RESUMO
Active transportation (walking or cycling) as a substitute for car trips still represents a small percentage of all daily travels in many European cities. This study aimed to estimate the health and economic co-benefits for the adult population of modal shift from driving to active travel in urban environments. Three scenarios were modelled for the case study, the city of Porto, Portugal, by comparing travel patterns of 2013 to hypothetical scenarios of modal shifts from driving to active transport, namely: i) SC1 - conservative scenario, with a change of 5% from driving to cycling and 10% from driving to walking; ii) SC2 - moderate scenario, with a shift of 10% and 15%, respectively; and iii) SC3 - optimistic scenario, with a shift of 15% and 20%, respectively. The mortality risk reduction for five health outcomes (colon and breast cancers, diabetes, ischemic heart disease, cerebrovascular disease) was assessed, including an estimation of traffic injury and air pollution exposure risks. Results were presented in Disability-Adjusted Life Years (DALYs) avoided. Economic valuation for each scenario was performed using a Willingness-to-Pay approach for morbimortality and a Cost of Illness approach for 2013 hospitalizations and work absenteeism. Significant health benefits were found in all modelled scenarios, ranging from 1657 (16%) to 2881 (28%) DALYs avoided. Total costs averted ranged from 3894 to 6769 million through the scenarios. Cardio and cerebrovascular diseases mortality presented the largest benefit, accounting for about 3/4 of all avoidable DALYs in all scenarios. Reductions in CO2 and PM10 emissions were calculated, showing a decrease from 31.6 to 73.7 kt of CO2 and 7 to 16 t for PM10, respectively. A modal shift towards active transportation could lead to significant health and economic benefits, indicating that the evaluation of health impacts should be included in the analysis of active transport interventions.
Assuntos
Poluição do Ar , Comportamentos Relacionados com a Saúde , Mortalidade , Meios de Transporte/métodos , Adulto , Condução de Veículo , Ciclismo , Transporte Biológico Ativo , Cidades , Humanos , Portugal , Comportamento de Redução do Risco , CaminhadaRESUMO
The effects of air pollution on health have been studied worldwide. Given that air pollution triggers oxidative stress and inflammation, it is plausible that high levels of air pollutants cause higher number of hospitalisations. This study aimed to assess the impact of air pollution on the emergency hospitalisation for respiratory disease in Rio de Janeiro, Brazil. The study was divided in two parts: Part I specifically addressing the air pollution assessment and Part II addressing the health assessment. Accordingly, this Part II aimed to estimate the association between the concentrations of PM10, SO2 and CO observed in Rio de Janeiro and the number of emergency hospitalisations at a central hospital due to respiratory diseases. The pollutant concentrations were measured at two different sites in Rio de Janeiro, but the excess relative risks were calculated based on the concentrations observed at one of the sites, where limits were generally exceeded more frequently, between September 2000 and December 2005. A time series analysis was performed using the number of hospitalisations, divided in three categories (children until 1 year old, children aged between 1 and 5 years old and elderly with 65 years old or more) as independent variable, the concentrations of pollutants as dependent variables and temperature, relative humidity, long term trend, and seasonality as confounders. Data were analysed using generalised additive models with smoothing for some of the dependent variables. Results showed an excess risk of hospitalisation for respiratory disease higher than 2% per 10 µg m⻳ increase in PM10 concentrations for children under 5 years old, of 2% per 10 µg m⻳ increase in SO2 for elderly above 65 years old and around 0.1% per 10 µg m⻳ increase in CO for children under 1 year and elderly. Other studies have found associations that are in agreement with the results achieved in this study. The study suggests that the ambient levels of air pollutants experienced in Rio de Janeiro between 2000 and 2005 were linked to the number of hospitalisations for respiratory diseases among children and elderly.
Assuntos
Poluentes Atmosféricos/toxicidade , Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Idoso , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Brasil , Monóxido de Carbono/análise , Pré-Escolar , Exposição Ambiental/análise , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Morbidade , Material Particulado/análise , Medição de Risco , Dióxido de Enxofre/análiseRESUMO
Exposure to air pollution has been related with the most varied adverse health outcomes. This study aims to assess the impact of air pollution on the emergency hospitalization for respiratory disease in Rio de Janeiro, Brazil. The study was divided in two parts: Part I specifically addressing the air pollution assessment and Part II addressing the health assessment. Accordingly, this Part I aims to: i) evaluate the concentrations of PM(10), SO(2) and CO at two sites in Rio de Janeiro and compare them; ii) analyse the concentrations observed according to the national and international standards; and iii) analyse the air pollutants behaviour, namely, annually, seasonally, daily and considering weekdays/weekends variations. The pollutant concentrations were measured at two different sites in Rio de Janeiro and the analysis was performed for the period between September 2000 and December 2005. Results showed that PM(10) concentrations in Rio de Janeiro exceeded the daily and annual standards imposed by the European Union, the Brazilian legislation and WHO guidelines. Regarding SO(2) and CO, concentrations were, generally, below both European and Brazilian standards. Nevertheless, considering WHO guidelines, SO(2) threshold for daily concentrations (20 µg m(-3)) was exceeded around 150 times. Behaviour assessment showed that the influence of traffic is a major factor affecting the air pollution in Rio de Janeiro. Considering the results achieved and the proven health effects of air pollution, strategies should be defined for its reduction, particularly concerning particulate matter, and consequently contribute to the protection of public health.