Influência da exposição ambiental
na percepção do estado de saúde
de indivíduos de cinco países latino-americanos

Marilyn Urrutia-Pereira; Lucas Pitrez Mocelin; Herberto José Chong-Neto; Héctor Badellino; Veronica Riquelme Martinez; Paulo Oliveira Lima; Raphael Coelho Figueredo; Oscar Caldeón Llosa; José Ignacio Larco Sousa; Marcela Soria; Adelmir de Souza Machado; Raquel de Carvalho Baldaçara; Doris Mora; Maria Suzana Repka Ramirez; Maria Isabel Rojo; Geraldo Lopez Perez; Veronica Acosta; Marylin Valentin Rostan; Patricia Latour; Dirceu Solé

doi:10.5935/2526-5393.20230075

Artigo Original

Influência da exposição ambiental na percepção do estado de saúde de indivíduos de cinco países latino-americanos

Effect of environmental exposure on the perceived health status of individuals from five Latin American countries

Marilyn Urrutia-Pereira; Lucas Pitrez Mocelin; Herberto José Chong-Neto; Héctor Badellino; Veronica Riquelme Martinez; Paulo Oliveira Lima; Raphael Coelho Figueredo; Oscar Caldeón Llosa; José Ignacio Larco Sousa; Marcela Soria; Adelmir de Souza Machado; Raquel de Carvalho Baldaçara; Doris Mora; Maria Suzana Repka Ramirez; Maria Isabel Rojo; Geraldo Lopez Perez; Veronica Acosta; Marylin Valentin Rostan; Patricia Latour; Dirceu Solé

http://dx.doi.org/10.5935/2526-5393.20230075 Arq Asma Alerg Imunol, vol.8, n1, p.43-53, 2024

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Resumo

Objetivo: A relação entre exposição ambiental e risco à saúde é amplamente reconhecida e a avaliamos em cinco países da América Latina com condições culturais distintas, mas com Índices de Desenvolvimento Humano semelhantes. Métodos: Estudo transversal envolvendo 3.016 indivíduos (18 a 75 anos) oriundos de: Argentina (n = 878), Brasil (n = 1.030), México (n = 272), Paraguai (n = 508) e Peru (n = 328). A seleção foi aleatória e todos responderam questionário padronizado (fatores sociodemográficos, fatores ambientais e hábitos de vida) derivado do Clinical Screening Tool for Air Pollution Risk. Segundo o estado atual de saúde, foram categorizados em: saúde regular/má/ péssima ou excelente/boa. Tendo-a como desfecho, realizou-se análise multivariada. Os dados foram apresentados como razão de verossimilhança (RV) e intervalos de confiança de 95% (IC 95%), tendo-se 5% o nível de significância. Resultados: Foram significantemente associados a pior percepção de situação de saúde: morar em qualquer um dos países, ter umidade na residência (OR = 1,68; IC 95%: 1,33-2,12), dirigir automóvel com janelas abertas (OR = 1,31; IC 95%: 1,03-1,65), ter baixa renda familiar (OR = 1,59; IC 95%: 1,26-2,01), nível educacional incompleto (OR = 1,54; IC 95%: 1,22-1,94), histórico pessoal/familiar de hipertensão arterial (OR = 2,25; IC 95%: 01,64-3,09), doença pulmonar obstrutiva crônica/asma (OR = 1,74; IC 95%: 1,28-2,36), diabete melito (OR = 3,74; IC 95%: 2,23-6,29), obesidade (OR = 1,84; IC 95%: 1,84-3,19) ou comorbidades oftalmológicas (OR = 1,89; IC 95%: 1,55-2,30); realizar exercícios ao ar livre (OR = 1,60; IC 95%: 1,31-1,96). Conclusões: Apesar das diferentes exposições a que foram submetidos, alguns fatores permanecem muito significativos, e ter baixa renda familiar, expor-se à poluição e ter antecedentes de doenças crônicas foram associados à percepção de condição ruim de saúde.

Palavras-chave

Poluição ambiental, saúde, doenças crônicas não transmissíveis, tabagismo, asma, doenças cardiovasculares.

Abstract

Objective: The relationship between environmental exposure and health outcomes is well known. We investigated this relationship in five Latin American countries with different cultural backgrounds but similar Human Development Indexes. Methods: This was a cross-sectional study involving 3,016 individuals (18 to 75 years old) from Argentina (n=878), Brazil (n=1030), Mexico (n=272), Paraguay (n=508), and Peru (n=328). Participants were randomly selected and responded to a standardized questionnaire (including sociodemographic and environmental factors and lifestyle habits) derived from a clinical screening tool for air pollution risk. Based on their current health status, participants were categorized as having regular/bad/very bad or excellent/good health. Multivariate analysis was conducted, and data were presented as likelihood ratios and 95% confidence intervals (95%CI). The significance level was set at 5%. Results: Living in any of the study countries; indoor humidity (OR=1.68; 95%CI: 1.33-2.12); driving with the windows open (OR=1.31; 95%CI: 1.03-1.65); low family income (OR=1.59; 95%CI: 1.26-2.01); incomplete education (OR=1.54; 95%CI: 1.22-1.94); personal/family history of hypertension (OR=2.25; 95%CI: 01.64- 3.09), chronic obstructive pulmonary disease/asthma (OR=1.74; 95%:CI: 1.28-2.36), diabetes (OR=3.74; 95%CI:2.23-6.29), obesity (OR=1.84; 95%CI: 1.84-3.19), or ocular comorbidities (OR=1.89; 95%CI: 1.55-2.30); and exercising outdoors (OR=1.60; 95%CI: 1.31-1.96) were significantly associated with a worse perceived health status. Conclusions: Despite the different exposures to which participants were subjected, some factors remain very significant. Low family income, exposure to pollution, and a history of chronic diseases were associated with the perception of a poor health condition.

Keywords

Environmental pollution, health, noncommunicable chronic diseases, smoking, asthma, cardiovascular diseases.

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Submetido em:
27/11/2023

Aceito em:
14/12/2023