Impact on human health of particulate matter emitted from burnings in the Brazilian Amazon regionImpactos na saúde humana de partículas emitidas por queimadas na Amazônia brasileira ABSTRACT OBJECTIVE: To analyze the impact on human health of exposure to particulate matter emitted from burnings in the Brazilian Amazon region. METHODS:This was an ecological study using an environmental exposure indicator presented as the percentage of annual hours (AH%) of PM 2.5 above 80 μg/m 3 . The outcome variables were the rates of hospitalization due to respiratory disease among children, the elderly and the intermediate age group, and due to childbirth. Data were obtained from the National Space Research Institute and the Ministry of Health for all of the microregions of the Brazilian Amazon region, for the years 2004 and 2005. Multiple regression models for the outcome variables in relation to the predictive variable AH% of PM 2.5 above 80 μg/m 3 were analyzed. The Human Development Index (HDI) and mean number of complete blood counts per 100 inhabitants in the Brazilian Amazon region were the control variables in the regression analyses. RESULTS:The association of the exposure indicator (AH%) was higher for the elderly than for other age groups (β = 0.10). For each 1% increase in the exposure indicator there was an increase of 8% in child hospitalization, 10% in hospitalization of the elderly, and 5% for the intermediate age group, even after controlling for HDI and mean number of complete blood counts. No association was found between the AH% and hospitalization due to childbirth. CONCLUSIONS:The indicator of atmospheric pollution showed an association with occurrences of respiratory diseases in the Brazilian Amazon region, especially in the more vulnerable age groups. This indicator may be used to assess the effects of forest burning on human health.

O processo de mudanças climáticas e ambientais globais, que vem se agravando nas últimas décadas mas que foi divulgado mais amplamente pela mídia nos últimos dois anos, porta para a sociedade e setores de governo um desafio sobre as causas e o papel das alterações ambientais sobre as condições de saúde. Esse trabalho tem como objetivo avaliar cenários de mudanças climáticas e ambientais e suas incertezas para o Brasil. Além disso identifica recursos que podem ser utilizados para desenvolver uma rede de diagnóstico, modelagem, análise e intervenção sobre as repercussões dessas mudanças sobre as condições de saúde. Os principais grupos de doenças que podem ser afetados por essas mudanças são as doenças de veiculação hídrica, as transmitidas por vetores e as respiratórias. No entanto, os riscos associados às mudanças climáticas globais não podem ser avaliados em separado do contexto globalização, mudanças ambientais e precarização de sistemas de governo. Cabe ao setor saúde, não só prevenir esses riscos, mas atuar na redução de suas vulnerabilidades sociais.Palavras-chave: mudanças globais; vigilância ambiental em saúde; vigilância epidemiológica; modelos preditivos.

OBJETIVO: Analisar as internações hospitalares por doenças respiratórias em menores de 15 anos de idade em uma área com elevados níveis de poluição ambiental. MÉTODOS: Estudo transversal da morbidade hospitalar por doenças respiratórias de residentes no município de Tangará da Serra (MT) na Amazônia brasileira, no período de 2000 a 2005, através de dados de internações hospitalares do Sistema Único de Saúde brasileiro e de estimativas populacionais do Instituto Brasileiro de Geografia e Estatística. RESULTADOS: Em 2005, a taxa de internações por doenças respiratórias em menores de 15 anos foi de 70,1/1.000 crianças na microrregião de Tangará da Serra. Entre 2000 a 2005 ocorreram, no município de Tangará da Serra, 12.777 internações de crianças, das quais 8.142 (63,7%) por doenças respiratórias. No período da seca (maio a outubro) houve 10% mais internações por doenças respiratórias que no período da chuva (novembro a abril). As principais causas de internação foram: pneumonias (90,7%) e insuficiência respiratória (8,5%). Em menores de 5 anos de idade, as internações por pneumonia foram mais de 4 vezes o esperado para o município. Os menores de 12 meses de idade foram mais frequentemente internados, com incremento médio de 32,4 internações por 1.000 crianças a cada ano. CONCLUSÕES: Tangará da Serra tem apresentado elevado número de internações por doenças respiratórias, portanto, é coerente considerá-lo como área prioritária para investigação e monitoramento dos fatores de risco ambientais para tais doenças.

