A poluição e o clima podem influenciar as infecções respiratórias
                        em crianças?

Passos, Saulo Duarte; Gazeta, Rosa Estela; Felgueiras, Ana Paula; Beneli, Patrícia Costa; Coelho, Micheline de S. Z. S.

doi:10.1590/1806-9282.60.03.018

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Review Article • Rev. Assoc. Med. Bras. 60 (3) • May-Jun 2014 • https://doi.org/10.1590/1806-9282.60.03.018 copiar

A poluição e o clima podem influenciar as infecções respiratórias em crianças?

Autoria SCIMAGO INSTITUTIONS RANKINGS

Rever se a poluição e as alterações do clima podem influenciar nas infecções respiratórias de crianças. Fontes de dados: foram revisados artigos publicados sobre o tema no PubMed, SciELO, Bireme, EBSCO e UpToDate. Os seguintes critérios de inclusão foram levados em consideração: trabalhos científicos entre 2002 e 2012, delineamento de estudo, população pediátrica, documentos de referência, como Cetesb e Organização Mundial da Saúde. Síntese dos dados: foram analisadas as pesquisas que correlacionavam vírus respiratórios e alterações do clima e/ou poluição. O vírus sincicial respiratório tem sido o vírus mais relacionado com alterações climáticas e umidade. Outros "velhos e novos" vírus respiratórios, como parainfluenza (VPH), metapneumovírus humano (hMPV), bocavírus (HBoV) e parechovirus (HPeV), precisariam ser investigados pela sua importância clínica. Embora muito se tenha estudado sobre a relação das mudanças climáticas na saúde coletiva, estudos específicos sobre sua influência na saúde das crianças ainda são escassos.

mudança climática; poluição do ar; infecções respiratórias, criança

Impact	Exposure	Result
Direct	Air pollution	Decreased pulmonary function
		Asthma
		Birth defects
		Other respiratory diseases
		Mortality
	Heat waves	Increased respiratory diseases
		Increased hospital admissions
		Hyperthermia
		Possibility of birth defects
Indirect	Water reduction (quality and quantity)	Respiratory diseases
	Allergic diseases	Asthma
	Infectious diseases

Pollutant	Sampling Time	Conama Standards		WHO Standards
Pollutant	Sampling Time	Primary standard (µg/m³)	Secondary standard (µg/m³)	WHO Standards
Inhalable particles	24 hours ^* * Not to be exceeded more than once per year	150	100	50 (PM10) ^ Value not to be exceeded more than 3 days per year
				25 (PM2.5) ^ Value not to be exceeded more than 3 days per year
	AGM	60	50
Sulfur dioxide	24 hours ^* * Not to be exceeded more than once per year	365	100	20
Sulfur dioxide	AAM	80	40
Carbon monoxide	15min	NR	NR	10,000
	30min	NR	NR	60,000
	1 hour ^* * Not to be exceeded more than once per year	40,000 (35ppm)	40,000 (35ppm)	30. 000
	8 hours ^* * Not to be exceeded more than once per year	10,000 (9ppm)	10,000 (9ppm)	10. 000
Ozone	1 h ^* * Not to be exceeded more than once per year	160	160	100
Nitrogen dioxide	1 h ^* * Not to be exceeded more than once per year	320	190	200
Nitrogen dioxide	AAM	100	100	40

