Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2004 Jan;58(1):41–46. doi: 10.1136/jech.58.1.41

Influence of socioeconomic conditions on air pollution adverse health effects in elderly people: an analysis of six regions in São Paulo, Brazil

M Martins 1, F Fatigati 1, T Vespoli 1, L Martins 1, L Pereira 1, M Martins 1, P Saldiva 1, A Braga 1
PMCID: PMC1757032  PMID: 14684725

Abstract

Study objective: To evaluate if the effects of particulate matter (PM10) on respiratory mortality of elderly people are affected by socioeconomic status.

Design: Time series studies. The daily number of elderly respiratory deaths were modelled in generalised linear Poisson regression models controlling for long term trend, weather, and day of the week, from January 1997 to December 1999, in six different regions of São Paulo City, Brazil. The regions were defined according to the proximity of air pollution monitoring stations. Three socioeconomic indicators were used: college education, monthly income, and housing.

Main results: For a 10 µg/m3 increase in PM10, the percentage increase in respiratory mortality varied from 1.4% (95% CI 5.9 to 8.7) to 14.2% (95% CI 0.4 to 28.0). The overall percentage increase in the six regions was 5.4% (95% CI 2.3 to 8.6). The effect of PM10 was negatively correlated with both percentage of people with college education and high family income, and it was positively associated with the percentage of people living in slums.

Conclusions: These results suggest that socioeconomic deprivation represents an effect modifier of the association between air pollution and respiratory deaths.

