Arquivos de Asma, Alergia e Imunologia
https://aaai-asbai.org.br/article/doi/10.5935/2526-5393.20220008
Arquivos de Asma, Alergia e Imunologia
Artigo de Revisão

Poluição do ar e saúde respiratória

Air pollution and respiratory health

Faradiba Sarquis Serpa; Valderio Anselmo Reisen; Eliana Zandonade; Higor Cotta Aranda; Dirceu Solé

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Resumo

O aumento da prevalência de doenças respiratórias crônicas coincide com o da exposição aos poluentes atmosféricos pelo crescente processo de industrialização, aumento do tráfego veicular e migração da população para áreas urbanas. A poluição do ar é uma mistura complexa de poluentes e outros compostos químicos tóxicos e não tóxicos, e o efeito na saúde pode derivar dessa mistura e da interação com parâmetros meteorológicos. Apesar disso, busca-se estabelecer o papel de um poluente específico em separado e consideram-se os parâmetros meteorológicos como fatores de confusão. Há evidências de que a exposição aos poluentes contribui para maior morbidade e mortalidade por doenças respiratórias, especialmente nas crianças, mesmo em concentrações dentro dos padrões estabelecidos pela legislação. Identificar os efeitos dos poluentes no sistema respiratório, isoladamente e em associação, é um desafio, e os estudos têm limitações devido à variabilidade de resposta individual, a presença de doenças pré-existentes, aos fatores socioeconômicos, às exposições a poluentes intradomiciliares, ocupacionais e ao tabaco. A maioria das evidências sobre o efeito dos poluentes no sistema respiratório de crianças deriva de estudos que incluem desfechos de função pulmonar. Entretanto, esses estudos têm diferenças quanto ao desenho, ao método de avaliação de exposição aos poluentes, às medidas de função pulmonar, às covariáveis consideradas como capazes de alterar a resposta aos poluentes e aos tipos de modelos utilizados na análise dos dados. Considerar todas essas diferenças é fundamental na interpretação e comparação dos resultados dessas pesquisas com os dados já existentes na literatura.

Palavras-chave

Poluição do ar, doenças respiratórias, material particulado, poluentes atmosféricos, criança.

Abstract

The increase in the prevalence of chronic respiratory diseases coincides with that of exposure to air pollutants due to the growing industrialization process, increased vehicular traffic and population migration to urban areas. Air pollution is a complex mixture of pollutants and other toxic and non-toxic chemical compounds and its effect on health can derive from this mixture and the interaction with meteorological parameters. Despite this, it seeks to establish the role of a specific pollutant separately and considers the meteorological parameters as confounding factors. There is evidence that exposure to pollutants contributes to greater morbidity and mortality from respiratory diseases, especially in children, even at concentrations within the standards established by legislation. Identifying the effects of pollutants on the respiratory system, alone and in association, is a challenge and studies have limitations due to the variability of individual response, the presence of pre-existing diseases, socioeconomic factors, exposure to indoor, occupational and environmental pollutants as well tobacco. Most of the evidence on the effect of pollutants on the respiratory system of children comes from studies that include lung function outcomes. However, these studies differ in terms of design, method of assessing exposure to pollutants, measures of lung function, covariates considered capable of altering the response to pollutants, and types of models used in data analysis. Considering all these differences is fundamental in interpreting and comparing the results of these researches with data already existing in the literature.

Keywords

Air pollution, respiratory tract diseases, particulate matter, environmental pollutants, child.

Referências

1. Guo Y, Jiang F, Peng L, Zhang J, Geng F, Xu J. The association between cold spells and pediatric outpatient visits for asthma in Shanghai, China. PloS One. 2012;7:e42232.

2. Guo Y, Punnasiri K, Tong S, Aydin D, Feychting M. Effects of temperature on mortality in Chiang Mai city, Thailand: a time series study. Environ Health. 2012;11:36.

3. Jenerowicz D, Silny W, Danczak-Pazdrowska A, Polanska A, Osmola-Mankowska A, Olek-Hrab K. Environmental factors and allergic diseases. Ann Agric Environ Med. 2012;19:475e81.

4. Helldén D, Anderson C, Nilsson M, Ebi KL, Friberg P, Alfvén T. Climate change and child health: a scoping review and an expanded conceptual framework. Lancet Planet Health. 2021;5:e164-75. doi:10.1016/S2542-5196(20)30274.

5. Maio S, Cerrai S, Simoni M, Sarno G, Baldacci S, Viegi G. Environmental risk factors: indoor and outdoor pollution. In: Pawankar R, Canonica GW, Holgate ST, Blaiss MS, eds. White Book on Allergy: Update. World Allergy Organization (WAO), USA; 2013. p. 91e8.

