Análise dos condicionantes climáticos e do material particulado fino nas internações por pneumonia em Manaus - Amazonas

Abstract

The main objective of this study was to explain how the types of weather and atmospheric pollutants influence the occurrence of pneumonia in the city of Manaus - Amazonas, from 2009 to 2019. For this purpose, it departed from the theoretical approach of Besancenot's Human Bioclimatology (2001), together with the theoretical-methodological concepts of climate rhythm and the Urban Climate System (UCS), focusing on the analysis of the physical-chemical subsystem, proposed by Monteiro (1976). Furthermore, the study was based on the theoretical references of the Climate Geography paradigm by Sant'Anna Neto (2001) and the Social Vulnerability Index (SoVI®) by Cutter (2003). Data from different sources were used for the city of Manaus: secondary data on climate variables were provided by the National Institute of Meteorology (INMET); hospital admission data for pneumonia were obtained from the Unified Health System database (SUS/DATASUS) and estimates of PM2.5 levels were collected from the Integrated Health Environmental Information System (SISAM/INPE), as well as the socioenvironmental variables made available in the Demographic Census (IBGE, 2010). The analyzes of the mentioned data consisted of descriptive and exploratory statistical methods, as well as the choice of “standard years” and rhythmic analyzes of the study variables, in addition to the analysis of morbidity rates. Furthermore, morbidity rates and socioenvironmental information were spatially represented in the study area. The results obtained by the Percentiles technique showed that hospitalizations for pneumonia in Manaus occurred in years with records of precipitation and relative humidity above the usual, while the most significant decrease in hospitalizations occurs in years with the highest average temperature and the lowest humidity. In the monthly and seasonal analysis, it appears that hospital morbidity due to pneumonia occurs predominantly from March to June, thus constituting a seasonal pattern that may be more related to the rainiest period in the region, especially with the relative humidity of the air. The average monthly concentrations of PM2.5 µg/m³ varied between 8.5 and 54.2 µg/m³, becoming more pronounced in the atmosphere during the driest period, on a daily scale, concentrations reached 165 µg/m³, surpassing with significantly beyond the air quality limits recommended by the World Health Organization and the National Council of Environment. Hospitalizations for pneumonia did not show a direct relationship with PM2.5 µg/m³. Among the general population, children are biologically vulnerable to occurrences of pneumonia, therefore, it showed statistically satisfactory direct associations with relative humidity and inverse associations with air temperatures and PM2,5. In addition, it is observed that in the daily rhythm, hospitalizations for pneumonia were influenced by weather conditions and air pollution in the days before the daily peak of cases, however, it presented a heterogeneous pattern. recipitating atmospheric systems showed a significant contribution to the highest daily morbidities. Racial and social inequality is the main factor that reveals the social vulnerability of Manaus and showed a center-periphery pattern. The highest rates of morbidity from pneumonia were identified in neighborhoods with low conditions of vulnerability, such as Cachoerinha, Ponta Negra, Centro and Praça 14 de Janeiro, and can be explained by the predominance of the elderly population in these areas. In addition to the fact that the Tarumã, Lago Azul and Santa-Etelvina neighborhoods require the implementation of preventive public health measures, as they stood out as potentially risky, these neighborhoods presented moderate to extremely high conditions of social vulnerability and the predominance of the child population group.