Percorrer por autor "Monteiro, Alexandra"
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- Air pollution: a public health approach for PortugalPublication . Torres, Pedro; Ferreira, Joana; Monteiro, Alexandra; Costa, Solange; Pereira, Maria Carmo; Madureira, Joana; Mendes, Ana; Teixeira, João PauloAt the global level, several epidemiological studies have conclusively pointed out the associations between short-term exposure to air pollution and acute health effects, and long-term exposure with adverse health effects such as premature mortality from severe respiratory and cardiovascular diseases. This study intended to characterize exposures and their adverse health effects. Three independent sets of vectors were analyzed on a nationwide level and annual basis: air pollutant emissions, ambient air concentrations and health indicators of the period 2009 to 2015. The emissions analysis, for the studied pollutants, pointed out the main findings: (i) Lisbon Metropolitan Area presents the most problematic region with regard to the emissions of all the pollutants under study; (ii) the regions of the Alentejo and Algarve showed reduced emissions of the studied pollutants compared to other parts of the country; (iii) Northern regions PM10 concentrations decreased during the two years in analysis. Regarding the analysis of air quality, it was concluded that: (i) regarding ozone, concentration shown a decreasing trend throughout the country; (ii) nitrogen dioxide and particulate matter, concentrations demonstrated an increasing trend in most of the northern part of the country; (iii) the regions of Alentejo and Lisbon Metropolitan Area showed increasing trends for sulfur dioxide and fine particles for the evaluated period. Decreasing trends in mortality associated with cardiovascular and respiratory causes are found mainly in the Alentejo and Algarve regions. In comparison, the North, Central regions, as well as, Lisbon Metropolitan Area exhibited higher mortality values related to this health indicators.
- Exposure to ambient particulate matter increases blood count parameters with potential to mediate a cardiovascular event: results from a population-based study in PortugalPublication . Gaio, Vânia; Roquette, Rita; Monteiro, Alexandra; Ferreira, Joana; Rafael, Sandra; Dias, Carlos Matias; Nunes, BaltazarVariations in blood count parameters are potential mechanisms involved in the occurrence of cardiovascular events caused by particulate matter (PM) exposure. This study aims to estimate the effect of PM10 exposure on blood count parameters with potential to mediate a cardiovascular event. We used data from 2211 participants of the 1st Portuguese Health Examination Survey (INSEF, 2015) with available information on blood count parameters and living within a 30-km radius of at least one air quality monitoring station with available PM10 measurements. Generalised linear models were used to assess both short (3 days) and long-term effects (1 year) of PM10 exposure on blood count parameters. Both short and long-term PM10 effects on blood count parameters were found, with males and females affected in a different way. In the short-term scenario, we found a 2.76% (95% CI: 0.65–4.87) increase in white blood cells among females per each 10μg/m3 PM10 increment. Additionally, there was a 2.96% (95% CI: 0.80–5.12) increase in red cell distribution width (RDW), per each 10μg/m3 PM10 increment, among males, when considering the long-term scenario. In conclusion, we detected some sex-differential associations regarding the short and long-term effect of PM10 exposure on blood count parameters with potential to mediate a cardiovascular event, namely on the RDW parameter, that were never been described. It is uncertain whether changes in blood count parameters due to PM10 exposure constitute an adverse health outcome or it reflects only a normal immunity response. However, due to its potential to trigger cardiovascular events, it is essential to reduce PM10 levels exposure to protect the population’s cardiovascular health.
- Impactos da poluição atmosférica na Saúde: perspetivas do projeto FUTURARPublication . Mendes, Ana; Costa, Solange; Ferreira, Joana; Leitão, Joana; Torres, Pedro; Silveira, Carlos; Relvas, Hélder; Lopes, Myriam; Monteiro, Alexandra; Roebeling, Peter; Miranda, Ana Isabel; Teixeira, João PauloA poluição atmosférica é um importante fator para o desenvolvimento e exacerbação de doenças respiratórias, como a asma, a doença pulmonar obstrutiva crónica e o cancro do pulmão, bem como, um impacto substancial na doença cardiovascular. Além disso, a poluição atmosférica responde por 3,1% dos anos de vida ajustados pela incapacidade global (tempo gasto em estados de saúde reduzida). Apesar da redução de emissões de poluentes atmosféricos e melhoria da qualidade do ar verificadas na Europa e em Portugal na última década, os valores limite legislados para as concentrações de ozono (O3) e matéria particulada (PM) continuam a ser excedidos. Nesse contexto, o projeto FUTURAR - Qualidade do Ar em Portugal em 2030 - apoio à decisão política, pretende investigar os impactos, custos e benefícios das projeções de redução de emissões para 2030, usando modelos numéricos para estimar a distribuição espacial dos efeitos no ambiente e na saúde em Portugal.