6. Dockery DW. Outdoor Air Pollution. Children’s Environmental Health. Oxford, New York, 2014, p. 201-9.

7. Gowers AM, Cullinan P, Ayres JG, Anderson HR, Strachan DP, Holgate ST, et al. Does outdoor air pollution induce new cases of asthma? Biological plausibility and evidence: a review. Respirology. 2012;17(6):887-98.

8. Lee SY, Chang YS, Cho SH. Allergic diseases and air pollution. Asia Pac Allergy. 2013;3:145e54.

9. Lin S, Luo M, Walker RJ, Liu X, Wang SA, Chinery R. Extreme high temperatures and hospital admissions for respiratory and cardiovascular diseases. Epidemiology. 2009;20:738-46.

10. Di Cicco ME, Ferrante G, Amato D, Capizzi A, De Pieri C, Ferraro VA, et al. Climate Change and Childhood Respiratory Health: A Call to Action for Paediatricians. Int J Environ Res Public Health. 2020;17(15):5344. doi:10.3390/ijerph17155344.

11. Li G, Sun J, Jayasinger R, Pan X, Zhou M, Wang X, et al. Temperature Modifies the Effects of Particulate Matter on Non-Accidental Mortality: A Comparative Study of Beijing, China and Brisbane, Australia. Pub Heal Res. 2012;2(2):21-7.

12. Li S, Baker PJ, Jalaludin BB, Marks GB, Denison LS, Willians GM. Ambient temperature and lung function in children with asthma in Australia. Eur Respir J. 2014;43:1059-66.

13. Li S, Williams G, Jalaludin B, Baker P. Panel studies of air pollution on children’s lung function and respiratory symptoms: a literature review. J Asthma. 2012;49:895-910.

14. Wu S, Deng F, Hao Y, Wang X, Zheng C, LV H, et al. Fine particulate matter, temperature, and lung function in healthy adults: findings from the HVNR study. Chemosphere. 2014;108:168-74.

15. Zhang Y, He M, Wu S, Zhu Y, Wang S, Shima M, et al. Short-term effects of fine particulate matter and temperature on lung function among healthy college students in Wuhan, China. Int J Environ Res Public Health.2015;12(7):7777-93.

16. Rice MB, Li W, Wilker EH, Gold DR, Schwartz J, Zanobetti A, et al. Association of outdoor temperature with lung function in a temperate climate. Eur Respir J. 2019;53(1). pii: 1800612. doi: 10.1183/13993003.00612-2018.

17. Froes Asmus CI, Camara VM, Landrigan PJ, Claudio LA. Systematic Review of Children’s Environmental Health in Brazil. Ann Glob Health. 2016;82(1):132-48.

18. Souza JB, Reisen VA, Franco GC, Ispany M, Bondon P, Meri J. Generalized additive model with principal component analysis: An application to time series of respiratory disease and air pollution data. J Royal Stat Soc Ser C Applied Stat. 2018;67:453-80.

19. Serpa FS, Zandonade E, Reis JL, Borja TN, Moyses TR, Campinhos FL, et al. Prevalência de asma, rinite e eczema atópico em escolares do município de Vitória, Espirito Santo, Brasil. Rev Bras Pesq Saúde. 2014;16(3):107-14.

20. Matos EP, Reisen VA, Serpa FS, Prezotti Filho PR, Leite MFS. Space-time analysis of the effect of air pollution on children’s health. Cad Saude Publica. 2019;35(10):e00145418. doi: 10.1590/0102- 311X00145418.

21. Souza JB, Reisen VA, Santos JM, Franco GC. Componentes principais e modelagem linear generalizada na associação entre atendimento hospitalar e poluição do ar. Rev Saúde Púb. 2014;48(3):451-8.

22. Freitas CU, Ponce de Leon A, Juger W, Gouveia N. Poluição do ar e impactos na saúde em Vitória, Espírito Santo. Rev Saúde Púb. 2016;50:4. DOI:10.1590/S1518-8787.2016050005909.

23. Nascimento AP, Santos JM, Mill JG, Souza JB, Reis Júnior NC, Reisen VA. Association between the concentration of fine particles in the atmosphere and acute respiratory diseases in children. Rev Saúde Púb. 2017;51:3. doi: 10.1590/S1518-8787.2017051006523.

24. Coeli CM. Sistemas de Informação em Saúde e uso de dados secundários na pesquisa e avaliação em saúde. Cad Saúde Colet. 2010;18(3):335-6.

25. Hunt A, Abraham JL, Judson B, Berry CL. Toxicologic and epidemiologic clues from the characterization of the 1952 London smog fine particulate matter in archival autopsy lung tissues. Environ Health Perspect. 2003;111:1209-14.

