13th LBA SCIENTIFIC STEERING COMMITTEE IMPACTS OF PARTICLES AND OZONE ON HUMAN HEALTH Helena Ribeiro Environmental Health Department School of Public Health University of São Paulo, Brazil

1.Introduction Scarcity of studies on the impacts of biomass fires on human health. Complex Research in Environmental Health: web of interrelated factors: exogenous (biotic and non-biotic), endogenous (physiological and anathomical), behavior (psychological, social, cultural), human density (AUDY, 1971)

Direct and indirect effects of biomass fires: Direct: Reduction of visibility, closing of airports and schools, increase in traffic accidents, destruction of fauna and flora, increase in incidence and prevalence of diseases, decrease of productivity, restriction of activities related to work and leisure, psychological effects and economic costs.

Indirect: climate changes in large and local scale with consequences on biotic elements that would alter the health/disease equilibrium in a given place. Main effects on health related to air pollution. Source of fire and stage cause different emissions = specific effects on human health. (YAMASOE ET AL. 2000)

2.Air Pollution and Respiratory Diseases Individual’s exposure will depend on the time spent in different microenvironments and on activity patters. Ex.: vigorous exercises increase dose rate; Children may receive an increased dose of pollutants because of higher minute ventilation per unit body mass, are more physically active, and spend more time outdoors.

2 approaches: - Toxicological studies- Done in laboratories: animal bioassays, in vitro studies, controlled human exposure. -Epidemiological Studies- Examine the association between exposure to different air pollution levels and health effects -To compare changes in time of ambient air conditions with fluctuations in mortality or morbidity data (short-term effects) -To evaluate long-term effects, comparing morbidity and mortality data of areas with different pollution levels. Studies continue in search of a methodology that would eliminate all confounding factors

Table 1: Health Effects of Air Pollutants AgentClinical Consequences ParticlesIncreased respiratory symptoms in children (PM10)Increased respiratory illness in children Decreased lung function in children Excess mortality for chronic lung/heart disease patients Increased asthma exacerbation in asthmatics Some particles are carcinogenic (diesel) OzoneDecreased lung function Increased airway reactivity Lung Inflammation Increased respiratory symptoms Decreased exercise capacity in athletes Increased hospitalizations in asthmatics Eye irritation

-NO2Increased airway reactivity Decreased lung function in asthmatics Increased respiratory infections in children -CODecreased exercise capacity Angina pectoris and excess mortality for patients with ischemic heart disease Headaches Episodes of very high pollution levels have been associated to excess mortality, increased hospital admissions mainly for circulatory and respiratory diseases

Chronic Obstructive Pulmonary Diseases Asthma-a general shrinking of the bronchial airways Bronchitis- excessive phlegm that provokes expectoration and chronic or recurrent cough in most days, for at least three subsequent months in one year. Emphysema of the lung- abnormal and permanent expansion of airways until the final bronchiole with concomitant destruction of their walls, causing irreversible alterations of the pulmonary parenchyma. Reduction of blood flow in the affected area and consequently pulmonary hypertension that, when constant, forces the right ventricle in order to maintain an adequate heart debt. Muscular fatigue, enlargement, and finally an insufficiency of the right ventricle. Cough and dyspnea are common symptoms

Particles Smaller ones (PM10 and PM2,5) have worst effects Measurements have registered: -70  g/m3 of particles smaller than 10  m for an average of 54 days; 100,9  g/m3 as average for the period February to April 1998; 450  g/m3 daily average; 600 to 1000  g/m3 for many hours in Brunei Darussalam, during forest fire’s season. Daily standards recommended by W.H.O (World Health Organization) for PM10 is 70  g/m2 Brazilian standards for PM 10 are daily 150  g/m2, annual 50  g/m2

PM10 Concentrations in a 24 hours period, in 3 different sites in Brunei (  g/m2) during forest fires nearby Date Laboratory Hospital School 15/4/ /4/ /4/ /4/ /4/ Source: Muraleedharan et al., 2000: 2729

Studies done in urban areas also indicate that the effects of particles on children´s morbidity may be further reinforced by low socio-economic conditions, mainly inadequate housing (RIBEIRO SOBRAL, 1989). Results of time series studies using Poisson regression models, in the city of São Paulo, suggest that socioeconomic deprivation represents an effect modifier of the association between air pollution and respiratory deaths, since lower income and lower education, increase the PM10 effect on elderly mortality.

Ozone Levels of ozone measured during fire episodes in Brunei (5,1 to 99,9  g/m3), in 1998, were well below standards recommended by USEPA (Environmental Protection Agency): 235  g/m3 in an hour average, not to be exceeded more than 3 times in 3 years (MURALEEDHARAN ET AL., 2000; RADOJEVIC & HASSAN, 1999). Data obtained indicated that although ozone was produced during biomass fires in different amounts, its concentrations did not represent a public health risk (RADOJEVIC & HASSAN, 1999).

4. Conclusions The knowledge is urgent to define policies and air quality standards Background pollution may be increased by biomass fires What are the health impacts of pollutants on humans already impaired by disease, by age or by social conditions?