Summary of the first Brazilian Symposium on Human Biometeorology.

This brief background highlights Brazil as a 'climate-health hotspot', i.e. a country where climate affects local populations negatively through multiple pathways (Di Napoli et al. BMC Public Health 22(1):1-8, 2022). Knowledge gaps still need to be filled concerning the various climaterelated dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers in the country (Krüger et al. Int J Biometeorol 66(7):1297-1315, 2022). Motivated by this, the first Brazilian Symposium on Human Biometeorology (Simpósio Brasileiro de Biometeorologia Humana 2022) was organized and held at the Federal University of Rio Grande do Norte (UFRN) in Natal, northeastern Brazil, between July 4 and 8, 2022. The symposium was organized as a hybrid event by a committee composed of researchers acting in different regions of the country, and who had an ongoing research collaboration on matters related to human biometeorology. The event was partly sponsored by the ISB and partly self-supported by the organizers and institutions involved. The symposium aimed to promote the development of the research area on human biometeorology in Brazil in facing challenges imposed by a globally and locally changing climate. To achieve this, the symposium focused on five main topics of discussion: a) climate-driven diseases; b) thermal comfort, urban and architectural biometeorology; c) atmospheric pollution and health; d) climate change; e) climate, health and climate change. This summary highlights the main findings, future research directions, and policy implications in each topic from the presentations and panel discussions.

A first approach to human biometeorology research in Brazil: a systematic review and meta-analysis.

This systematic review aims to give an overview of the diversity of research areas related to human biometeorology in Brazil. The main focus of this paper addresses research trends, represented by published papers with national and international authorship, main contributions and shortcomings, as well as challenges and prospects of research in this area of study. An extensive literature search was conducted in the Scopus, Web of Science, and Science Direct databases so as to identify relevant publication output up to July 2021 related to the research area. The screening resulted in 96 studies chosen for full-text reading. Overall, results indicated a reduced amount of articles on the subject matter published internationally, with noticeable gaps in research in some regions of the country, such as the Amazon region and in the Brazilian Midwest region. Research gaps in relevant areas have been identified with limited output in the climate dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers. Such gaps should further encourage researchers to engage in research focused on those areas.

Air pollution and its impact on the concentration of airborne fungi in the megacity of São Paulo, Brazil.

In the context of megacities in an urban environment, air quality is an important issue, due to the direct correlation to population's health. The biomonitoring of pollutants can indicate subtle environmental alterations, for that, anemophilous fungi can be monitored for changes in atmospheric conditions related to pollution. In the present study, the concentration of fungi and bacteria in the atmosphere was measured during a specific vehicle fleet reduction in the city of São Paulo, Brazil, from May 24 to 30, 2018, using impactor air samplers. The number of isolated developed colonies was related to atmospheric conditions and the concentration of other air pollutants constantly monitored. Aspergillus, Curvularia, Penicillium, Neurospora, Rhizopus and Trichoderma were identified. The number of colony-forming units increased by approximately 80% during the sampling period in response to environmental changes favored by the fleet reduction. This result implies the relation between fuel emissions, concentration of atmospheric pollutants, and the presence of viable fungal spores in the urban environment, which highlights the importance of combined public policies for air quality in large cities.

Survival and ice nucleation activity of Pseudomonas syringae strains exposed to simulated high-altitude atmospheric conditions.

Pseudomonas syringae produces highly efficient biological ice nuclei (IN) that were proposed to influence precipitation by freezing water in clouds. This bacterium may be capable of dispersing through the atmosphere, having been reported in rain, snow, and cloud water samples. This study assesses its survival and maintenance of IN activity under stressing conditions present at high altitudes, such as UV radiation within clouds. Strains of the pathovars syringae and garcae were compared to Escherichia coli. While UV-C effectively inactivated these cells, the Pseudomonas were much more tolerant to UV-B. The P. syringae strains were also more resistant to radiation from a solar simulator, composed of UV-A and UV-B, while only one of them suffered a decline in IN activity at -5 °C after long exposures. Desiccation at different relative humidity values also affected the IN, but some activity at -5 °C was always maintained. The pathovar garcae tended to be more resistant than the pathovar syringae, particularly to desiccation, though its IN were found to be generally more sensitive. Compared to E. coli, the P. syringae strains appear to be better adapted to survival under conditions present at high altitudes and in clouds.

Biomarkers as indicators of fungal biomass in the atmosphere of São Paulo, Brazil.

