Pleural anthracosis as an indicator of lifetime exposure to urban air pollution: An autopsy-based study in Sao Paulo

• Published in: Environmental research 2019-06, Vol.173, p.23-32
• Main Authors: Takano, Ana Paula Cremasco, Justo, Lisie Tocci, dos Santos, Nathalia Villa, Marquezini, Mônica Valeria, de André, Paulo Afonso, da Rocha, Francisco Marcelo Monteiro, Pasqualucci, Carlos Augusto, Barrozo, Lígia Vizeu, Singer, Julio M., De André, Carmen Diva Saldiva, Saldiva, Paulo Hilário Nascimento, Veras, Mariana Matera
• Format: Article
• Language: English
• Subjects: Air Pollutants; Air pollution; Air Pollution - statistics & numerical data; Anthracosis; Autopsy; Brazil; Environmental Exposure - statistics & numerical data; Exposure assessment; Humans; Lung; Pleura
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2019.03.006

Many studies have been conducted to evaluate the association between air pollution and adverse health effects using a wide variety of methods to assess exposure. However, the assessment of individual long-term exposure to ambient air pollution is a challenging task and has not been evaluated in a large autopsy study. Our goal was to investigate whether exposure to urban air pollution is associated to the degree of lung anthracosis, considering modifying factors such as personal habits, mobility patterns and occupational activities. We conducted a study in Sao Paulo, Brazil from February 2017 to June 2018, combining epidemiological, spatial analysis and autopsy-based approaches. Information about residential address, socio-demographic details, occupation, smoking status, time of residence in the city and time spent commuting was collected via questionnaires applied to the next-of-kin. Images of the pleura surface from upper and lower lobes were used to quantify anthracosis in the lungs. We used multiple regression models to assess the association between the amount of carbon deposits in human lungs, measured by the fraction of pleural anthracosis (FA), and potential explanatory variables. We analyzed 413 cases and our data showed that for each additional hour spent in daily commuting, the ratio FA/(1-FA) is multiplied by 1.05 (95% confidence interval: [1.02; 1.08]). The estimated coefficient for daily hours spent in traffic was not considerably affected by the inclusion of socio-demographic variables and smoking habits. We estimate a tobacco equivalent dose of 5 cigarettes per day in a city where annual PM2.5 concentration oscillates around 25 μg/m3. Pleural anthracosis is a potential index of lifetime exposure to traffic-derived air pollution. •Pleural anthracosis is a potential index of lifetime exposure to air pollution.•Pleural carbon deposition in non-smokers increases with exposure to traffic sources.•Carbon deposition in lungs is associated with age, commuting and smoking load.•One hour of exposure to air pollution is equivalent to smoking 5 cigarettes a day.