Multicity Study of Air Pollution and Health Effects in Latin America

Abstract

SS1-08 Abstract: The overall goal of this project is to use a common analytic framework to examine the association between exposure to outdoor air pollution and health effects in several Latin American and Caribbean (LAC) cities to obtain comparable and updated information on effects of air pollution on several age/cause groups. This will be achieved through developing a common protocol for the design and analysis of time-series data to be followed by all centers involved in the project. An important focus will be the detailed examination of the impact of such exposures in specific subgroups of the population considered most vulnerable such as infants and young children and the analysis by socioeconomic position. In the first steps, we will collect data and perform quality assurance for air pollution and mortality data from the participating cities from Brazil, Mexico, and Chile. Candidate cities so far are: Mexico City, Guadalajara, Toluca, Monterey, and Juarez City (Mexico); Sao Paulo, Rio de Janeiro, Porto Alegre, and Vitoria (Brazil); and Santiago, Antofogasta, Calama, Copiapo, and Temuco (Chile). Assessment of the availability and completeness of data in other large Latin American cities will also be pursued and those who fit the inclusion criteria will be included. Descriptive data of air pollutants and frequency distribution of mortality by cause and age groups will be carried out. First, single-city analysis will be conducted using a standardized analytical protocol (first-stage analysis). Heterogeneity will be explored and data combined using metaregression models (second-stage analysis). Overall and subgroup analyses will be conducted using generalized additive models (GAMs) in Poisson regression. We also explore the potential effect modification of socioeconomic position (SEP) and other variables on the association of air pollution and mortality using multilevel modeling (second-stage analysis). A common SEP indicator is identified that can equally represent the SEP of populations in the different cities. This project aims to contribute to the international scientific discussion on the conduct and interpretation of time-series studies of the effects of short-term exposure and to provide relevant information to decision-makers in the LAC region to support prevention and control strategies of air pollution.