(4):501–506

    Google Scholar 

  • Nogueira T, Cordeiro DS, Munoz RAA, Fornaro A, Miguel AH, Andrade MF (2015) Bioethanol and biodiesel as vehicular fuels in Brazil - assessment of atmospheric impacts from the long period of biofuels use. Biofuels – Status and Perspective. InTech, In. https://doi.org/10.5772/60944

    Book  Google Scholar 

  • Nogueira T, Dominutti PA, De Carvalho LRF, Fornaro A, Andrade MDF (2014) Formaldehyde and acetaldehyde measurements in urban atmosphere impacted by the use of ethanol biofuel: metropolitan area of Sao Paulo (MASP), 2012-2013. Fuel 134:505–513

    CAS  Google Scholar 

  • Onursal B, Gautam SP (1997) Vehicular air pollution: experiences from seven Latin American urban centres. World Bank Technical Paper No. 373, Washington

    Google Scholar 

  • Pacheco MT, Parmigiani MMM, de Fatima AM, Morawska L, Kumar P (2017) A review of emissions and concentrations of particulate matter in the three major metropolitan areas of Brazil. J Transp Health 4:53–72

    Google Scholar 

  • Pope CA III, Coleman N, Pond ZA, Burnett RT (2019) Fine particulate air pollution and human mortality: 25+ years of cohort studies. Environ Res 108924. https://doi.org/10.1016/j.envres.2019.108924

  • Rodriguez CAM, Rocha RP, Bombardi R (2010) On the development of summer thunderstorms in the city of São Paulo: mean meteorological characteristics and pollution effect. Atmos Res 96:477–488

    Google Scholar 

  • Sacks JD, Lloyd JM, Zhu Y, Anderton J, Jang CJ, Hubbell B, Fann N (2018) The environmental benefits mapping and analysis program–community edition (BenMAP–CE): a tool to estimate the health and economic benefits of reducing air pollution. Environ Model Softw 104:118–129

    Google Scholar 

  • Salvi SS, Barnes PJ (2009) Chronic obstructive pulmonary disease in non-smokers. Lancet 374(9691):733–743

    Google Scholar 

  • Santos FS, Miranda GA, Carvalho AMN, Carvalho VSB, Albuquerque TT (2019) Regulated air pollutant emissions from higher emitters stationary sources in Belo Horizonte, Minas Gerais, Brazil. Braz J Chem Eng 36(2). https://doi.org/10.1590/0104-6632.20190362s20180352

  • Santos FS (2018) Diagnóstico das emissões atmosféricas em Minas Gerais: um estudo para as fontes fixas e veiculares. Federal University of Minas Gerais, MSc Dissertation

    Google Scholar 

  • Silva AMCD, Mattos IE, Ignotti E, Hacon SDS (2013) Particulate matter originating from biomass burning and respiratory. Rev Saude Publica 47(2):345–352

    Google Scholar 

  • SISMOB-BH – System of information about accessibility and sustainability in Belo Horizonte (2015) Indicadores Populacionais. Prefeitura de Belo Horizonte https://prefeiturapbhgovbr/sites/default/files/imagens/authenticated%2C%20editor_a_bhtrans/item2_2_SisMobBH_DadosAbertos_Frota%20e%20condutores%20de%20ve%C3%ADculos%20automotores_2017_01_23pdf Acessed 10 August 2019

  • Soluri DS, Godoy MLDP, Godoy JM, Roldao LA (2007) Multi-site PM2.5 and PM2.5-10 aerosol source apportionment in Rio de Janeiro. Brazil Braz Chem Soc 18:838–845

    CAS  Google Scholar 

  • Souza JB, Reisen VA, Franco GC, Ispány M, Bondon P, Santos JM (2018) Generalized additive models with principal component analysis: an application to time series of respiratory disease and air pollution data. Appl Statist 67(2):453–480

    Google Scholar 

  • Souza LSVD, Nascimento LFC (2016) Air pollutants and hospital admission due to pneumonia in children: a time series analysis. Rev Assoc Med Bras 62(2):151–156

    Google Scholar 

  • Sun X, Cook KH, Vizy EK (2017) The South Atlantic subtropical high: climatology and interannual variability. J Clim 30:3279–3296

    Google Scholar 

  • The World Bank (2019) Urban population (% of total) https://data.worldbank.org/indicator/SP.URB.TOTL.IN.ZS .Accessed in 31 July 2019

  • United Nations, Department of Economic and Social Affairs (2015) Population Division, 2015. World Urbanization Prospects: the 2014 revision. ST/ESA/SER.A/366

  • Vasconcellos EA, Carvalho CHR, Pereira RHM (2011) Transporte e mobilidade urbana. CEPAL\IPEA, Brasília

    Google Scholar 

  • Vilela JA (2007) Variáveis do clima urbano: análise da situação atual e prognósticos para a região do bairro Belvedere III. Federal University of Minas Gerais, MSc Dissertation

    Google Scholar 

  • World Health Organization (1987) Air quality guidelines for Europe. WHO Regional Office for Europe, Copenhagen

    Google Scholar 

  • World Health Organization (2006) Air quality guidelines: global update 2005. World Health Organization, Geneva

    Google Scholar 

  • World Health Organization (2018) World health statistics 2018: monitoring health for the SDGs, sustainable development goals. World Health Organization, Geneva

    Google Scholar 

Download references

Funding

This research was partially funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Código de Financiamento 001, Brazil. The authors also would like to thank the financial support of the R & D from ArcelorMittal Brazil to the GPAMA research group.

Author information

Authors and Affiliations

  1. Dept. of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, 31270-010, Brazil

    Matheus Augusto de Oliveira Fernandes, Willian Lemker Andreão, Felipe Marinho Maciel & Taciana Toledo de Almeida Albuquerque

  2. ArcelorMittal Brasil Sustainability Management, Belo Horizonte, 30130-915, Brazil

    Felipe Marinho Maciel

Authors
  1. Matheus Augusto de Oliveira Fernandes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Willian Lemker Andreão
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Felipe Marinho Maciel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Taciana Toledo de Almeida Albuquerque
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Taciana Toledo de Almeida Albuquerque.

Additional information

Responsible editor: Philippe Garrigues

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 79 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Oliveira Fernandes, M.A., Andreão, W.L., Maciel, F.M. et al. Avoiding hospital admissions for respiratory system diseases by complying to the final Brazilian air quality standard: an estimate for Brazilian southeast capitals. Environ Sci Pollut Res 27, 35889–35907 (2020). https://doi.org/10.1007/s11356-020-07772-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11356-020-07772-x

Keywords

Search

Navigation