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Risk and burden of hospital admissions associated with wildfire-related PM2·5 in Brazil, 2000-15: a nationwide time-series study.
Ye, Tingting; Guo, Yuming; Chen, Gongbo; Yue, Xu; Xu, Rongbin; Coêlho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Zhao, Qi; Li, Shanshan.
Affiliation
  • Ye T; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Public Health and Management, Binzhou Medical University, Yantai, China.
  • Guo Y; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Public Health and Management, Binzhou Medical University, Yantai, China. Electronic address: yuming.guo@monash.edu.
  • Chen G; Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
  • Yue X; Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, China.
  • Xu R; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
  • Coêlho MSZS; Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
  • Saldiva PHN; Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
  • Zhao Q; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
  • Li S; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: shanshan.li@monash.edu.
Lancet Planet Health ; 5(9): e599-e607, 2021 09.
Article in En | MEDLINE | ID: mdl-34508681
BACKGROUND: In the context of climate change and deforestation, Brazil is facing more frequent and unprecedented wildfires. Wildfire-related PM2·5 is associated with multiple adverse health outcomes; however, the magnitude of these associations in the Brazilian context is unclear. We aimed to estimate the association between daily exposure to wildfire-related PM2·5 and cause-specific hospital admission and attributable health burden in the Brazilian population using a nationwide dataset from 2000 to 2015. METHODS: In this nationwide time-series analysis, data for daily all-cause, cardiovascular, and respiratory hospital admissions were collected through the Brazilian Unified Health System from 1814 municipalities in Brazil between Jan 1, 2000, and Dec 31, 2015. Daily concentrations of wildfire-related PM2·5 were estimated using the 3D chemical transport model GEOS-Chem at a 2·0° latitude by 2·5° longitude resolution. A time-series analysis was fitted using quasi-Poisson regression to quantify municipality-specific effect estimates, which were then pooled at the regional and national levels using random-effects meta-analyses. Analyses were stratified by sex and ten age groups. The attributable fraction and attributable cases of hospital admissions due to wildfire-related PM2·5 were also calculated. FINDINGS: At the national level, a 10 µg/m3 increase in wildfire-related PM2·5 was associated with a 1·65% (95% CI 1·51-1·80) increase in all-cause hospital admissions, a 5·09% (4·73-5·44) increase in respiratory hospital admissions, and a 1·10% (0·78-1·42) increase in cardiovascular hospital admissions, over 0-1 days after the exposure. The effect estimates for all-cause hospital admission did not vary by sex, but were particularly high in children aged 4 years or younger (4·88% [95% CI 4·47-5·28]), children aged 5-9 years (2·33% [1·77-2·90]), and people aged 80 years and older (3·70% [3·20-4·20]) compared with other age groups. We estimated that 0·53% (95% CI 0·48-0·58) of all-cause hospital admissions were attributable to wildfire-related PM2·5, corresponding to 35 cases (95% CI 32-38) per 100 000 residents annually. The attributable rate was greatest for municipalities in the north, south, and central-west regions, and lowest in the northeast region. Results were consistent for all-cause and respiratory diseases across regions, but remained inconsistent for cardiovascular diseases. INTERPRETATION: Short-term exposure to wildfire-related PM2·5 was associated with increased risks of all-cause, respiratory, and cardiovascular hospital admissions, particularly among children (0-9 years) and older people (≥80 years). Greater attention should be paid to reducing exposure to wildfire smoke, particularly for the most susceptible populations. FUNDING: Australian Research Council and Australian National Health and Medical Research Council.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Wildfires Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Child / Humans Country/Region as subject: America do sul / Brasil / Oceania Language: En Journal: Lancet Planet Health Year: 2021 Document type: Article Affiliation country: China Country of publication: Netherlands

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Wildfires Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Child / Humans Country/Region as subject: America do sul / Brasil / Oceania Language: En Journal: Lancet Planet Health Year: 2021 Document type: Article Affiliation country: China Country of publication: Netherlands