Poluição atmosférica e internações por insuficiência cardíaca congestiva em adultos e idosos em Santo André (SP)

Urban atmospheric pollution causes adverse health effects on most susceptible groups. Objective: To evaluate the effects of exposure to air pollution on hospital admissions due to congestive heart failure in adults and elderly residents in the city of Santo Andre, SP, Brazil. Methods: We obtained data on hospitalizations for congestive heart failure (CHF) of adults and the elderly (older than 35 years of age) in all hospitals under the National Health System in the city of Santo Andre for the period from 2000 to 2007. Levels of PM 10 , temperature and humidity were provided by CETESB. We used generalized linear Poisson regression model and a sixtieth-degree polynomial distributed lag model with length up to 20 days to estimate pollutant effect on the outcome, controlling for seasonality, weather variables and short-term trend. Results: The average of PM 10 during the studied period was below the air quality standard adopted by CETESB, which is 50 mg/m3. Also, PM 10 daily records did not surpassed the standard of 150 mg/m3. An increase of 24.6 mg/m3 in PM 10 was associated with an increase of 3.0% (95%CI: 0,3-5,7) in hospitalizations for congestive heart failure in the same day of exposure. The pollutant's effect in the outcome presented a biphasic behavior, with another increase of the outcome 10 to 12 days after exposure. Conclusions: Increases in PM 10 in the city of Santo Andre are associated with increases in the number of hospitalizations for CHF among adults and the elderly.