26. Ruckerl R, Schneider A, Breitner S, Cyrys J, Peters A. Health effects of particulate air pollution: A review of epidemiological evidence. Inhalation Toxicol. 2011;23(10):555-92.

27. Lippman M. Toxicological and epidemiological studies of cardiovascular effects of ambient air fine particulate matter (PM2,5) and its chemical components: Coherence and public health implications. Crit Rev Toxicol. 2014;44(4):299-347.

28. Jasinski R, Pereira LA, Braga ALF. Poluição atmosférica e internações hospitalares por doenças respiratórias e crianças e adolescentes em Cubatão, São Paulo, Brasil, entre 1997-2004. Cad Saúde Pub. 2011;27(11):2242-52.

29. Yamazaki S, Shima M, Ando M, Nitta H, Watanabe H, Nishimuta T. Effect of hourly concentration of particulate matter on peak expiratory flow in hospitalized children: a panel study. Environ Health. 2011;10(15):1-10.

30. Zheng XY, Ding H, Jiang LN, Chen SW, Zheng JP, Qiu M, et al. Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis. PLoS One. 2015;10(9):e0138146.

31. WHO Global air quality guideliines. Particulate matter (PM2.5 and PM10), ozone, nitrogen oxide, sulfur dioxide, and carbon monoxide. Geneva: World Health Organization, 2021. License CCBY-NC-SA 3.0 IGO. Disponível em: https://apps.who.int/iris/bitstream/handle/1 0665/345329/9789240034228-eng.pdf?sequence=1&isAllowed=y. Accessado em 22/09/2021.

32. US EPA. US Environmental Protection Agency (2018). Disponível em: https://www.epa.gov/pm-pollution/particulate-matter-pm-basics. Acessado em 10/10/2021.

33. Bekki K, Ito T, Yoshida Y, He C, Arashidani K, He M, et al. PM2,5 collected in China causes inflammatory and oxidative stress responses in macrophages through the multiple pathways. Environ Toxicol Pharmacol.2016;45:362-9.

34. Spann K, Snape N, Baturcam E, Fantino E. The Impact of Early-Life Exposure to Air-borne Environmental Insults on the Function of the Airway Epithelium in Asthma. Ann Glob Health. 2016;82(1):28‑40.

35. Baldacci S, Maio S, Cerrai S, Sarno G, Baïz N, Simoni M, et al. Allergy and asthma: Effects of the exposure to particulate matter and biological allergens. Respir Med. 2015;109(9):1089-104.

36. Guarnieri M, Balmes JR. Air pollution and asthma. Lancet. 2014;3(383):1581-92.

37. Roderique JD, Josef CS, Feldman MJ, Spiess BD. A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement. Toxicology. 2015;6(334):45-58.

38. Patel MM, Chillrud SN, Correa JC, Hazi Y, Feinberg M, Prakash S, et al. Traffic-related particulate matter and acute respiratory symptoms among New York City area adolescents. Environ Health Perspect. 2010;119:1338-43.

39. Liu L, Poon R, Chen L, Frescura AM, Montuschi P, Ciabattoni G, et al. Acute Effects of Air Pollution on Pulmonary Function, Airway Inflammation, and Oxidative Stress in Asthmatic Children. Environ Health Perspec. 2009;117(4):668-74.

40. Moreira D, Tirabassi M, Moraes MR. Meteorologia e poluição atmosférica. Ambient soc. 2008;11(1):1-13. doi 10.1590/S1414- 753X2008000100002.

41. MacIntyre EA, Gehring U, Mölter A, Fuertes E, Klümper C, Krämer U, et al. Air pollution and respiratory infections during early childhood: an analysis of 10 European birth cohorts within the ESCAPE Project, Environ Health Perspect. 2014;122(1):107-13.

42. Mu L, Deng F, Tian L, Li Y, Swanson M, Ying J, et al. Peak expiratory flow, breath rate and blood pressure in adults with changes in particulate matter air pollution during the Beijing Olympics: A panel study. Environ Res. 2014;133:4-11.

43. Anderson JO, Thundiyil JG, Stolbach A. Clearing the air: a review of the effects of particulate matter air pollution on human health. J Med Toxicol. 2012;8(2):166-75.

44. Bekki K, Ito T, Yoshida Y, He C, Arashidani K, He M, et al. PM2,5 collected in China causes inflammatory and oxidative stress responses in macrophages through the multiple pathways. Environ Toxicol Pharmacol. 2016;45:362-9.

45. Evolution of WHO air quality guidelines: past, present and future. Copenhagen: WHO Regional Office for Europe; 2017. Disponível em: https://www.euro.who.int/__data/assets/pdf_file/0019/331660/ Evolution-air-quality.pdf. Acessado em agosto/2021.

