Respiratory Changes due to Long-term Exposure to Urban Levels of Air Pollution: Materials and Methods

Exposure Classification: Indoor and Outdoor Pollution
The high pollution area was Guarulhos, an industrial neighborhood city of Sao Paulo, Brazil. Sao Paulo is the most industrialized center of Latin America and, with its satellites, is an urban region with 16,000,000 people (greater Sao Paulo) that occupies an area of about 5,000 km2, situated 715 to 900 m above sea level. Due to the above characteristics and the occurrence of frequent thermal inversions, air pollution is considered a serious problem. An environmental state agency (CETESB) was established to monitor and help control air pollution levels. This agency established a telemetric monitoring network and has estimated that vehicles are the main source of atmospheric pollution. Based on this monitoring network, Guarulhos and much of Sao Paulo have had a mean annual concentration of inhalable particulates ranging from 80 to 100 μg/m between 1991 and 1995.
The low pollution areas were Ribeirao Preto and Ourinhos.
Ribeirao Preto is about 300 km and Ourinhos is 400 km from Sao Paulo. These two cities have an economy based primarily on agricultural activities mostly related to burning for harvesting purposes, such as the sugar cane industry and have no other major sources of air pollution. Ribeirao Preto has a population of approximately 420,000, and Ourinhos has approximately 70,000 persons. In Ribeirao Preto, S02 and black smoke reach levels of 30 and 50 μg/m, respectively, during the episodes of sugar cane burning. Unfortunately, no measurements of air quality were available for Ourinhos, although it can be assumed that it is far superior to that noted in the urban area. buy glycomet

Lifetime smoking was computed by determining the number of pack-years smoked (number of cigarette packs smoked per day multiplied by the number of years of smoking). Also, lifetime occupational exposure and passive smoking were computed.
Study Population
Lung tissue samples were obtained from victims of sudden traumatic deaths in each area occurring outside of the hospital over a period between 1992 and 1995. The total number of cases collected and the main cause of sudden traumatic deaths in Guarulhos, Ribeirao Preto, and Ourinhos are shown in Table 1.
Table 1—Legal Causes of Death in the 84 Cases Studied Distributed According to the Cities