Health effects of air pollution exposure on children and adolescents in Sao Paulo, Brazil

Children and adolescents have been considered more susceptible to the effec ts of air pollution than adults. In order to investigate the responses of c hildren of different ages to air pollution exposure, daily records or hospi tal admissions for children in five age groups (equal or less than 2 years of age, 3-5, 6-13, 14-19, and all ages together, i.e., from 0-19 years of a ge) were obtained from January 1993 to November 1997 in Sao Paulo, Brazil, and were compared to daily records of PM10, O-3, SO2, CO and NO2 concentrat ions in ambient air. For each age group a generalized additive Poisson regr ession was fitted controlling for smooth functions of time, temperature, hu midity, and days of the week, with an additional indicator for holidays. Po lynomial distributed lag models were used to estimate the 7-day cumulative effect of each pollutant. Children 2 years or less were the most susceptible to the effects of all fi ve pollutants with an increase of 9.4% (95% CI: 7.9,10.9) in respiratory ad missions associated with each interquartile range increase in PM10. The old est group was the second most susceptible to air pollutants, with each inte rquartile range increase in PM10 associated with a 5.1% (95% CI: 0.3,9.8) i ncrease in respiratory admissions. An interquartile range increase in CO wa s associated with an 11.3% (95% CI: 5.9,16.8) increase in respiratory hospi talizations. When a multipollutant model was used, the effect of PM10 on re spiratory admissions for all ages together was unchanged, while the SOP and the other pollutants effect was substantially reduced. This study showed that daily respiratory hospital admissions for children a nd adolescents in Sao Paulo increased with air pollution, and that the larg est effects were found for the youngest (2 years or less) and oldest (14-19 years) age groups. Pediatr Pulmonol. 2001; 31:106-113. (C) 2001 Wiley-Liss , Inc.