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      Asociación de síntomas respiratorios con factores atmosféricos y climáticos en adultos en Santa Marta, Colombia Translated title: Association of respiratory symptoms with atmospheric and climatic factors in adults in Santa Marta, Colombia

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          Abstract

          Objetivo: A nivel mundial existe una fuerte evidencia que la exposición a contaminantes atmosféricos incrementa las enfermedades respiratorias en los adultos, de esta manera el objetivo del presente trabajo fue observar la asociación de síntomas respiratorios con factores atmosféricos y climáticos en adultos en Santa Marta. Métodos: Fueron identificadas zonas expuestas a PM10 mayor a 75 μg/m³. Las enfermedades respiratorias, de los registros hospitalarios, fueron clasificadas en agudas, altas e inferiores, y crónicas. Se realizaron análisis de asociación epidemiológica y regresión logística. Resultados: Se encontró que las concentraciones de PM10 fueron mayores en Pescaíto y Gaira superando los valores máximos sugeridos por la Organización Mundial de la Salud (OMS). No se observó asociación epidemiológica significativa entre los periodos lluviosos y secos, el PM10 y las enfermedades respiratorias en adultos agudas y crónicas. Sin embargo se observó asociación epidemiológica entre ser del sexo masculino y mayor riesgo de presentar síntomas respiratorios agudos; y también se observó asociación epidemiológica entre ser del sexo masculino y disminución del riesgo de presentar síntomas respiratorios crónicos. Discusión: Para Santa Marta, se sugiere que el mes de abril debería ser el primer mes de vigilancia temprana de las enfermedades respiratorias. Este es de los primeros trabajos en Colombia, y específicamente en Santa Marta, en presentar análisis entre enfermedades respiratorias y los factores climáticos, contribuyendo así a los sistemas de vigilancia temprana de salud pública.

          Translated abstract

          Objective: Globally there is strong evidence that exposure to air pollutants increases respiratory diseases in adults. Thus the goal of this study was to observe the association of respiratory symptoms with atmospheric and climatic factors in adults in Santa Marta. Methods: The exposed areas were those that had higher concentrations of 75 ug/m³ PM10. From hospital records respiratory diseases were classified into acute, high and low, and chronic. Statistical analyzes that were performed were epidemiological association and logistic regression. Results: It was found that PM10 concentrations were higher in Gaira and Pescaíto overcoming protection values suggested by the World Health Organization (WHO). No significant association was observed between epidemiological wet and dry periods, the PM10 and respiratory diseases in adults acute and chronic. However we observed epidemiological association between being male and increased risk of acute respiratory symptoms, and also observed epidemiological association between being male and decreased risk of chronic respiratory symptoms. Discussion: For Santa Marta, it is suggested that April should be the first month of early surveillance of respiratory diseases. This is one of the first works in Colombia, specifically in Santa Marta in present analysis between respiratory diseases and climatic factors, contributing to early surveillance systems for public health.

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          Most cited references59

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          Seasonal variation in host susceptibility and cycles of certain infectious diseases.

          S Dowell (2001)
          Seasonal cycles of infectious diseases have been variously attributed to changes in atmospheric conditions, the prevalence or virulence of the pathogen, or the behavior of the host. Some observations about seasonality are difficult to reconcile with these explanations. These include the simultaneous appearance of outbreaks across widespread geographic regions of the same latitude; the detection of pathogens in the off-season without epidemic spread; and the consistency of seasonal changes, despite wide variations in weather and human behavior. In contrast, an increase in susceptibility of the host population, perhaps linked to the annual light/dark cycle and mediated by the pattern of melatonin secretion, might account for many heretofore unexplained features of infectious disease seasonality. Ample evidence indicates that photoperiod-driven physiologic changes are typical in mammalian species, including some in humans. If such physiologic changes underlie human resistance to infectious diseases for large portions of the year and the changes can be identified and modified, the therapeutic and preventive implications may be considerable.
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            Cold temperature and low humidity are associated with increased occurrence of respiratory tract infections.

