Association of sulfur dioxide exposure with circulatory system deaths in a medium-sized city in Brazil

Abstract

There is a demonstrable association between exposure to air pollutants and deaths due to cardiovascular diseases. The objective of this study was to estimate the effects of exposure to sulfur dioxide on mortality due to circulatory diseases in individuals 50 years of age or older residing in São José dos Campos, SP. This was a time-series ecological study for the years 2003 to 2007 using information on deaths due to circulatory disease obtained from Datasus reports. Data on daily levels of pollutants, particulate matter, sulfur dioxide (SO2), ozone, temperature, and humidity were obtained from the São Paulo State Environmental Agency. Moving average models for 2 to 7 days were calculated by Poisson regression using the R software. Exposure to SO2 was analyzed using a unipollutant, bipollutant or multipollutant model adjusted for mean temperature and humidity. The relative risks with 95%CI were obtained and the percent decrease in risk was calculated. There were 1928 deaths with a daily mean (± SD) of 1.05 ± 1.03 (range: 0-6). Exposure to SO2 was significantly associated with mortality due to circulatory disease: RR = 1.04 (95%CI = 1.01 to 1.06) in the 7-day moving average, after adjusting for ozone. There was an 8.5% decrease in risk in the multipollutant model, proportional to a decrease of SO2 concentrations. The results of this study suggest that residents of medium-sized Brazilian cities with characteristics similar to those of São José dos Campos probably have health problems due to exposure to air pollutants.

Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study

“…In another study, which used a generalized linear model, sulfur dioxide was found to be a statistically significant risk factor for death due to stroke in the fifth and sixth moving means. 4 This result is more similar to what was found in the present study, thus showing the importance of exposure to sulfur dioxide on the fifth day after exposure when using both the moving mean and the lag methodology. In turn, ozone was not a statistically significant risk factor in the present study, and this coincides with research using a generalized linear model for hospital admissions.…”

“…[1][2][3][4] However, little has been discussed about the increased risk of stroke, particularly in Brazil. An association between stroke and exposure to air pollutants has been shown, in Europe, Asia and Brazil, mainly covering hospitalization due to this cause.…”

Estimates of community exposure and health risk to sulfur dioxide from power plant emissions using short-term mobile and stationary ambient air monitoring

“…Health effects are believed to lag exposure, and the moving average is a tool used to estimate the cumulative impact of pollutant concentrations and is more consistent with actual exposure than the block averages typically used in compliance monitoring (Amancio et al, 2012;Kloog et al, 2012;Mar et al, 2005;Mcbride et al, 2011). The time span most relevant to human exposure in clinical trials is 5-10 min, as only one study reviewed reported respiratory effects under 5 min (Horstman et al, 1988).…”

Association between long-term exposure to air pollutants and cardiopulmonary mortality rates in South Korea

“…Wichmann et al [24] reported associations between cardiovascular and cerebrovascular mortality with SO 2 in Cape Town, South Africa, too. Amancio et al [25] also found positive associations between short term SO 2 exposure and circulatory disease and stroke mortality in Brazil with ecological study design. Moreover, Chung et al [26] found signi cant positive associations between PM 10 and SO 2 and cardioembolic stroke incidence on the basis of the Clinical Research Center for Stroke 5th division centers registry data in South Korea.…”