Contaminación ambiental y enfermedades agudas y crónicas del tracto respiratorio alto y bajo

Abstract

Air pollution significantly impacts human health and well-being and is a key risk factor in the development of cardiorespiratory conditions. The municipality of Bello, located in the Aburrá Valley at the mouth of a major watershed, faces acute environmental challenges due to high population density, intensive industrial activity, and elevated vehicular traffic. These conditions increase human exposure to atmospheric pollutants. This study aims to correlate levels of measured criteria pollutants with the number of medical consultations for upper and lower respiratory tract conditions, classified as acute or chronic, during pollution contingency periods in 2016 and 2017. Methodology: A quantitative, observational, retrospective, ecological, and exploratory study was conducted, focusing on latency periods between environmental exposure and medical consultations. Results: Consultations for acute lower respiratory tract infections increased after two days of exposure to PM2.5 and PM10. Exacerbated chronic lower respiratory conditions were associated with exposure to PM2.5 after five days, while acute upper respiratory infections increased after six days of exposure to NOx, PM2.5, and PM10. Conclusions: Exposure to PM2.5 was associated with both acute and chronic respiratory diseases of the upper and lower tract. PM10 exposure was linked to acute conditions, and NOx exposure was associated primarily with acute upper respiratory conditions. While causality cannot be definitively established, these findings suggest a strong correlation and may inform public health policies focused on environmental monitoring and respiratory health equity.

Keywords

Air pollution

atmospheric pollutants

air quality control

respiratory diseases

environmental health

References

Alcaldía de Bello. (2018). Anuario estadístico de Bello 2018. https://bello.gov.co/index.php/styles/anuario-estadistico-2016

Almetwally, A. A., Bin-Jumah, M., & Allam, A. A. (2020). Ambient air pollution and its influence on human health and welfare: an overview. Environ Sci Pollut Res Int, 27(20), 24815-24830. doi: 10.1007/s11356-020-09042-2

AMVA. (2016). Resolución metropolitana N° 000379 de 2016. Por la cual se declara el nivel de contingencia atmosférica en la jurisdicción del Área Metropolitana del Valle de Aburrá y se toman otras determinaciones. Área Metropolitana del Valle de Aburrá. Medellín, Colombia, 18 de marzo. http://proyectos.andi.com.co/Ambiental/SiteAssets/Resoluci%C3%B3n%20379%20AMVA.pdf.

AMVA. (2017). Resolución metropolitana N° 00-000395 de 2017. Por medio de la cual se adoptan medidas con ocasión de la contingencia atmosférica que se presenta en el Valle de Aburrá. Marzo 22, 2017. https://www.metropol.gov.co/ambiental/calidad-del-aire/Documents/Normatividad/Resolucion_395_2017%20contingencia.pdf.

AMVA. (2019). Plan Integral de Gestión de la Calidad del Aire (Pigeca). https://www.metropol.gov.co/ambiental/calidad-del-aire/Paginas/Gestion-integral/PIGECA.aspx

AMVA. (2019). Plan Operacional para Enfrentar Episodios Críticos de Contaminación Atmosférica (Poeca).https://www.metropol.gov.co/ambiental/calidad-del-aire/Paginas/Gestion-integral/POECA.aspx

Ardusso, L., Neffen, H., Fernández-Caldas, E., Saranz, R., Parisis, C., Tolcachier, A., Cicerán, A., Smith, S., Máspero, J., Nardacchione, N., y Marino, N. 2019). Intervención ambiental en las enfermedades respiratorias. Medicina (Buenos Aires), 79(2), 123-136. https://medicinabuenosaires.com/revistas/vol79-19/n2/123-136-Med6871-Arduso-A.pdf

Boyd, D. R. (2019). The Human Right to Breathe Clean Air. Annals of global health, 85(1), 146-146. doi: 10.5334/aogh.2646

Burbank, A. J. (2023). Risk Factors for Respiratory Viral Infections: A Spotlight on Climate Change and Air Pollution. Journal of Asthma and Allergy, 183-194. doi: 10.2147/JAA.S364845