            The association between cold exposure and acute respiratory tract infections (RTIs) has remained unclear. The study examined whether the development of RTIs is potentiated by cold exposure and lowered humidity in a northern population. A population study where diagnosed RTI episodes, outdoor temperature and humidity among conscripts (n=892) were analysed. Altogether 643 RTI episodes were diagnosed during the follow-up period. Five hundred and ninety-five episodes were upper (URTI) and 87 lower (LRTI) RTIs. The mean average daily temperature preceding any RTIs was -3.7+/-10.6; for URTI and LRTI they were -4.1+/-10.6 degrees C and -1.1+/-10.0 degrees C, respectively. Temperature was associated with common cold (p=0.017), pharyngitis (p=0.011) and LRTI (p=0.048). Absolute humidity was associated with URTI (p<0.001). A 1 degrees C decrease in temperature increased the estimated risk for URTI by 4.3% (p<0.0001), for common cold by 2.1% (p=0.004), for pharyngitis by 2.8% (p=0.019) and for LRTI by 2.1% (p=0.039). A decrease of 1g/m(-3) in absolute humidity increased the estimated risk for URTI by 10.0% (p<0.001) and for pharyngitis by 10.8% (p=0.023). The average outdoor temperature decreased during the preceding three days of the onset of any RTIs, URTI, LRTI or common cold. The temperature for the preceding 14 days also showed a linear decrease for any RTI, URTI or common cold. Absolute humidity decreased linearly during the preceding three days before the onset of common cold, and during the preceding 14 days for all RTIs, common cold and LRTI. Cold temperature and low humidity were associated with increased occurrence of RTIs, and a decrease in temperature and humidity preceded the onset of the infections.
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              The effect of ozone and PM10 on hospital admissions for pneumonia and chronic obstructive pulmonary disease: a national multicity study.

              A case-crossover study was conducted in 36 US cities to evaluate the effect of ozone and particulate matter with an aerodynamic diameter of < or =10 microm (PM10) on respiratory hospital admissions and to identify which city characteristics may explain the heterogeneity in risk estimates. Respiratory hospital admissions and air pollution data were obtained for 1986-1999. In a meta-analysis based on the city-specific regression models, several city characteristics were evaluated as effect modifiers. During the warm season, the 2-day cumulative effect of a 5-ppb increase in ozone was a 0.27% (95% confidence interval (CI): 0.08, 0.47) increase in chronic obstructive pulmonary disease admissions and a 0.41% (95% CI: 0.26, 0.57) increase in pneumonia admissions. Similarly, a 10-microg/m(3) increase in PM10 during the warm season resulted in a 1.47% (95% CI: 0.93, 2.01) increase in chronic obstructive pulmonary disease at lag 1 and a 0.84% (95% CI: 0.50, 1.19) increase in pneumonia at lag 0. Percentage of households with central air conditioning reduced the effect of air pollution, and variability of summer apparent temperature reduced the effect of ozone on chronic obstructive pulmonary disease. The study confirmed, in a large sample of cities, that exposure to ozone and PM10 is associated with respiratory hospital admissions and provided evidence that the effect of air pollution is modified by certain city characteristics.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rcsp
                Revista Costarricense de Salud Pública
                Rev. costarric. salud pública
                Asociación Costarricense de Salud Pública (San José )
                1409-1429
                June 2013
                : 22
                : 1
                : 27-34
                Article
                S1409-14292013000100006
                e41df540-73b1-43d0-89c8-9e94a64eb53a

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Costa Rica

                Self URI (journal page): http://www.scielo.sa.cr/scielo.php?script=sci_serial&pid=1409-1429&lng=en
                Categories
                Public, Environmental & Occupational Health

                Public health
                Colombia,Respiratory Tract Diseases,Air Pollution,Particulate Matter,Enfermedades Respiratorias,Contaminación del Aire,Material Particulado

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