Association between sugar cane burning and acute respiratory illness on the island of Maui

Abstract

BackgroundSugar cane harvesting by burning on Maui island is an environmental health issue due to respiratory effects of smoke. Volcanic smog (“vog”) from an active volcano on a neighboring island periodically blankets Maui and could confound a study of cane smoke’s effects since cane burning is not allowed on vog days. This study examines the association between cane burning and emergency department (ED) visits, hospital admissions, and prescription fills for acute respiratory illnesses.MethodsThis retrospective study controlled for confounders that could increase respiratory distress on non-burn days by matching each burn day with a non-burn day and then comparing the ratio of patients with respiratory distress residing in the path of sugar burn smoke to those residing elsewhere on Maui on burn versus non-burn days. Patients with acute respiratory distress were defined as those with one or more acute respiratory diagnoses at one of the hospitals or emergency departments on Maui. Separately, patients with acute respiratory illness were identified through prescription records from four community pharmacies, specifically defined as those who filled prescriptions for acute respiratory distress.ResultsThere were 1,256 reports of respiratory distress prescriptions and 686 hospital/ED diagnoses of acute respiratory illness. The ratio of cases within to outside of smoke exposure was higher on burn days for both the ED/hospital data and the pharmacy, though not statistically significant. In post-hoc analyses of the pharmacy data based on the number of acres burned as a proxy for volume of smoke, there was a dose response trend for acreage burned such that the highest quartile showed a statistically significant higher proportion of acute respiratory distress in the exposed versus non-exposed regions (P = 0.015, OR 2.4, 95 % CI [1.2–4.8]).ConclusionsAfter adjusting for confounders on non-burn days, there was a significantly higher incidence of respiratory distress in smoke-exposed regions when greater amounts of acres were burned. Health officials should consider actions to reduce the negative health outcomes associated with sugar cane burning practices.

Efeitos das emissões de cana de açúcar sobre as vias respiratórias

“…Mnatzaganian et al 17 , 2015 Houve uma incidência significativamente maior de desconforto respiratório em regiões expostas à fumaça quando grandes quantidades de acres foram queimadas. Funcionários de saúde devem considerar ações para reduzir os resultados negativos para a saúde associados às práticas de queima da cana-de-açúcar.…”

“…, quadros de tuberculose7 , dispersão de microorganismos patogênicos4 , exacerbação da asma e da DPOC 8 , alteração do transporte mucociliar 9,10 , câncer de cavidade oral 11,12 e pulmão 13,14 e sintomas de rinite 15,16,17 .Em um estudo feito pela pesquisadora Verena Matos e colaboradores com ratos Wistar foi constatado a lesão nas vias aéreas superiores por inalação de MP grosso e pelo acúmulo de MP fino nos brônquios e bronquíolos causando inflamação intersticial, perivascular, brônquica,…”

“…17 Algumas das manifestações clínicas em razão da exposição a esses compostos voláteis são irritação da pele e dos olhos, tontura, tosse, falta de ar, chiado no peito, coceira, muco , ardor na garganta, alergias nasais. Em nível laboratorial, os níveis das atividades de enzimas antioxidantes diminuiram e a quantidade de marcadores de estresse oxidativo atingiram grandes magnitudes durante o período da colheita.…”

Queima de biomassa da cana-de-açúcar e hospitalizações de crianças e idosos por agravos respiratórios em Pernambuco, Brasil

“…Mnatzaganian et al 50 apontam uma possível relação direta entre a extensão da área queimada e maiores prevalências por agravos agudos do aparelho respiratório. Sabe-se também que a exposição humana à fuligem tóxica, proveniente da queima da biomassa, é maior nas localidades encontradas às proximidades dos focos de calor 11 .…”

Acute Respiratory and Cardiovascular Outcomes Associated with Low Levels of Ambient Fine Particulate Matter (PM2.5) on the Island of Oahu

“…Previous studies using this data set indicate it holds promise for other air quality research. One study examined the association between sugar cane burning and acute respiratory illness in 2011 in a subset of patients on Maui [22] and another examined the association of pollution from volcanic emissions on ED visits for pulmonary and cardiovascular conditions and used ED visits for fractures as a comparison group expected to be unrelated to pollution [23]. Thus, Hawaii is an ideal location to study associations between relatively low levels of PM 2.5 and health outcomes.…”