Most of the studies on air pollution focus on emissions from fossil fuel burning in urban centers. However, approximately half of the world's population is exposed to air pollution caused by biomass burning emissions. In the Brazilian Amazon population, over 10 million people are directly exposed to high levels of pollutants resulting from deforestation and agricultural fires. This work is the first study to present an integrated view of the effects of inhalable particles present in emissions of biomass burning. Exposing human lung cells to particulate matter smaller than 10 µm (PM10), significantly increased the level of reactive oxygen species (ROS), inflammatory cytokines, autophagy, and DNA damage. Continued PM10 exposure activated apoptosis and necrosis. Interestingly, retene, a polycyclic aromatic hydrocarbon present in PM10, is a potential compound for the effects of PM10, causing DNA damage and cell death. The PM10 concentrations observed during Amazon biomass burning were sufficient to induce severe adverse effects in human lung cells. Our study provides new data that will help elucidate the mechanism of PM10-mediated lung cancer development. In addition, the results of this study support the establishment of new guidelines for human health protection in regions strongly impacted by biomass burning.

OBJECTIVE:To analyze the effects of exposure to fi ne particulate matter from burning on hospital admissions due to respiratory diseases in children and the elderly. METHODS:This is an ecological time series study that took place in the city of Cuiaba, Mato Grosso, in Brazil's Amazon Region, in 2005. Information on the daily levels of fi ne particulate matter PM 2.5 was made available by the Brazilian National Institute for Spatial Research. The model included variables related to temperature, relative humidity and adjusts for seasonality and calendar effects. Poisson regression with generalized additive models was used. RESULTS:A 10 μg/m 3 increase in the level of exposure to PM 2.5 was associated with increases of 9.1%, 9.2% and 12.1% in hospital admissions due to respiratory diseases in children for moving averages of 1, 2 and 5 days, respectively. For the dry season, the level of exposure to particulate matter was associated with increases of 11.4%, 21.6% and 22.0% in hospital admissions in children for moving averages of 1, 5 and 6 days, respectively. No signifi cant link was noticed in the elderly. CONCLUSIONS:The results show the infl uence of PM 2.5 on hospitalizations for respiratory disease in children under 5 in the region studied.

24The Brazilian Amazon represents about 40% of the world's remaining tropical rainforest. 25However, human activities have become important drivers of disturbance in that region. The 26 majority of forest fire hotspots in the Amazon arc due to deforestation are impacting the health 27 of the local population of over 10 million inhabitants. In this study we characterize western 28Amazonia biomass burning emissions through the quantification of 14 Polycyclic Aromatic 29Hydrocarbons (PAHs), Organic Carbon, Elemental Carbon and unique tracers of biomass 30 burning such as levoglucosan. From the PAHs dataset a toxic equivalence factor is calculated 31 estimating the carcinogenic and mutagenic potential of biomass burning emissions during the 32 studied period. Peak concentration of PM 10 during the dry seasons was observed to reach 60 33 µg.m -3 on the 24h average. Conversely, PM 10 was relatively constant throughout the wet season 34indicating an overall stable balance between aerosol sources and sinks within the filter sampling 35 resolution. Similar behavior is identified for OC and EC components. Levoglucosan was found 36 in significant concentrations (up to 4 µg. m -3 ) during the dry season. Correspondingly, the 37 estimated lung cancer risk calculated during the dry seasons largely exceeded the WHO health-38 based guideline. A source apportionment study was carried out through the use of Absolute 39Principal Factor Analysis (APFA), identifying a three-factor solution. The biomass burning 40 factor is found to be the dominating aerosol source, having 75.4% of PM 10 loading. The second 41 factor depicts an important contribution of several PAHs without a single source class and 42 therefore was considered as mixed sources factor, contributing to 6.3 % of PM 10 . The third factor 43 was mainly associated with fossil fuel combustion emissions, contributing to 18.4 % of PM 10 . 44This work enhances the knowledge of aerosol sources and its impact on climate variability and 45 local population, on a site representative of the deforestation which occupies a significant 46 fraction of the Amazon basin. 47

Abstract

The Hansen's disease new case detection rate, which reflects the magnitude of disease, is associated with social conditions and land settlement practices in the Brazilian Amazon.