Abstract
ABSTRACTOBJECTIVE To analyze the impact of two interventions (implementation and suspension of mandatory vehicle inspection) on morbidity and mortality due to conditions related to air pollution, from 2008 to 2017.METHODS Interrupted time series (ARIMA models), using data available in public repositories.RESULTS A total of 229,337 children of up to 5 years old were hospitalized due to respiratory diseases, and 1,053 died (average monthly mortality ratio for this population: 1.12/100,000). Exact 137,876 individuals over 40 years old were hospitalized for an acute myocardial infarction, and 19,492 died (3.7/100,000). A total of 11,010 individuals over 40 years old were hospitalized with malignant neoplasms of the respiratory system; 2,898 died (0.5/100,000). A total of 20,807 individuals over 60 years old were hospitalized with chronic obstructive pulmonary diseases; 2,627 died (1.5/100,000). As for strokes, 69,180 individuals were hospitalized, and 10,866 died (2.1/100,000). We found no significant regression coefficient for the implementation or suspension of the program regarding hospitalizations and deaths. 38,207 children of up to 14 years old were hospitalized with asthma, and 25 of them died (0.007/100,000). The coefficients show a monthly increase of 0.05 deaths/100,000 people (p = 0.01) in the post-inspection period. We found no correlation between the measured concentrations of the pollutants PM2.5 and CO – in a monitoring station, in the central region of the municipality – and the implementation or suspension of the inspection.CONCLUSIONS No evidence confirms that the program had a measurable beneficial impact on morbidity and mortality due to respiratory and circulatory diseases.
Highlights
In many urban areas, motor vehicles emissions have become a major source of air pollutants, such as carbon monoxide and dioxide, volatile organic compounds or hydrocarbons, nitrogen oxides, and particulate matter[1]
We found no significant regression coefficient for the implementation or suspension of the program regarding hospitalizations and deaths. 38,207 children of up to 14 years old were hospitalized with asthma, and 25 of them died (0.007/100,000)
We found no correlation between the measured concentrations of the pollutants PM2.5 and carbon monoxide (CO) – in a monitoring station, in the central region of the municipality – and the implementation or suspension of the inspection
Summary
Motor vehicles emissions have become a major source of air pollutants, such as carbon monoxide and dioxide, volatile organic compounds or hydrocarbons, nitrogen oxides, and particulate matter[1]. In Brazil, vehicle pollution control programs have led manufacturers to adopt technologies to reduce pollutant emissions. This effective medium-term measure tends to be compensated by the increase in vehicle fleet and their intensive use, as well as their ageing[4]. In 2008, the municipality of São Paulo passed a legislation making motor vehicle inspection mandatory for controlling pollutants emission – the Vehicle inspection and maintenance (I/M-SP) program[6]. This study aimed to analyze potential impacts of the two interventions – the implementation of mandatory inspection and its subsequent suspension – on morbidity and mortality due to conditions commonly associated with air pollution
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