Quantifying the impact of particle matter on mortality and hospitalizations in four Brazilian metropolitan areas.

Air quality management involves investigating areas where pollutant concentrations are above guideline or standard values to minimize its effect on human health. Particulate matter (PM) is one of the most studied pollutants, and its relationship with health has been widely outlined. To guide the construction and improvement of air quality policies, the impact of PM on the four Brazilian southeast metropolitan areas was investigated. One-year long modeling of PM and PM was performed with the WRF-Chem model for 2015 to quantify daily and annual PM concentrations in 102 cities. Avoidable mortality due to diverse causes and morbidity due to respiratory and circular system diseases were estimated concerning WHO guidelines, which was adopted in Brazil as a final standard to be reached in the future; although there is no deadline set for its implementation yet. Results showed satisfactory representation of meteorology and ambient PM concentrations. An overestimation in PM concentrations for some monitoring stations was observed, mainly in São Paulo metropolitan area. Cities around capitals with high modelled annual PM concentrations do not monitor this pollutant. The total avoidable deaths estimated for the region, related to PM, were 32,000 ± 5,300 due to all-cause mortality, between 16,000 ± 2,100 and 51,000 ± 3,000 due non-accidental causes, between 7,300 ± 1,300 and 16,700 ± 1,500 due to cardiovascular disease, between 4,750 ± 900 and 10,950 ± 870 due ischemic heart diseases and 1,220 ± 330 avoidable deaths due to lung cancer. Avoidable respiratory hospitalizations were greater for PM among 'children' age group than for PM (all age group) except in São Paulo metropolitan area. For circulatory system diseases, 9,840 ± 3,950 avoidable hospitalizations in the elderly related to a decrease in PM concentrations were estimated. This study endorses that more restrictive air quality standards, human exposure, and health effects are essential factors to consider in urban air quality management.