Acute effects of fine particulate air pollution in Latin America: a systematic review and meta-analysis

* This is a guest blog post regarding our recently published paper entitled “Short-term effects of fine particulate matter pollution on daily health events in Latin America: a systematic review and meta-analysis”. This post was written by Laís Fajersztajn, first author of the paper. Laís obtained her PhD in Science from the School of Medicine, University of São Paulo, Brazil and conducted her research at Laboratory of Experimental Air Pollution. She also concluded a Specialization in Systematic Reviews and Meta-analysis at the same University. She is currently an associate researcher  at the USP Global Cities Program, hosted at the Institute of Advanced Studies, University of São Paulo, Brazil and vice-coordinator of the study Group “Urban Environment and Health” at the same Institute



a polluted day in São Paulo, Brazil 


Acute effects of fine particulate air pollution in Latin America

Latin America should reinforce local scientific documentation on the acute health effects of PM2.5 pollution (particulate matter with aerodynamic diameter ≤ 2.5 μm).

Evidence of its effect on morbidity and mortality is scarce in the continent, concentrated in few cities and trend of publication is not increasing. This is the conclusion of a systematic review that retrieved 1628 studies.

In a previous paper we discussed that local scientific knowledge is important to reinforce air pollution control polices (Fajersztajn et al., 2013). Now we show that Latin America is not producing much evidence on the health effects of fine particulate pollution.

Transferability of existing concentration response functions derived in the developed world to a continent with significant differences in air pollution levels, mixes and demographic age structure are questionable. Doubt can weakness willing for air pollution control in the region. In a global context air pollution in Latin America usually receive less attention, probably because of data quality and scarcity, as well as because of the very high levels of PM2.5 pollution in Africa, Asia and Middle East. However PM2.5 annual mean levels trends are increasing in parts of South America. Indeed, data availability and quality is a major obstacle in Latin America. Less than half of the air pollution monitoring stations of the metropolitan network of São Paulo (Brazil) measure fine particulate matter and many Brazilian cities does not measure PM2.5 in regular basis. The same is true for most Latin American cities.

The good news is that similar to developed countries, the polled risk in the continent was small, but significant for respiratory and cardiovascular mortality in all-ages. However high quality evidence from more Latin American cities would be important to confirm the findings.

A major challenge of this review was to evaluate the quality of the included studies, a crucial strength of systematic reviews, compared to non-systematic ones. None of the available validated tools seemed to be applicable to epidemiological time-series studies and few systematic reviews of the literature that retrieved studies with these designs have addressed this topic. We have evaluated the quality of the included studies qualitatively, according to criteria previously registered at the protocol of this study.




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