46. Conselho Nacional do Meio Ambiente (CONAMA) – Resolução Nº 491, de 19 de novembro de 2018. Padrões de Qualidade do ar (Brasil). Disponível em: https://www.in.gov.br/materia/-/asset_publisher/ Kujrw0TZC2Mb/content/id/51058895 Acessado em junho/2021.

47. Penard-Morand C, Raherison C, Charpin D, Kopferschmitt C, Lavaud F, Caillaud D, et al. Long-term exposure to close-proximity air pollution and asthma and allergies in urban children. Eur Respir J. 2010;36(1):33-40.

48. Eckel SP, Berhane K, Salam MT, Rappaport EB, Linn WS, Bastian WS, et al. Residential traffic-related pollution exposures and exhaled nitric oxide in the children’s health study. Environ Health Perspect. 2011;119(10):1472-7.

49. Gehring U, Gruzieva O, Agius RM, Beelen R, Custovic A, Cyrs J, et al. Air pollution exposure and lung function in children: the ESCAPE project. Environ Health Perspect. 2013;121:1357-64.

50. Gauderman WJ, Urman R, Avol E, Berhane K, McConnell R, Chang R, et al. Association of Improved Air Quality with Lung Development in Children. N Engl J Med. 2015;372:905-13.

51. Peters JM, Avol E, Gauderman WJ, Linn WS, Navidi W, London SJ, et al. A study of twelve Southern California communities with differing levels and types of air pollution, II, Effects on pulmonar function. Am J Respir Crit Care Med. 1999;1:768-75.

52. Gauderman WJ, McConnell R, Gilliland F, London S, Thomas D, Avol E, et al. Association between air pollution and lung function growth in southern California children. Am J Respir Crit Care Med. 2000;162(4):1383-90.

53. Gauderman WJ, Avol E, Gilliland F, Vora H, Thomas D, Berhane K, et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med. 2004;351:1057-67.

54. Gauderman WJ, Vora H, McConnell R, Berhane K, Gilliland F, Thomas D, et al. Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohort study. Lancet. 2007;369:571-7.

55. Rojas-Martinez R, Perez-Padilla R, Olaiz-Fernandez G, MendozaAlvarado L, Moreno-Macias H, Fortoul T, et al. Lung function growth in children with long-term exposure to air pollutants in Mexico City. Am J Respir Crit Care Med. 2007;176(4):377-84.

56. Oftedal B, Brunekreef B, Nystad W, Madsen C, Walker SE, Nafstad P. Residential outdoor air pollution and lung function in schoolchildren. Epidemiology. 2008;19:129-37.

57. Toledo MF, Saraiva-Romanholo BM, Oliveira RC, Saldiva PH, Silva LF, Nascimento LF, et al. Changes over time in the prevalence of asthma, rhinitis and atopic eczema in adolescents from Taubate, Sao Paulo, Brazil (2005-2012): Relationship with living near a heavily travelled highway. Allergol Immunopathol (Madr). 2016;44(5):439-44. doi: 10.1016/j.aller.2016.02.006.

58. Neophytou AM, White MJ, Oh S, Thakur N, Galanter JM, Nishimura KK, et al. Air Pollution and Lung Function in Minority Youth with Asthma in the GALA II (Genes–Environments and Admixture in Latino Americans) and SAGE II (Study of African Americans, Asthma, Genes, and Environments) Studies. Am J Resp Crit Care Med. 2016;193(11):1271-80.

59. Ierodiakonou D, Zanobetti A, Coull BA, Melly S, Postma DS, Boezen HM, et al. Ambient air pollution, lung function and airway responsiveness in children with asthma. J Allergy Clin Immunol. 2016;137(2):390-9.

60. Xu D, Zhang Y, Zhou L, Li T. Acute effects of PM2.5 on lung function parameters in schoolchildren in Nanjing, China. Environ Sci Pollut Res Int. 2018;25(15):14989-95.

61. Ghozikali MG, Ansarin K, Naddafi K, Nodehi RN, Yaghmaeian K, Hassanvand MS, et al. Short term effects of particle size on lung function of late adolescents. Environ Sci Pollut Res Int. 2018;25(22):21822-32.

62. Jacobson LS, Hacon SS, De Castro HA, Ignoti E, Artaxo P, Saldiva PH, et al. Acute effects of particulate matter and black carbon from seasonal fires on peak expiratory flow of schoolchildren in the Brazilian Amazon. PLoS One. 2014;9(8):e104177.

63. Missagia S, Amaral CAS, Jesus AS, Arbex MA, Santos UP, André CDS, et al. Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city. Rev Bras de Epidemiol. 2018;20:21:e180009. doi:10.1590/1980- 549720180009.


Submetido em:
12/10/2021

Aceito em:
18/12/2021

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