Assessing socioeconomic bias of exposure to urban air pollution: an autopsy-based study in São Paulo, Brazil

Julio da Motta Singer; Carmen Diva Saldiva de André; Paulo Afonso de André; Francisco Marcelo Monteiro Rocha; Dunia Waked; Aline Macedo Vaz; Gustavo Ferreira Gois; Maria de Fátima Andrade; Mariana Matera Veras; Paulo Hilário Nascimento Saldiva; Ligia Vizeu Barrozo

doi:10.1016/j.lana.2023.100500

Assessing socioeconomic bias of exposure to urban air pollution: an autopsy-based study in São Paulo, Brazil

Lancet Reg Health Am. 2023 May 1:22:100500. doi: 10.1016/j.lana.2023.100500. eCollection 2023 Jun.

Affiliations

¹ Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil.
² Medical School, University of São Paulo, São Paulo, Brazil.
³ INSPER Institute of Education and Research, São Paulo, Brazil.
⁴ Paulista School of Politics, Economics and Business, Federal University of São Paulo, São Paulo, Brazil.
⁵ Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, São Paulo, Brazil.
⁶ School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo, Brazil.

Abstract

Background: The characterisation of individual exposure to air pollution in urban scenarios is a challenge in environmental epidemiological studies. We investigated if the city's pollution monitoring stations over or underestimate the exposure of individuals depending on their socioeconomic conditions and daily commuting times.

Methods: The amount of black carbon accumulated in the lungs of 604 deceased who underwent autopsy in São Paulo was considered as a proxy for PM₁₀. The concentrations of PM₁₀ in the residence of the deceased were estimated by interpolating an ordinary kriging model. These two-exposure metrics allowed us to construct an environmental exposure misclassification index ranging from -1 to 1. The association between the index and daily commuting, socioeconomic context index (GeoSES), and street density as predictors was assessed by means of a multilevel linear regression model.

Findings: With a decrease of 0^.1 units in GeoSES, the index increases, on average, by 0^.028 units and with an increase of 1 h in daily commuting, the index increases, on average, by 0^.022 units indicating that individual exposure to air pollution is underestimated in the lower GeoSES and in people with many hours spent in daily commuting.

Interpretation: Reduction of health consequences of air pollution demands not only alternative fuel and more efficient mobility strategies, but also should include profound rethink of cities.

Funding: São Paulo Research Foundation (FAPESP-13/21728-2) and National Council for Scientific and Technological Development (CNPq-304126/2015-2, 401825/2020-5).

Keywords: Anthracosis; Black carbon; Exposure assessment; Exposure misclassification; Mobility; Monitoring station; Particulate matter.