- Investigating the association between ambient particulate matter (PM10) exposure and blood pressure values: Results from the link between the Portuguese Health Examination Survey and air quality dataPublication . Gaio, Vânia; Roquette, Rita; Monteiro, Alexandra; Ferreira, Joana; Matias Dias, Carlos; Nunes, BaltazarIntrodução e objetivo: A pressão arterial elevada (PA) continua a ser um importante fator de risco cardiovascular (CV) modificável. Vários estudos epidemiológicos têm sido realizados para avaliar a associação entre a exposição à poluição do ar e este fator de risco CV, mas os resultados permanecem inconsistentes. Este estudo tem como objetivo estimar o efeito da exposição de curta duração às PM10 (concentração média dos últimos três dias) nos valores da pressão arterial diastólica (PAD) e sistólica (PAS) da população residente em Portugal Continental. Métodos: O nosso estudo baseou-se nos dados disponíveis de PAD e PAS de 2272 participantes do primeiro Inquérito Nacional de Saúde com Exame Físico (INSEF, 2015) que viviam num raio de 30 km de pelo menos uma estação de monitoração da qualidade do ar com medições disponíveis de material particulado com diâmetro aerodinâmico ≤10 m (PM10). Foram utilizados os dados da rede de monitoração da qualidade do ar da Agência Portuguesa do Ambiente para atribuir as exposições individuais de PM10. Os modelos lineares generalizados foram utilizados para estimar o efeito da exposição às PM10 nos valores de PAD e PAS. Resultados: Nenhuma associação estatisticamente significativa foi encontrada entre a exposição a PM10 e os valores de PAD e PAS (0,42% de incremento de PAD por cada aumento de 10 g/m3 de PM10 [IC de 95%: −0,85; 1,70] e de 0,47% de incremento de PAS por cada aumento de 10 g/m3 [IC 95%: −0,86; 1,79]). Os resultados permaneceram inalterados após restringir a análise aos participantes hipertensos ou aos participantes obesos ou após alteração da metodologia para atribuir as exposições individuais de PM10. Conclusões: Tendo em consideração os níveis de PM10 observados em 2015, os nossos resultados sugerem que a exposição às concentrações de PM10 terá um efeito pequeno ou nenhum efeito sobre os valores da pressão arterial. Outros poluentes atmosféricos e misturas de poluentes que não foram incluídos no nosso estudo devem ser analisados em estudos futuros.
- PM10 exposure interacts with abdominal obesity to increase blood triglycerides: a cross-sectional linkage studyPublication . Gaio, Vânia; Roquette, Rita; Monteiro, Alexandra; Ferreira, Joana; Lopes, Diogo; Dias, Carlos Matias; Nunes, BaltazarBackground: Blood lipids and glucose levels dysregulation represent potential mechanisms intermediating the adverse cardiovascular effects of ambient particulate matter (PM) exposure. This study aims to estimate the effect of long-term PM10 exposure on blood lipids and glucose levels and to assess the potential mediation and/or modification action of abdominal obesity (AO) (waist-to-height ratio). Methods: Our study was based on 2,390 participants of the first Portuguese Health Examination Survey (INSEF, 2015) with available data on blood lipids and glucose parameters and living within a 30-km radius of an air quality monitoring station with available PM10 measurements. PM10 concentrations were acquired from the air quality monitoring network of the Portuguese Environment Agency. Generalized linear models were used to assess the effect of 1-year PM10 exposure on blood lipids and glucose levels. An interaction term was introduced in the models to test the modification action of AO. Results: We found an association between PM10 and non-fasting blood triglycerides (TG) after adjustment for age, sex, education, occupation, lifestyles-related variables and temperature but only in participants with AO. Per each 1 mg/m3 PM10 increment, there was a 1.84% (95% confidence interval: 0.02–3.69) increase in TG. For the remaining blood lipid and glucose parameters, no associations were found. Conclusions: Our study demonstrates that even at low levels of exposure, long-term PM10 exposure interacts with AO to increase blood TG. Our findings suggest that reducing both AO prevalence and PM10 below current standards would result in additional health benefits for the population.
- The influence of ambient air pollution on health impacts: The Project FUTURAR preliminary resultsPublication . Mendes, Ana Sofia; Costa, Solange; Ferreira, Joana; Silveira, Carlos; Relvas, Hélder; Lopes, Miriam; Monteiro, Alexandra; Roebeling, Peter; Miranda, A.I; Teixeira, JPThe main goal of FUTURAR Project is to estimate the air pollution impact, costs and benefits of emission reduction scenarios for 2030, using modelling tools to estimate the spatial distribution of environment and health impacts over Portugal. This research will support strategies on air pollution mitigation allowing to fill knowledge gaps and adjust/tune/improve estimates of emissions reduction and consequently environment and health impacts for Portugal, by providing information on key uncertainties and research needs