Paulo Henrique de Moura et al. Leandro Dias Gomes de Carvalho Paulo Henrique Godoy Lucia Helena Alvares Salis … Marina Silva Paez Mariane Branco Alves Luiz Francisco Pires Guimarães Maia Renata Libonati dos Santos Nelson Albuquerque de Souza e Silva
Abstract
Background
Air pollution by fine particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5) is the main environmental risk factor associated with diseases of the circulatory system (DCS), ischemic heart disease (IHD), and cerebrovascular diseases (CBVD).
Objective
To estimate mortality rates from DCS, IHD, and CBVD (2000-2019) among residents of the 164 neighborhoods of Rio de Janeiro, according to PM2.5 levels.
Methods
This retrospective ecological study used georeferenced satellite data classified into three PM2.5 levels and mortality records from the Department of Information and Informatics of the Unified Health System for DCS, IHD, and CBVD among individuals of both sexes aged ≥ 20 years from 2000 to 2019. Age-adjusted mortality rates per 1,000 inhabitants were calculated, and comparative statistical analyses were performed by sex, PM2.5 level, and age group (5% significance).
Results
Approximately 91% of the 4.7 million residents (≥ 20 years) live in areas with high or extreme PM2.5 pollution. Deaths occurred up to 3.4 years earlier among men living in highly polluted areas compared with those in moderately polluted areas. The highest DCS mortality rates were observed in neighborhoods with high and extreme pollution (female = 3.9 ± 1.7; 95% CI = 3.5-4.2; male = 4.6 ± 2.1; 95% CI = 4.1-4.9), particularly in individuals aged ≥ 70 years. Significant associations were found between mortality rates and pollution levels for DCS (p = 0.019), IHD (p = 0.025), and CBVD (p = 0.002) in the 50-69-year age group when comparing moderately and extremely polluted areas. Intermediate/high social vulnerability was identified in 71% of neighborhoods, with an increasing socioenvironmental gradient linking higher vulnerability to higher PM2.5 concentrations (R = 0.354; p = 0.001).
Conclusion
Mean PM2.5 concentrations in the neighborhoods of Rio de Janeiro exceeded the World Health Organization’s recommended standard by a factor of four. Mortality from DCS is significantly higher and occurs earlier in areas with high or extreme levels of pollution.