Efeitos agudos da qualidade do ar no pico de fluxo expiratório e na pressão arterial de adultos no município do Rio de Janeiro.

Abstract

Air pollution is the largest environmental risk factor for health in the world, responsible for a major impact on mortality and mortality, especially respiratory and cardiovascular diseases. The main objective of this study was to evaluate the acute effects of ambient air pollution on peak expiratory flow and blood pressure. The study population consisted of adult individuals, health professionals from the João Barros Barroso Municipal Health Center (where the research was done), located in Copacabana in the municipality of Rio de Janeiro from July 24, 2016 to July 27, 2017. The pollutants of the ambient air assessed were: inhalable particulate matter (PM10), sulfur dioxide (SO2), carbon monoxide (CO), ozone (O3) on the current day exposure (lag0) and in the lags of 24hs /day each lag of exposure over the three preceding days (1 day previous-lag1, 2 dias-lag2 e 3 dias-lag3) and moving averages of two previous days (m2=(lag0+ lag1+ lag2)/3) and three days previous (m3= (lag0+ lag1+ lag2+ lag3)/4). Two studies were performed. The first, a longitudinal study of repeated measures, in five phases with irregular intervals of months, including 96 individuals in phase 1(baseline). The objectives of this study were to evaluate the acute effects of ambient air pollution (PM10, SO2, CO, O3) on peak expiratory flow (PEF) and adult blood pressure. The mixed effects models were used in the estimation of the effects of air pollution with outcomes. (PEF and systolic and diastolic blood pressure). The most relevant finding was the reduction in PEF of 5.05 L/min (IC95%: -8.89;-1.21) in the current day exposure associated with increase of 10μg/m³ de O3 (p<0.05). The other pollutants (PM10, SO2, CO) did not present consistent and significant effects. In relation to blood pressure (systolic-SBP and diastolic-DBP) this did not suffer significant and plausible effects of air pollutants. The second study was a cross-sectional design, during the third phase of the previous research, with a sample of 70 individuals. For the construction of this model, the primary strategy was to apply the reference equation of Leiner et al., (1963) in the PEF of each participant to homogenize this pulmonary parameter in the most important determinants (sex, height and age), with the predicted PEF(PFEperc) being the outcome variable resulting from this process. This measure led to the reduction of PEF variability among individuals, highlighting the other explanatory variables, among them exposure to air pollution and blood pressure. The final model obtained by multiple linear regression and selection criterion Akaike s Information Criterion was described as: PEFperc= ɑ+ PAS+PM10lag3. This finding allowed to explore the association between blood pressure and pulmonary function and the short effect in decrease 9.85(IC95%:-1.7;-0.26) L/min associated with increase of 10μg/m³ on PM10 in the PEF% predicted. In summary, the acute effects of air pollution were found in PEF, but not in blood pressure.