Author/Year	Location	Association	Conclusion
Reese & Marchette ⁴²42. Reese PE, Marchette NJ. Respiratory syncytial virus infection and prevalence of subgroups A and B in Hawaii. J Clin Microbiol. 1991;29(11):2614. 1991	Hawaii, USA	October/April	Rotation of serotypes A and B
Chew et al. ⁴³43. Chew FTS, Doraisingham S, AE Ling, Kumarasinghe G, Lee BW. Seasonal trends of viral respiratory tract infections in the tropics. Epidemiol Infect. 1998;121(1):121-8. 1998	Singapore	Association with low relative humidity, temperature variation, day and daily temperature variation	There is a seasonal relationship with ARI in the tropics
Vieira et al. ⁴⁴44. Vieira SE, Gilio AE, Miyao CR, Hein N, Betta SL, Lotufo JPB et al. Sazonalidade do virus respiratório sincicial na Cidade de São Paulo, SP. Pediatria (Säo Paulo). 2002;24(1/2):73-4. 2001	São Paulo	May/June	There is a correlation in a determined period in the city of São Paulo
Azamorano et al. ⁴⁵45. Zamorano W, Márquez S, Aránguiz JL, Bedregal P, Sánchez I. Relación entre bronquiolitis aguda con factores climáticos y contaminación ambiental. Rev Méd Chile. 2003;131(10):1117-22. 2003	Chile	Acute bronchiolitis, climate factors and environmental contamination	No association between environmental variations or air pollution and the number of clinical and emergency consultations in patients under one year old
Yusuf et al. ⁴⁶46. Yusuf S, Piedimonte G, Auais A, Demmler G, Krishnan S, Van Caeseele P et al. The relationship of meteorological conditions to the epidemic activity of respiratory syncytial virus. Epidemiol Infect. 2007;135(7):1077-90. 2007	Buffalo, Miami, Tucson, Canada, Mexico, India and Chile.	Humidity (45-65%) and high temperature	RSV infections were continuous throughout the year, reaching a peak in summer and the start of autumn. In temperate climates the maximum RSV activity was in the winter. In areas where temperatures remained colder throughout the year, RSV activity again became nearly continuous
Omer et al. ⁴⁷47. Omer B, Sutanto A, Sarwo H, Linehan M, Djelantik G, Mercer D et al. Climatic, temporal, and geographic characteristics of respiratory syncytial virus disease in a tropical island population. Epidemiol Infect. 2008;136(10):1319-27. 2008	Indonesia	Climate, weather and geographical characteristics of RSV respiratory illness	Rain, humidity and temperature increased the incidence of illness caused by RSV
Karr et al. ⁴⁸48. Karr CJ, Rudra CB, Miller KA, Gould TR, Larson T, Sathyanarayana S et al. Infant exposure to fine particulate matter and traffic and risk of hospitalization for RSV bronchiolitis in a region with lower ambient air pollution. Environ Res. 2009;109(3):321-7. 2008	Washington	Particulate material and other air pollutants derived from traffic and bronchiolitis caused by RSV	Increase in the number of bronchiolitis hospitalizations caused by RSV during the peak seasons of the occurrence of the virus
Meerhoff et al. ⁴⁹49. Meerhoff TJ, Paget WJ, Kimpen JLL. Variation of respiratory syncytial virus and the relation with meteorological factors in different winter seasons. Pediatr Infect Dis J. 2009;28(10):860-6. 2009	Netherlands	Increased relative air humidity, minimum temperature was negatively and cloudy weather positively related	The combination of low temperature and high humidity contributes more to RSV infections
Prel et al. ⁵⁰50. Prel JB, Puppe W, Grondahl B, Knuf M, Weigl JAI, Schaaff F et al. Are meteorological parameters associated with acute respiratory tract infections? Clin Infect Dis. 2009;49(6):861-8. 2009	Germany	Positive meteorological influence for ARI	Influenza A, RSV and Adenovirus correlation with temperature. Rhinovirus correlates with humidity
Sloan et al. ⁵¹51. Sloan C, Moore ML, Hartert T. Impact of pollution, climate, and sociodemographic factors on spatiotemporal dynamics of seasonal respiratory viruses. Clin Transl Sci. 2011;4(1):48-54. 2011	Review article	Pollution, climate and social/ demographic factors and seasonal respiratory viruses: RSV influenza and rhinovirus	Seasonality, cold climate, humidity, natural immunity cycle and individual antigenic variation
Vandini et al. ⁵²52. Vandini S, Corvaglia L, Alessandroni R, Aquilano G, Marsico C, Spinelli M et al. Respiratory syncytial virus infection in infants and correlation with meteorological factors and air pollutants. Ital J Pediatr. 2013;39(1):1. 2013	Italy	Infection by the respiratory syncytial virus in infants and correlation with meteorological factors and air pollutants	The tendency for RSV epidemics in Bologna (Italy) is related to the average minimum temperature and average concentration of MP₁₀

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[1] Correspondence: Laboratório de Infectologia Pediátrica, Address: Rua Francisco Telles, 250, Vila Arens, Jundiaí, SP - Brazil, ZIP Code: 13.202-550. sauloduarte@uol.com.br