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José E.D. Cançado,¹ Paulo H.N. Saldiva,¹ Luiz A.A. Pereira,^1,2 Luciene B.L.S. Lara,² Paulo Artaxo,⁴ Luiz A. Martinelli,³ Marcos A. Arbex,^1,5 Antonella Zanobetti,⁶ and Alfesio L.F. Braga^1,2,7

¹Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo, Brazil; ²Community Health Post-graduation Program, Catholic University of Santos, Santos, Brazil; ³Center for Nuclear Energy in Agriculture, University of São Paulo, Piracicaba, Brazil; ⁴Physics Institute, University of São Paulo, São Paulo, Brazil; ⁵Pulmonary Physiopathology and Air Pollution Research Group, Internal Medicine Department, Federal University of São Paulo Medical School, São Paulo, Brazil; ⁶Exposure Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA; ⁷Environmental Pediatrics Program, University of Santo Amaro Medical School, São Paulo, Brazil

Abstract
We analyzed the influence of emissions from burning sugar cane on the respiratory system during almost 1 year in the city of Piracicaba in southeast Brazil. From April 1997 through March 1998, samples of inhalable particles were collected, separated into fine and coarse particulate mode, and analyzed for black carbon and tracer elements. At the same time, we examined daily records of children (< 13 years of age) and elderly people (> 64 years of age) admitted to the hospital because of respiratory diseases. Generalized linear models were adopted with natural cubic splines to control for season and linear terms to control for weather. Analyses were carried out for the entire period, as well as for burning and nonburning periods. Additional models were built using three factors obtained from factor analysis instead of particles or tracer elements. Increases of 10.2 µg/m³ in particles ≤ 2.5 µm/m³ aerodynamic diameter (PM_2.5) and 42.9 µg/m³ in PM₁₀ were associated with increases of 21.4% [95% confidence interval (CI) , 4.3-38.5] and 31.03% (95% CI, 1.25-60.21) in child and elderly respiratory hospital admissions, respectively. When we compared periods, the effects during the burning period were much higher than the effects during nonburning period. Elements generated from sugar cane burning (factor 1) were those most associated with both child and elderly respiratory admissions. Our results show the adverse impact of sugar cane burning emissions on the health of the population, reinforcing the need for public efforts to reduce and eventually eliminate this source of air pollution. Key words: air pollution, biomass burning, children, elderly people, health effects, Poisson regression, respiratory diseases, time series. Environ Health Perspect 114:725-729 (2006) . doi:10.1289/ehp.8485 available via http://dx.doi.org/ [Online 13 January 2006]

Address correspondence to J.E. Cançado, Av. Dr. Arnaldo, 455, 1° Andar, Sala 1308, Cerqueira César, CEP 01246-903, São Paulo, Brazil. Telephone: 55-19-3434-3734. Fax: 55-19-3433-4655. E-mail: educancado@uol.com.br

This study was supported by Laboratório de Investigação Médica 05, Faculdade de Medicina da Universidade de São Paulo, Universidade Santo Amaro, Universidade Federal de São Paulo, and Universidade Católica de Santos.

The authors declare they have no competing financial interests.

Received 10 July 2005 ; accepted 12 January 2006.

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