Health impact assessment of air pollution in Lisbon, Portugal.

BACKGROUND: Lisbon has about 500,000 inhabitants and it's the capital and the main economic hub of Portugal. Studies have demonstrated that exposure to Particulate Matter with an aerodynamic diameter<2.5 µm (PM2.5) have strong association with health effects. Researchers continue to identify new harmful air pollutants effects in our health even in low levels. OBJECTIVES: This study evaluates air pollution scenarios considering a Health Impact Assessment approach in Lisbon, Portugal. METHODS: We have studied abatement scenarios of PM2.5 concentrations and the health effects in the period from 2015 to 2017 using the APHEKOM tool and the associated health costs were assessed by Value of Life Year. RESULTS: The mean concentration of PM2.5 in Lisbon was 23 µg/m3 ± 10 µg/m3 (±Standard Deviation). If we consider that World Health Organization (WHO) standards of PM2.5 (10 µg/m3) were reached, Lisbon would avoid more than 423 premature deaths (equivalent to 9,172 life years' gain) and save more than US$45 million annually. If Lisbon city could even diminish the mean of PM2.5 by 5 µg/m3, nearly 165 deaths would be avoided, resulting in a gain of US$17 million annually. CONCLUSION: According to our findings, if considered the worst pollution scenario, levels of PM2.5 could improve the life's quality and save a significant amount of economic resources.Implications: The manuscript addresses the health effects and costs of air pollution and constitutes an important target for improving public policies on air pollutants in Portugal. Although Portugal has low levels of air pollution, there are significant health and economic effects that, for the most part, are underreported. The health impact assessment approach associated with costs had not yet been addressed in Portugal, which makes this study more relevant in the analysis of policies aimed to drive stricter control on pollutants' emissions. Health costs are a fundamental element to support decision-making process and to orientate the trade-offs in investments for improving public policies so that to diminish health effects, which can impact the management of the local health services and the population's quality of life, especially after the pandemic period when resources are scarce.

Avaliação de impacto à saúde da incidência de dengue associada à pluviosidade no município de Ribeirão Preto, São Paulo / Health impact assessment of the incidence of dengue associated with precipitation in the city of Ribeirão Preto, São Paulo

Resumo Introdução A dengue é considerada um problema de saúde pública. O município de Ribeirão Preto possui condições climáticas e geográficas favoráveis à proliferação do Aedes aegypti , sendo reportadas altas taxas de incidência de dengue. Objetivo Avaliar a relação entre a precipitação pluviométrica e a incidência de casos confirmados de dengue. Método Foi utilizado o coeficiente de correlação de Spearman para a análise da relação entre a pluviosidade e a incidência de dengue. Resultados Encontrou-se associação entre a precipitação e os casos de dengue, com p < 0,01, considerando um intervalo de defasagem (time lag ) que ocorre a partir do primeiro mês e se estende até o quinto mês. Conclusão Estudos como este contribuem para o conhecimento sobre a influência de fatores climáticos na incidência e na dinâmica de transmissão da dengue, sendo essenciais para auxiliar os gestores na tomada de decisão para a prevenção e o controle da doença.

Abstract Background Dengue is considered a public health problem. The municipality of Ribeirão Preto has climatic and geographical conditions conducive to the proliferation of Aedes aegypti and high rates of dengue incidence are reported. Objective To evaluate the relationship between rainfall and the incidence of confirmed cases of dengue. Method The Spearman Correlation Coefficient was used to analyze the relationship between rainfall and the dengue incidence. Results An association between precipitation and dengue cases was found, with p < 0.01, considering a time lag, which occurs from the first month until the fifth month. Conclusion Studies such as this contribute to the knowledge about the influence of climatic factors on the incidence and transmission dynamics of dengue fever, being essential to guide managers in decision making for disease prevention and control.

Avaliação de Impacto à Saúde (AIS) no Brasil e América Latina: uma ferramenta essencial a projetos, planos e políticas / Health Impact Assessment (HIA) in Brazil and Latin America: an essential tool for projects, plans and policies / Evaluación de Impacto a la Salud (EIS) en Brasil y América Latina: una herramienta esencial para los proyectos, planes y las políticas

O presente artigo apresenta uma revisão de literatura e discute a aplicação da metodologia de Avaliação de Impacto à Saúde (AIS), divulgada pela Organização Mundial de Saúde (OMS), para o Brasil e América Latina. Esse estudo mostrou que a prática e a aplicação da AIS não é comum nestas regiões, e, além disso, a análise de impactos à saúde é realizada de forma superficial em licenciamentos ambientais e em políticas públicas, o que aponta para a necessidade da utilização de metodologias específicas, treinamento de profissionais e iniciativa governamental. A adoção da AIS no Brasil e América Latina evitaria a geração de efeitos adversos à saúde, potencializando os aspectos positivos, mitigando os efeitos negativos de projetos e políticas públicas, garantindo que a saúde da população não seja negligenciada.(AU)

