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city, 2009-2011
Osorio, Samuel; Ikefuti, Priscilla; Ribeiro, Helena.
The effects of temperature on human health are of different types. Within the direct
effects are those who have influence on mortality from cardiovascular diseases, in
which acute myocardial infarction (AMI) and stroke has a strong relationship with
temperatures outside of the thermal comfort, especially in adults and elderly. This ratio
can vary between cities with different climatic and geographical features, in this case
we chosen two major Latin American cities. The aim of this study was to explore a
possible association between temperature and mortality from cardiovascular disease in
adults living in the city of So Paulo and Bogot, for the period 2009 to 2011. For this
research we used the methodology of ecological study and series time analysis. We
built generalized additive models (GAM), with Quasi-Poisson family through the
process step forward. We used third-order splines to remove the effect of trend and
seasonality. The different temperature variables available (maximum, minimum, and
mean temperature range) were tested independently to see which related better with
two mortalities separately (AMI and stroke). Up to 7 days lags were tested for each
independent variable in the model, and we included the most significant lags in the
case of Bogot using generalized linear models (GLM) with Quasi-Poisson to calculate
Risks Relating for the So Paulo city was used GAM with the Poisson family. The
variables relative humidity, particulate matter less than 10 micrometres ozone, sulfur
dioxide and nitrogen dioxide were used as control variables in the models. As a result
we find that for cases of mortality from stroke in So Paulo, the mean temperature and
atmospheric pressure were the variables with statistical significance in the final model,
yet entered the pollutants: carbon monoxide (CO) and PM10, the deviation explained
by the model was almost 4%. For mortality from AMI the explained deviation was more
than 10%, the most explanatory variables for the model were: minimum temperature,
atmospheric pressure, amplitude and PM10. To Bogota, using generalized linear
models (GLM) with the dependent variable IAM, the minimum temperature was the
only statistically significant RR for the lag of three days; stroke to the maximum
temperature had the greatest statistically significant RR for a lag of 0 days. Using GAM
for AMI and stroke in the same city, the models that best explained the temperature
ratio - mortality were: AMI with the independent variables: minimum temperature,
humidity, PM10, O3 and SO2, with 3 to 4 days lags for each, the model explained 11%
of the variance in mortality, since the AVC with the maximum temperature independent
variables, humidity, PM10, O3 and NO2, the model explained 3.42% of the variance.
We conclude, according to the results, the temperature influence in different ways the
two mortalities studied, and differently in the two cities: So Paulo with higher average
temperatures, the minimum temperature had most influence on deaths, on the other
hand Bogota, a city with lower average temperatures, the heat played an important
role in deaths from stroke. The obtained models can explain a part of the percentage
of mortality, taking into account other processes such as obesity, comorbidities, diet,
lifestyle and others may have a strong influence in the event of the deaths of adults.
Key Words: Temperature, Climate and Health, So Paulo Bogot.