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Title: Effect of air pollution on diabetes and cardiovascular diseases in São Paulo, Brazil
Authors: Pereira Filho, M.a. [UNIFESP]
Pereira, L.a.a. [UNIFESP]
Arbex, Flávio Ferlin [UNIFESP]
Arbex, Marcos Abdo [UNIFESP]
Conceição, G.m. [UNIFESP]
Santos, U.p.
Lopes, Antonio Carlos [UNIFESP]
Saldiva, Paulo Hilário Nascimento
Braga, A.l.f.
Cendon Filha, Sônia Perez [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Universidade Católica de Santos Programa de Pós-graduação em Saúde Coletiva
Universidade de São Paulo (USP)
Universidade de Santo Amaro Faculdade de Medicina Programa de Pediatria Ambiental
Keywords: Cardiovascular diseases
Air pollution
Emergency room visits
Time-series study
Issue Date: 1-Jun-2008
Publisher: Associação Brasileira de Divulgação Científica
Citation: Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 41, n. 6, p. 526-532, 2008.
Abstract: Type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. There is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. The present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of São Paulo. Using a time-series approach, and adopting generalized linear Poisson regression models, we assessed the effect of daily variations in PM10, CO, NO2, SO2, and O3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. A semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. In this period, 45,000 cardiovascular emergency room visits were registered. The observed increase in interquartile range within the 2-day moving average of 8.0 µg/m³ SO2 was associated with 7.0% (95%CI: 4.0-11.0) and 20.0% (95%CI: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups, respectively. These data indicate that air pollution causes an increase of cardiovascular emergency room visits, and that diabetic patients are extremely susceptible to the adverse effects of air pollution on their health conditions.
ISSN: 0100-879X
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