The biogenic aerosol contribution to atmospheric particulate matter (PM) mass concentration is usually neglected due to the difficulty in identifying its components, although it can be significant. In the Metropolitan Area of São Paulo (MASP)-Brazil, several studies have been performed to identify sources for PM, revealing vehicular emissions and soil re-suspension as the main identified sources. The organic fraction has been related primarily to biomass burning (BB) and fuel combustion, although there is significant presence of green areas in the city which render biogenic emissions as an additional source of organic carbon (OC). The objectives of this work are to (i) characterise the composition of the PM10 (ii) estimate the relative mass contribution of fungal spores to PM concentrations with sizes smaller than 10µm (PM10) in MASP and (iii) assess the main sources of PM10. To achieve these objectives, we measured markers of biogenic sources and BB, during the fall-winter transition, which along with other constituents, such as ions, organic/elemental carbon, elemental composition and fungal spore concentrations, help assess the PM10 sources. We used receptor models to identify distinct source-related PM10 fractions and conversion factors to convert biomarker concentrations to fungal mass. Our results show the mean contributions of fungal aerosol to PM10 and OC mass were 2% and 8%, respectively, indicating the importance of fungal spores to the aerosol burden in the urban atmosphere. Using specific rotation factor analysis, we identified the following factors contributing to PM: soil re-suspension, biogenic aerosol, secondary inorganic aerosol, vehicular emissions and BB/isoprene-related secondary organic aerosol (I-SOA). BB/I-SOA was the main source representing 28% of the PM10 mass, while biogenic aerosol explained a significant (11%) fraction of the PM10 mass as well. Our findings suggest that primary biogenic aerosol is an important fraction of PM10 mass, yet not considered in most studies.

Environmental heat exposure and cognitive performance in older adults: a controlled trial.

Thermal stress has a negative effect on the cognitive performance of military personnel and industry workers exposed to extreme environments. However, no studies have investigated the effects of environmental thermal stress on the cognitive functions of older adults. We carried out a controlled trial with 68 healthy older adults (mean age 73.3 years, 69 % female), each of whom has been assessed twice on the same day with selected tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Repeated sessions were conducted with air temperatures set at 24 °C and 32 °C in a balanced order. Our primary analyses did not show significant differences when comparing the cognitive performance of the total sample under the two experimental temperatures. However, interaction analysis has shown that humidity levels modify the effect of temperature on cognitive outcomes. The subgroup exposed to relative humidity greater than the median value (57.8 %) presented worse cognitive performance in the heat session when compared to the control session. Reported exercising frequency explained individual vulnerability to heat stress. Volunteers with lower levels of physical activity (<4 times per week) were more likely to present worsened cognitive performance under heat stress. In a fully adjusted linear regression model, the performance under heat stress remained associated with relative humidity (ß = -0.21; p = 0.007) and frequency of exercising (ß = 0.18; p = 0.020). Our results indicate that heat stress may have detrimental effects on the cognitive functioning of some subgroups of older adults and under particular circumstances. Further research is needed for exploring a variety of potentially influential factors.

Uma análise da umidade relativa do ar em ambientes internos e externos na cidade de São Paulo: deve-se umidificar ou secar os ambientes internos? / An analysis of the air relative humidity in internal and external environment in the city of São Paulo, Brazil

Desde a Antiguidade a umidade do ar, tanto elevada como baixa, tem sido relacionada a problemas de saúde. Neste estudo foram coletados dados de umidade relativa do ar de 376 domicílios na cidade de São Paulo. Os resultados mostraram que a umidade relativa média das mínimas foi de 67%, durante o período diurno, e a umidade relativa média das máximas foi de 87%, durante o período noturno. Estes valores foram compatíveis aos obtidos na Estação Meteorológica do Instituto de Astronomia, Geofísica e Ciências Atmosféricas da Universidade de São Paulo. Não houve diferença significante durante o período seco de inverno. Somente 18 eventos com umidade relativa abaixo de 30% foram registrados. Por outro lado, 78 domicílios apresentaram umidade relativa média máxima de 100%. De acordo com a literatura, os valores aceitáveis de umidade relativa não devem ultrapassar 60% e o conforto térmico sugere que a umidade relativa oscile entre 40% e, no máximo, 70%. Assim, os resultados deste estudo mostram que a umidade relativa média da cidade de São Paulo está muito acima do recomendado. Devido às possíveis implicações na quantidade de fungos e ácaros, os quais têm preferência por umidade relativa ao redor de 80%, recomenda-se fortemente que os domicílios paulistanos sejam desumificados à noite, mesmo no período de inverno, oposto ao que a mídia apregoa, aumentando as doenças respiratórias.

Atmospheric conditions, lunar phases, and childbirth: a multivariate analysis.

Our objective was to assess extrinsic influences upon childbirth. In a cohort of 1,826 days containing 17,417 childbirths among them 13,252 spontaneous labor admissions, we studied the influence of environment upon the high incidence of labor (defined by 75th percentile or higher), analyzed by logistic regression. The predictors of high labor admission included increases in outdoor temperature (odds ratio: 1.742, P = 0.045, 95%CI: 1.011 to 3.001), and decreases in atmospheric pressure (odds ratio: 1.269, P = 0.029, 95%CI: 1.055 to 1.483). In contrast, increases in tidal range were associated with a lower probability of high admission (odds ratio: 0.762, P = 0.030, 95%CI: 0.515 to 0.999). Lunar phase was not a predictor of high labor admission (P = 0.339). Using multivariate analysis, increases in temperature and decreases in atmospheric pressure predicted high labor admission, and increases of tidal range, as a measurement of the lunar gravitational force, predicted a lower probability of high admission.

