Association between the incidence of acute respiratory diseases in children and ambient concentrations of SO2, PM10 and chemical elements in fine particles

The aim of this study consists of investigating the effects of the SO2, PM10, inorganic chemical elements and black carbon (BC) present in fine particulates on the acute outcomes of respiratory diseases in children up to 12 years of age living in Brazilian urban area in the southern hemisphere during the winter (2013) and summer (2013-2014) months. SO2, PM10, concentration data were obtained from six air quality monitoring stations spatially distributed in the area. PM2.5 samples were collected at the same locations with a MiniVol sampler over a 24-h period on alternating days. The PM2.5 components were analysed using the energy dispersive X-ray fluorescence and reflectance techniques. Hospital care and admission events due to acute respiratory diseases (n = 8,987) of the coded groups JJ00-JJ99 of the International Code of Diseases (ICD-10) were obtained from three hospitals (one public and two private hospitals). To quantify the association of acute respiratory disease events with pollutant concentrations, a generalized additive model (GAM) with a Poisson distribution was applied. The results showed a greater risk of acute respiratory events due to exposure to SO2 with a relative risk of 1.28 (95% CI: 1.22-1.34) and to PM10 with a risk of 1.14 (95% CI: 1.09-1.20) on the day of exposure (lag 0). The chemical constituents present in the fine particles with the highest risk for acute respiratory diseases were Si with a risk of 1.22 (95% CI: 1.15-1.29), S with a risk of 1.09 (95% CI: 1.06-1.12), Ti with a risk of 1.09 (95% CI: 1.01-1.17), BC with a risk of 1.07 (95% CI: 1.03-1.11), Se with a risk of 1.03 (95% CI: 0.96-1.10) and Ni with a risk of 1.03 (95% CI: 0.96-1.10).