Cohen, A., Brauer, M., Burnett, R., Anderson, R., Frostad, J., Estep, K., Ba Ross, K., Brunekreef, B., Dandona, L., Nandona, R., Feigiin, V., Freedman, G., Hubbell, B., Jobling, A., Kan, H., Knibbs, L., Liu, Y., Martin, R., Morawska, L., Pope, A., Shin, H., Straift, K., Shaddick, G., Thomas, M. , Dingenen, R.,

Donkelaar, A., Vos, T., Murray, C., y Forouzanfar, M.(2017). Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. The lancet, 389(10082), 1907-1918. doi: https://doi.org/10.1016/S0140-6736(17)30505-6

Croft, D P., Zhang, W., Lin, S., Thurston, S. W., Hopke, P. K., Masiol, M., Squizzato, S., Wijngaarden, E., y Rich, D. Q. (2019). The Association between Respiratory Infection and Air Pollution in the Setting of Air Quality Policy and Economic Change. Ann Am Thorac Soc, 16(3), 321-330. doi: 10.1513/AnnalsATS.201810-691OC

Chen, M. J., Yang, P. H., Hsieh, M. T., Yeh, C. H., Huang, C. H., Yang, C. M., & Lin, G. M. (2018). Machine learning to relate PM2.5 and PM10 concentrations to outpatient visits for upper respiratory tract infections in Taiwan: A nationwide analysis. World J Clin Cases, 6(8), 200-206. doi: 10.12998/wjcc.v6.i8.200

Dyląg, K. A., Wroński, B., Przybyszewska, K., & Dumnicka, P. (2018). Air pollution is associated with incidence of viral croup among children living in Kraków area, Poland. Folia Med Cracov, 58(1), 69-79.

EPA. (2009). United States Environmental Protection Agenc. Terminology Services., 2021. https://www.epa.gov/

Fan, X., Dong, T., Yan, K., Ci, X., & Peng, L. (2023). PM2.5 increases susceptibility to acute exacerbation of COPD via NOX4/Nrf2 redox imbalance-mediated mitophagy. Redox Biol, 59, 102587. doi: 10.1016/j.redox.2022.102587

Han, X., & Naeher, L. P. (2006). A review of traffic-related air pollution exposure assessment studies in the developing world. Environment international, 32(1), 106-120. doi: https://doi.org/10.1016/j.envint.2005.05.020

INS. (2018). Instituto Nacional de Salud, Observatorio Nacional de Salud, Carga de Enfermedad Ambiental. Décimo Informe Técnico Especial. Bogotá D.C., 177.

Jaspers, I., Ciencewicki, J. M., Zhang, W., Brighton, L. E., Carson, J. L., Beck, M. A., & Madden, M. C. (2005). Diesel exhaust enhances influenza virus infections in respiratory epithelial cells. Toxicological Sciences, 85(2), 990-1002. doi: https://doi.org/10.1093/toxsci/kfi141

Kirwa, K., Eckert, C. M., Vedal, S., Hajat, A., & Kaufman, J. D. (2021). Ambient air pollution and risk of respiratory infection among adults: evidence from the multiethnic study of atherosclerosis (MESA). BMJ Open Respir Res, 8(1). doi: 10.1136/bmjresp-2020-000866

Labraña, J., Folchi, M., Urquiza, A., & Rivas, M. (2021). La Construcción de la Contaminación Atmosférica como Problema Público, Santiago de Chile (1961-1978). Historia Ambiental Latinoamericana y Caribeña (HALAC) revista de la Solcha, 11(3), 149-177.