Full Text

The Full Text of this article is available as a PDF (381.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abbey D. E., Nishino N., McDonnell W. F., Burchette R. J., Knutsen S. F., Lawrence Beeson W., Yang J. X. Long-term inhalable particles and other air pollutants related to mortality in nonsmokers. Am J Respir Crit Care Med. 1999 Feb;159(2):373–382. doi: 10.1164/ajrccm.159.2.9806020. [DOI] [PubMed] [Google Scholar]
  2. Bobak M., Leon D. A. Air pollution and infant mortality in the Czech Republic, 1986-88. Lancet. 1992 Oct 24;340(8826):1010–1014. doi: 10.1016/0140-6736(92)93017-h. [DOI] [PubMed] [Google Scholar]
  3. Braga A. L., Saldiva P. H., Pereira L. A., Menezes J. J., Conceiço G. M., Lin C. A., Zanobetti A., Schwartz J., Dockery D. W. Health effects of air pollution exposure on children and adolescents in São Paulo, Brazil. Pediatr Pulmonol. 2001 Feb;31(2):106–113. doi: 10.1002/1099-0496(200102)31:2<106::aid-ppul1017>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  4. Braga A. L., Zanobetti A., Schwartz J. The lag structure between particulate air pollution and respiratory and cardiovascular deaths in 10 US cities. J Occup Environ Med. 2001 Nov;43(11):927–933. doi: 10.1097/00043764-200111000-00001. [DOI] [PubMed] [Google Scholar]
  5. Braga Alfésio L. F., Zanobetti Antonella, Schwartz Joel. The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environ Health Perspect. 2002 Sep;110(9):859–863. doi: 10.1289/ehp.02110859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Conceiço G. M., Miraglia S. G., Kishi H. S., Saldiva P. H., Singer J. M. Air pollution and child mortality: a time-series study in São Paulo, Brazil. Environ Health Perspect. 2001 Jun;109 (Suppl 3):347–350. doi: 10.1289/ehp.109-1240551. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dockery D. W., Pope C. A., 3rd, Xu X., Spengler J. D., Ware J. H., Fay M. E., Ferris B. G., Jr, Speizer F. E. An association between air pollution and mortality in six U.S. cities. N Engl J Med. 1993 Dec 9;329(24):1753–1759. doi: 10.1056/NEJM199312093292401. [DOI] [PubMed] [Google Scholar]
  8. Gouveia N., Fletcher T. Time series analysis of air pollution and mortality: effects by cause, age and socioeconomic status. J Epidemiol Community Health. 2000 Oct;54(10):750–755. doi: 10.1136/jech.54.10.750. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hoek Gerard, Brunekreef Bert, Goldbohm Sandra, Fischer Paul, van den Brandt Piet A. Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. Lancet. 2002 Oct 19;360(9341):1203–1209. doi: 10.1016/S0140-6736(02)11280-3. [DOI] [PubMed] [Google Scholar]
  10. Ito K., Thurston G. D. Daily PM10/mortality associations: an investigations of at-risk subpopulations. J Expo Anal Environ Epidemiol. 1996 Jan-Mar;6(1):79–95. [PubMed] [Google Scholar]
  11. Lemos M., Lichtenfels A. J., Amaro Júnior E., Macchione M., Martins M. A., King M., Böhm G. M., Saldiva P. H. Quantitative pathology of nasal passages in rats exposed to urban levels of air pollution. Environ Res. 1994 Jul;66(1):87–95. doi: 10.1006/enrs.1994.1046. [DOI] [PubMed] [Google Scholar]
  12. Lin C. A., Martins M. A., Farhat S. C., Pope C. A., 3rd, Conceiço G. M., Anastácio V. M., Hatanaka M., Andrade W. C., Hamaue W. R., Böhm G. M. Air pollution and respiratory illness of children in São Paulo, Brazil. Paediatr Perinat Epidemiol. 1999 Oct;13(4):475–488. doi: 10.1046/j.1365-3016.1999.00210.x. [DOI] [PubMed] [Google Scholar]
  13. Martins Lourdes Conceiço, Latorre Maria do Rosário Dias de Oliveira, Saldiva Paulo Hilário do Nascimento, Braga Alfésio Luís Ferreira. Air pollution and emergency room visits due to chronic lower respiratory diseases in the elderly: an ecological time-series study in São Paulo, Brazil. J Occup Environ Med. 2002 Jul;44(7):622–627. doi: 10.1097/00043764-200207000-00006. [DOI] [PubMed] [Google Scholar]
  14. Ostro B., Chestnut L., Vichit-Vadakan N., Laixuthai A. The impact of particulate matter on daily mortality in Bangkok, Thailand. J Air Waste Manag Assoc. 1999 Sep;49(9 Spec No):100–107. [PubMed] [Google Scholar]
  15. Pereira L. A., Loomis D., Conceiço G. M., Braga A. L., Arcas R. M., Kishi H. S., Singer J. M., Böhm G. M., Saldiva P. H. Association between air pollution and intrauterine mortality in São Paulo, Brazil. Environ Health Perspect. 1998 Jun;106(6):325–329. doi: 10.1289/ehp.98106325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Pereira P., Saldiva P. H., Sakae R. S., Bohm G. M., Martins M. A. Urban levels of air pollution increase lung responsiveness in rats. Environ Res. 1995 May;69(2):96–101. doi: 10.1006/enrs.1995.1030. [DOI] [PubMed] [Google Scholar]
  17. Saldiva P. H., Lichtenfels A. J., Paiva P. S., Barone I. A., Martins M. A., Massad E., Pereira J. C., Xavier V. P., Singer J. M., Böhm G. M. Association between air pollution and mortality due to respiratory diseases in children in São Paulo, Brazil: a preliminary report. Environ Res. 1994 May;65(2):218–225. doi: 10.1006/enrs.1994.1033. [DOI] [PubMed] [Google Scholar]
  18. Saldiva P. H., Pope C. A., 3rd, Schwartz J., Dockery D. W., Lichtenfels A. J., Salge J. M., Barone I., Bohm G. M. Air pollution and mortality in elderly people: a time-series study in Sao Paulo, Brazil. Arch Environ Health. 1995 Mar-Apr;50(2):159–163. doi: 10.1080/00039896.1995.9940893. [DOI] [PubMed] [Google Scholar]
  19. Schwartz J. Air pollution and hospital admissions for heart disease in eight U.S. counties. Epidemiology. 1999 Jan;10(1):17–22. [PubMed] [Google Scholar]
  20. Sobral H. R. Air pollution and respiratory diseases in children in São Paulo, Brazil. Soc Sci Med. 1989;29(8):959–964. doi: 10.1016/0277-9536(89)90051-8. [DOI] [PubMed] [Google Scholar]
  21. Wordley J., Walters S., Ayres J. G. Short term variations in hospital admissions and mortality and particulate air pollution. Occup Environ Med. 1997 Feb;54(2):108–116. doi: 10.1136/oem.54.2.108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Zanobetti A., Schwartz J. Race, gender, and social status as modifiers of the effects of PM10 on mortality. J Occup Environ Med. 2000 May;42(5):469–474. doi: 10.1097/00043764-200005000-00002. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES