O impacto da emissão de material particulado sobre a saúde respiratória da população de Manaus no período de 2008 a 2019

Abstract

The advancement of the debate about environmental issue has reoriented traditional economic theory, in the sense that the problem of scarcity of ecosystem goods and services is based on the analytical basis of Neoclassical Theory. In contrast to Environmental Economics, Ecological Economics refutes the hypothesis that technological advances can offer solutions in an undetermined way to the limits that the environment offers to economic growth. In addition to the traditional dilemma about compatibility between the economy and the environment, the health problems to which the populations of large cities are exposed are added due to how much and how anthropic processes are expanding in large urban centers, such as the case of Manaus. The hypothesis is that sources of particulate matter present in the city, such as: the vehicle fleet, the generation of fossil fuel-based thermoelectric energy, the refining of oil and the number of burnings influence the number of hospitalizations due to respiratory problems in the city. Based on this triad: Economy, Environment and Health, this research aimed to: (i) analyze how the main anthropic air pollution actions evolved in Manaus; (ii) estimate the amount of annual particulate matter emission from the main potentially polluting urban industrial activities in the years 2014 to 2019 and; (iii) verify if the concentration of particulate matter in the atmosphere of Manaus were associated with the number of hospitalizations due to respiratory problems in the city in the period from 2008 to 2019. To this, a historical review was made of the transition process of the capital's energy matrix, the characterization of the quantity and composition of the fleet, the quantification and description of the characteristics of the refining process in Manaus. The particulate matter emission inventory was made based on estimates based on the method of using emission factors, which represent an average emission of pollutants from different sources. Finally, Linear Models, Generalized Linear Models and Generalized Additive Models were tested to verify the best fit to verify if there was an association between the concentration of particulate matter in the atmosphere and the number of hospitalizations in Manaus, as well as, if there was an association between the evolution of human activities and the number of hospitalizations for respiratory diseases in the period from 2008 to 2019. It was found that the generation of thermoelectric energy was the main source of emission of particulate material in Manaus during almost the entire period analyzed, but with successive and significant reductions from the introduction of natural gas in the city's energy matrix. In the last year of the series, the main source of emission of particulate matter in Manaus was the vehicle fleet, a trend consistent with large urban centers in Brazil and the world. Regarding hospitalizations, generalized additive models with Poisson regression, with smoothing curves for seasonality adjustments due to climatic factors and months and years indicators, showed the most consistent results. It was not possible to establish an association between the concentration of PM2.5 and the number of hospitalizations, neither by the total nor by the number of occurrences by age groups. These episodes seem to be better explained by cases of Influenza, whose seasonality peaks in the rainy months in the Amazon. However, the GAM model showed a strong association between the intensity of the generation of thermoelectric energy, the vehicle fleet, the quantity of fires and the concentration of PM2.5 itself, which may indicate that another atmospheric pollutant resulting from urban economic activity may influence hospital visits for respiratory problems in the city of Manaus. The absence of observational data on the characterization of the vehicle fleet and the concentration of pollutants in the atmosphere of Manaus, may represent some kind of weakness in the results presented.