Relação entre a exposição a poluentes e internações por doenças respiratórias crônicas em residentes de São Caetano do Sul – SP

Abstract

Introduction: The ABC Paulista region in São Paulo faces challenges regarding sustainable urban development, where economic and social progress coexist with environmental and public health pressures. Despite its high Human Development Index (HDI) of 0.862, São Caetano do Sul (SCS) is not immune to the challenges of air pollution, given its substantial vehicle fleet and industrial sector. Air pollution—specifically particulate matter (PM)—has been linked to adverse respiratory health effects, primarily affecting children and the elderly. This study aims to investigate the relationship between air pollution and hospitalizations for chronic respiratory diseases in São Caetano do Sul, a municipality characterized by both a high HDI and significant environmental challenges. Objective: To understand the relationship between air pollution (PM10, O3, NO2) and the prevalence of chronic respiratory diseases between 2010 and 2023 in São Caetano do Sul (SP). Methods: This longitudinal time-series study utilizes aggregated secondary data from 2010 to 2023. Air pollution data were obtained from CETESB, while data on hospitalizations for chronic respiratory diseases (asthma, COPD, and CRD) were collected from DATASUS. Monthly hospitalization frequencies were calculated and stratified by sex, age group, and disease type. Statistical analysis included descriptive statistics, correlation analysis, and time-series analysis to identify trends and seasonality. Microsoft Excel and Google Colab were used for the analysis. Results: On an annual basis, there is a moderate-to-strong positive correlation between hospitalization rates for asthma and chronic respiratory diseases (CRD) and levels of particulate matter (PM₁₀) and nitrogen dioxide (NO₂) in São Caetano do Sul, with a notable long-term association between asthma and NO₂ (r = 0.6295). In contrast, monthly analyses revealed high volatility and inconsistent seasonal fluctuations—potentially driven by the modulating influence of climatic factors (such as winter thermal inversions)—while ozone (O₃) showed weak and predominantly negative correlations. Finally, a historical low in CRD hospitalizations was observed in 2020 (79 cases), constituting a “natural experiment” that demonstrates how social isolation and reduced urban mobility reliant on fossil fuels during the COVID-19 pandemic resulted in immediate, measurable epidemiological relief for municipal public health