The paper presents a literature review of the application of the Health Impact Assessment (HIA) methodology, disseminated by the World Health Organization in Brazil and Latin America. This study showed that the practice and application of the HIA is not common in Brazil or Latin America, as well as the analysis of health impacts is carried out in a superficial way regarding environmental licensing and public policies, indicating the need of the use of specific health impact assessment methodologies, professional training and government initiative. The adoption of HIA in Brazil could serve to avoid adverse health effects and could enhance the positive aspects, as well as to mitigate the negative aspects of projects and public policies, ensuring that people's health is not neglected.(AU)

Este artículo presenta una revisión de la literatura y discute la aplicación de la metodología de Evaluación del Impacto a la Salud (EIS), divulgada por la Organización Mundial de la Salud (OMS), para Brasil y América Latina. Ese estudio mostró que la práctica y la aplicación de EIS no es común en esas regiones y, además, el análisis de impactos a la salud se realiza de forma superficial en licencias ambientales y en políticas públicas, lo que señala la necesidad de la utilización de metodologías específicas, capacitación de profesionales e iniciativa gubernamental. La adopción de EIS en Brasil y en América Latina evitaría la generación de efectos adversos a la salud, potencializando los aspectos positivos, mitigando los efectos negativos de proyectos y políticas públicas, garantizando que no se descuide la salud de la población.(AU)

Health Impact Assessment of Air Pollution in São Paulo, Brazil.

Epidemiological research suggests that air pollution may cause chronic diseases, as well as exacerbation of related pathologies such as cardiovascular and respiratory morbidity and mortality. This study evaluates air pollution scenarios considering a Health Impact Assessment approach in São Paulo, Brazil. We have analyzed abatement scenarios of Particulate Matter (PM) with an aerodynamic diameter <10 µm (PM10), <2.5 µm (PM2.5) and ozone concentrations and the health effects on respiratory and cardiovascular morbidity and mortality in the period from 2009 to 2011 through the APHEKOM tool, as well as the associated health costs. Considering World Health Organization (WHO) standards of PM2.5 (10 µg/m³), São Paulo would avoid more than 5012 premature deaths (equivalent to 266,486 life years' gain) and save US$15.1 billion annually. If São Paulo could even diminish the mean of PM2.5 by 5 µg/m³, nearly 1724 deaths would be avoided, resulting in a gain of US$ 4.96 billion annually. Reduced levels of PM10, PM2.5 and ozone could save lives and an impressive amount of money in a country where economic resources are scarce. Moreover, the reduced levels of air pollution would also lower the demand for hospital care, since hospitalizations would diminish. In this sense, Brazil should urgently adopt WHO air pollution standards in order to improve the quality of life of its population.

In utero exposure to air pollution lowers erythrocyte antioxidant defense and decreases weight in adult mice.

In this study, we tested the influence of ambient air pollution on different phases of development of adult mice. With respect to adult weight, the animals that had spent their in utero period exposed to pollution showed less weight gain over their lifetime, as well as lower activity levels of the antioxidant enzymes catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPx). Our study suggests that contact with atmospheric pollutants during the foetal period produces important changes on enzymatic erythrocyte antioxidant defense and weight in adult mice.

Leptin deficiency leads to the regulation of kinin receptors expression in mice.

Kinins are vasoactive and pro-inflammatory peptides generated by the cleavage of the kininogen by kallikreins. Two kinin receptors have been described and denominated B1 and B2. Obesity frequently accompanies other pathologies, such as diabetes and hypertention. The clustering of these pathologies is usually known as "metabolic syndrome". Mice lacking leptin gene (ob/ob) are severely obese and hyperphagic. Using quantitative RT-PCR analysis of B1 and B2 mRNAs expression, we described for the first time a correlation between the kallikrein-kinin system (KKS) and severe obesity in mice. The ob/ob mice presented lower expression of B2 mRNA in the white adipose tissue (WAT) and hypothalamus, both primary sites for neuroendocrine regulation of the energetic metabolism. B1 mRNA, however, is overexpressed in these tissues of ob/ob mice. An upregulation of the B1 mRNA has also been seen in liver, abdominal aorta and stomach fundus. However, different from the lean mice, the expression of the B1 mRNA in brown adipose tissue (BAT) and heart is completely abolished. Our data show that kinin receptors are differently modulated in distinct tissues in obesity. These findings suggest a connection between the KKS and obesity, and suggest that kinin receptors could be involved in the ethiopathogenesis of the metabolic syndrome.