Indoor and outdoor atmospheric fungal spores in the São Paulo metropolitan area (Brazil): species and numeric concentrations.

The aim of this study was to estimate the indoor and outdoor concentrations of fungal spores in the Metropolitan Area of Sao Paulo (MASP), collected at different sites in winter/spring and summer seasons. The techniques adopted included cultivation (samples collected with impactors) and microscopic enumeration (samples collected with impingers). The overall results showed total concentrations of fungal spores as high as 36,000 per cubic meter, with a large proportion of non culturable spores (around 91% of the total). Penicillium sp. and Aspergillus sp. were the dominant species both indoors and outdoors, in all seasons tested, occurring in more than 30% of homes at very high concentrations of culturable airborne fungi [colony forming units(CFU) m(-3)]. There was no significant difference between indoor and outdoor concentrations. The total fungal spore concentration found in winter was 19% higher than that in summer. Heat and humidity were the main factors affecting fungal growth; however, a non-linear response to these factors was found. Thus, temperatures below 16 degrees C and above 25 degrees C caused a reduction in the concentration (CFU m(-3)) of airborne fungi, which fits with MASP climatalogy. The same pattern was observed for humidity, although not as clearly as with temperature given the usual high relative humidity (above 70%) in the study area. These results are relevant for public health interventions that aim to reduce respiratory morbidity among susceptible populations.

[Air pollution and emergency room visits due to pneumonia and influenza in São Paulo, Brazil]. / Poluição atmosférica e atendimentos por pneumonia e gripe em São Paulo, Brasil.

OBJECTIVE: A time series was developed to investigate the effect of air pollution levels on morbidity due to respiratory diseases such as pneumonia and influenza among elderly people from 1996 to 1998. METHODS: Daily data on emergency room visits was collected at the university clinics hospital in São Paulo, Brazil. Daily levels of CO, NO2, O3, SO2 and PM10 were obtained from the State Environmental Agency. Daily measures of temperature and relative humidity were obtained from the Institute of Astronomy and Geophysics of the University of São Paulo. Generalized additive Poisson regression models were used to assess the relationship between pneumonia and influenza and air pollution, using the number of emergency room visits as dependent variable and the average daily levels of each pollutant as independent variables. The models were estimated and adjusted by seasonality (non-parametric function), weather, weekdays, motor vehicle circulation curbs periods and daily numbers of non-respiratory hospital admissions. RESULTS: The pollutants O3 and SO2 showed a statistical association with pneumonia and influenza. These associations remained robust when control variables were included. An interquartile range for O3 (38.80 microgram/m3) and SO2 (15.05 microgram/m3) increased in 8.07% and 14.5%, respectively, the number of emergency room visits due to pneumonia and influenza. CONCLUSION: The study results suggest that air pollution in the city of São Paulo may promote adverse health effects in elderly people.

Poluiçäo atmosférica e atendimentos por pneumonia e gripe em Säo Paulo, Brasil / Air pollution and emergency room visits due to pneumonia and influenza in Säo Paulo, Brazil

OBJETIVO: Investigar os efeitos causados pela poluiçäo atmosférica na morbidade por pneumonia e por gripe em idosos entre 1996 e 1998. MÉTODOS: Foram obtidos dados diários de atendimentos por pneumonia e gripe para idosos em pronto-socorro médico de um hospital-escola de referência no Município de Säo Paulo, SP, Brasil. Os níveis diários de CO, O3, SO2, NO2 e PM10 foram obtidos na Companhia de Tecnologia de Saneamento Ambiental, e os dados diários de temperatura e umidade relativa do ar foram obtidos no Instituto Astronômico e Geofísico da USP. Para verificar a relaçäo existente entre pneumonia e gripe e poluiçäo atmosférica, utilizou-se o modelo aditivo generalizado de regressäo de Poisson, tendo como variável dependente o número diário de atendimentos por pneumonia e gripe e como variáveis independentes as concentraçöes médias diárias dos poluentes atmosféricos. A análise foi ajustada para sazonalidade de longa duraçäo (número de dias transcorridos), sazonalidade de curta duraçäo (dias da semana), temperatura mínima, umidade média, períodos de rodízio e os atendimentos por doenças näo-respiratórias em idosos. RESULTADOS: O3 e SO2 estäo diretamente associados à pneumonia e à gripe, independentemente das variáveis de controle. Porém, na análise conjunta, eles perdem sua significância estatística. Pôde-se observar que um aumento interquartil (25 por cento-75 por cento) para o O3 (38,80 mg/m3) e SO2 (15,05 mg/m3) levaram a um acréscimo de 8,07por cento e 14,51por cento, respectivamente, no número de atendimentos por pneumonia e gripe em idosos. CONCLUSOES: Os resultados sugerem que a poluiçäo atmosférica promove efeitos adversos para a saúde de idosos