Laumbach, R. J., Cromar, K. R., Adamkiewicz, G., Carlsten, C., Charpin, D., Chan, W. R., . . . Viegi, G. (2021). Personal Interventions for Reducing Exposure and Risk for Outdoor Air Pollution: An Official American Thoracic Society Workshop Report. Annals of the American Thoracic Society, 18(9), 1435-1443. doi: 10.1513/AnnalsATS.202104-421ST

Liang, Z., Meng, Q., Yang, Q., Chen, N., & You, C. (2021). Size-Specific Particulate Matter Associated With Acute Lower Respiratory Infection Outpatient Visits in Children: A Counterfactual Analysis in Guangzhou, China. Front Public Health, 9, 789542. doi: 10.3389/fpubh.2021.789542

Mao, M., Zhang, X., & Yin, Y. (2018). Particulate matter and gaseous pollutions in three metropolises along the Chinese Yangtze River: Situation and Implications. International journal of environmental research and public health, 15(6), 1102. doi: https://doi.org/10.3390/ijerph15061102

Meneses, R., Gonzalez-Gonzalez, M. V., Garay-Molina, N. M., Hoyos-Barba, M., & Agudelo-Henao, L. F. (2020). Informe de Calidad de Vida de Medellín, 2016-2019. Medellín, cómo vamos, 1-318. doi: 10.17230/19094108-2017d

Jerez, J. M., Molina, I., García-Laencina, P. J., Alba, E., Ribelles, N., Martín, M., & Franco, L. (2010). Missing data imputation using statistical and machine learning methods in a real breast cancer problem. Artificial Intelligence in Medicine, 50(2), 105–115. https://doi.org/10.1016/j.artmed.2010.05.002

Ministerio de Ambiente, Vivienda y Desarrollo Territorial. (2010). Resolución 2154 de 2010, por la cual se ajusta el Protocolo para el Monitoreo y Seguimiento de la Calidad del Aire adoptado a través de la Resolución 650 de 2010 y se adoptan otras disposiciones. https://www.minambiente.gov.co/documento-normativa/resolucion-2154-de-2010/

Ministerio de Ambiente y Desarrollo Sostenible. (2017). Resolución 2254 de 2017, por la cual se actualizan los niveles de calidad del aire ambiente. https://www.minambiente.gov.co

Pedregosa, F., Varoquaux, G., Gramfort, A., Michel, V., Thirion, B., Grisel, O., . . . Dubourg, V. (2011). Scikit-learn: Machine learning in Python. the Journal of machine Learning research, 12(85), 2825-2830.

Piñeros-Jiménez, J. G., Grisales-Romero, H. d. J., Nieto-López, E. S., Montealegre-Hernández, N. A., Villa-Garzón, F. A., Agudelo-Cadavid, R. M., & Cubaque-López, H. A. (2018). Contaminación atmosférica y sus efectos sobre la salud de los habitantes del Valle de Aburrá., 2008-2015.

Pirozzi, C. S., Jones, B. E., VanDerslice, J., Jephson, A., & Dean, N. C. (2015). Short-term effects of particulate air pollution exposure on incidence and severity of pneumonia C104. Indoor and outdoor pollution: epidemiology and mechanisms (pp. A5250-A5250): American Thoracic Society.

Prüss-Üstün, A., Wolf, J., Corvalán, C., Bos, R., & Neira, M. (2016). Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks: World Health Organization.

Ramirez-Rubio, O., Daher, C., Fanjul, G., Gascon, M., Mueller, N., Pajín, L., . . . Nieuwenhuijsen, M. J. (2019). Urban health: an example of a “health in all policies” approach in the context of SDGs implementation. Globalization and health, 15(1), 1-21. doi: https://doi.org/10.1186/s12992-019-0529-z

Ratajczak, A., & Badyda, A. (2021). Air Pollution Increases the Incidence of Upper Respiratory Tract Symptoms among Polish Children. J Clin Med, 10(10). doi: 10.3390/jcm10102150

Rice, M., Balmes, J., & Malhotra, A. (2021). Outdoor Air Pollution and Your Health. Am J Respir Crit Care Med, 204(7), P13-P14. doi: https://doi.org/10.1164/rccm.2046p13

Romero-Placeres, M., Más-Bermejo, P., Lacasaña-Navarro, M., Rojo-Solís, M. M. T., Aguilar-Valdés, J., & Romieu, I. (2004). Contaminación atmosférica, asma bronquial e infecciones respiratorias agudas en menores de edad, de La Habana. salud pública de méxico, 46(3), 222-233.

Roumeliotis, S., Abd-ElHafeez, S., Jager, K. J., Dekker, F. W., Stel, V. S., Pitino, A., . . . Tripepi, G. (2021). Be careful with ecological associations. Nephrology, 26(6), 501-505. doi: https://doi.org/10.1111/nep.13861

Schraufnagel, D. E., Balmes, J. R., Cowl, C. T., De Matteis, S., Jung, S. H., Mortimer, K., . . . Wuebbles, D. J. (2019). Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 2: Air Pollution and Organ Systems. Chest, 155(2), 417-426. doi: 10.1016/j.chest.2018.10.041

Sheppard, L. (2014). Ecological Study Design Wiley StatsRef: Statistics Reference Online.

Télles-Rojo, M., Romieu, I., Polo-Peña, M., Ruiz-Velasco, S., Meneses-González, F., & Hernández-Avila, M. (1997). Efecto de la contaminación ambiental sobre las consultas por infecciones respiratorias en niños de la Ciudad de México. salud pública de méxico, 39, 513-522.

The_SciPy_community. (s.f.). scipy.stats.pearsonr. Retrieved abril, 2022, from https://scipy.github.io/devdocs/reference/generated/scipy.stats.pearsonr.html?highlight=pearson#r8c6348c62346-3

Ubilla, C., & Yohannessen, K. (2017). Outdoor air pullution respiratory health effects in children. Revista Médica Clínica las Condes, 111-118.

Ünver, E., Altın, S., Bolat, E., Çoban, A., Aktaş, M., Fıçıcı, M., & Tecer, L. H. (2018). Effects of air pollution on respiratory system disease admission and health budget. Paper presented at the Allergy.

Wang, Q., & Liu, S. (2023). The Effects and Pathogenesis of PM2.5 and Its Components on Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis, 18, 493-506. doi: 10.2147/copd.s402122

WHO. (2006). Guías de calidad del aire de la OMS relativas al material particulado, el ozono, el dióxido de nitrógeno y el dióxido de azufre: actualización mundial 2005: Ginebra: Organización Mundial de la Salud.

WHO. (2016). Ambient air pollution: A global assessment of exposure and burden of disease.

WHO. (2021). WHO global air quality guidelines. Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Executive summary. Geneva: World Health Organization. 16. https://www.who.int/teams/environment-climate-change-and-health/air-quality-and-health/health-impacts

World Health Organization. Regional Office for, E. (2013). Health effects of particulate matter: policy implications for countries in eastern Europe, Caucasus and central Asia. Copenhagen: World Health Organization. Regional Office for Europe.

Yadav, M. K., Go, Y. Y., Jun, I., Chae, S.-W., & Song, J.-J. (2020). Urban particles elevated Streptococcus pneumoniae biofilms, colonization of the human middle ear epithelial cells, mouse nasopharynx and transit to the middle ear and lungs. Scientific reports, 10(1), 1-13. doi: https://doi.org/10.1038/s41598-020-62846-7

Yalnız, E., Uslu, Ö., Bolat, E., Altın, S., & Polat, G. (2020). Does the Hospital Admission of Patients with Respiratory Disease Increase in Izmir When the PM10 Level is High? Turkish Thoracic Journal, 21(1), 32. doi: doi: 10.5152/TurkThoracJ.2019.180148

Yan, Y., Li, Y., Sun, M., & Wu, Z. (2019). Primary pollutants and air quality analysis for urban air in China: evidence from Shanghai. Sustainability, 11(8), 2319. doi: https://doi.org/10.3390/su11082319

Yang, X., Zhang, T., Zhang, Y., Chen, H., & Sang, S. (2021). Global burden of COPD attributable to ambient PM2.5 in 204 countries and territories, 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Sci Total Environ, 796, 148819. doi: 10.1016/j.scitotenv.2021.148819

Zou, W., Wang, X., Sun, R., Hu, J., Ye, D., & Bai, G. (2021). PM2.5 Induces Airway Remodeling in Chronic Obstructive Pulmonary Diseases via the Wnt5a/β-Catenin Pathway. Int J Chron Obstruct Pulmon Dis, 16, 3285-3295. doi: 10.2147/copd.s334439