Relação entre qualidade ambiental e desempenho escolar dos alunos de ensino médio no Brasil / RP

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    Health impacts of wildfire-related air pollution in Brazil: a nationwide study of more than 2 million hospital admissions between 2008 and 2018
    (Nature Communications, 2021) Réquia Júnior, Weeberb João; Amini, Heresh; Mukherjee, Rajarshi; Gold, Diane R.; Schwartz, Joel D.
    We quantified the impacts of wildfire-related PM2.5 on 2 million hospital admissions records due to cardiorespiratory diseases in Brazil between 2008 and 2018. The national analysis shows that wildfire waves are associated with an increase of 23% (95%CI: 12%–33%) in respiratory hospital admissions and an increase of 21 (95%CI: 8%–35%) in circulatory hospital admissions. In the North (where most of the Amazon region is located), we estimate an increase of 38% (95%CI: 30%–47%) in respiratory hospital admissions and 27% (95%CI: 15%–39%) in circulatory hospital admissions. Here we report epidemiological evidence that air pollution emitted by wildfires is significantly associated with a higher risk of cardiorespiratory hospital admissions.
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    Prenatal exposure to wildfire-related air pollution and birth defects in Brazil
    (Journal of Exposure Science & Environmental Epidemiology, 2021) Réquia Júnior, Weeberb João; Kill, Erick; Papatheodorou, Stefania; Koutrakis, Petros; Schwartz, Joel D.
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    Greenness around Brazilian schools may improve students’ math performance but not science performance
    (Urban Forestry & Urban Greening, 2022) Réquia Júnior, Weeberb João; Saenger, Claúdia Costa; Cicerelli, Rejane Ennes; Abreu, Lucijane Monteiro de; Cruvinel, Vanessa R. N.
    Green spaces play a vital role in the social, economic, and physical well-being of people. To further research on this topic, in this paper, we estimated the association of greenness and academic performance at the school-level in Brazil. We analyzed this association using mixed-effects regression models, adjusted for air pollution, SES, and spatiotemporal terms. We used the Normalized Difference Vegetation Index (NDVI) as the exposure variable. Data from the high school national exam in Brazil (at the school level, measured with a score varying from 0 to 1000) was used to represent the academic performance. The primary analysis results indicate that green areas surrounding schools are positively associated with school-level academic performance in math, with an estimated coefficient of 17.18 (95%CI: 10.46; 23.90). The results were statistically insignificant for science, with a coefficient of − 2.39 (95%CI: − 7.49; 2.71). Our findings are relevant for policymakers and urban planners to improve the environment surrounding schools to promote public health by making schools healthier.
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    Increased preterm birth following maternal wildfire smoke exposure in Brazil
    (International Journal of Hygiene and Environmental Health, 2022) Réquia Júnior, Weeberb João; Papatheodorou, Stefania; Koutrakis, Petros; Mukherjee, Rajarshi; Roig, Henrique L.
    Preterm birth (PTB) complications are the leading cause of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015, according to the World Health Organization. Those infants born prematurely who survived the first 5 years, studies suggest that these infants are more likely to experience a range of poor health outcomes during childhood and even adulthood. Wildfire smoke has been suggested as a type of air pollution source with high toxicity for reproductive health. In this study, we estimated the association between preterm birth and wildfire periods in Brazil, a country included in the list of the 10 nations with the greatest number of preterm birth and also considered as a very fire-prone region. We applied a time-stratified case-crossover study design using conditional logistic regression models to estimate the odds ratio for preterm birth associated with wildfire-related prenatal PM2.5, during different windows of exposure, including trimesters 1–3. After adjusting for several confounders (other air pollutants, demographics, meteorological variables, and spatiotemporal terms), we found that wildfire smoke exposure during pregnancy may be associated with preterm birth in Brazil. Southeast was the region with the highest increase in the odds of PTB (OR:1.41 (95%CI: 1.31–1.51) when the exposure occurred in the first trimester. In the North, exposure to PM2.5 during wildfire periods in the second trimester of pregnancy was associated with increased odds of PTB (OR:1.05 (95%CI: 1.01–1.09) in preterm birth when the exposure occurred in the second trimester. This study suggests that wildfire smoke exposure during pregnancy may increase the risk for preterm birth in Brazil. This should be of great concern to the public health authorities, obstetricians, and policymakers.
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    The impact of long-term weather changes on air quality in Brazil
    (Atmospheric Environment, 2022) Castelhano, Francisco Jablinski; Pedroso, Ana Claro Neme; Cobelo, Igor; Borge, Rafael; Roig, Henrique L.; Adams, Matthew D.; Amini, Heresh; Koutrakis, Petros; Réquia Júnior, Weeberb João
    In this study, we estimate the weather-related increases in ambient air pollution (CO, NO2, SO2, O3 and PM2.5) in Brazil between 2003 and 2018. The impact of long-term weather changes on each air pollutant was defined as “weather penalty”. Overall, ambient air pollution levels in Brazil during the period 2003–2018 have decreased in most of the Brazilian regions. We estimated significant trends in meteorological variables, indicating an increase in temperature, relative humidity, and wind speed in all Brazilian regions over the 16-study period. Our findings suggest that PM2.5 was the pollutant most impacted by weather changes. For the 16-year period of analysis, we estimated a weather penalty ranging from 1.58 μg/m− 3 (CI 95%:1.25; 1.91) to 0.41 μg/m− 3 (CI 95%:0.28; 0.53) among the different Brazilian regions. If weather parameters had remained constant, PM2.5 would have decreased by 1.10 μg/m3 (95%CI: 0.74; 1.46) in the South and by 2.25 μg/m3 (95%CI: 2.72; 1.79) in the Midwest. Over the 16-year study period, the weather impact on PM2.5 in Brazil was associated with over 6500 excess deaths.
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    Nationwide assessment of green spaces around 186,080 schools in Brazil
    (Cities, 2021) Réquia Júnior, Weeberb João; Li, Longxiang; Amini, Heresh; Roig, Henrique L.; James, Peter; Koutrakis, Petros
    Green spaces in cities play an important role in people's social, economic and physical well-being. Children spend a large proportion of their time at school, and to date there have been no studies that have investigated the proximity of schools to green spaces. In this work, we conducted a nationwide assessment of the green spaces surrounding 186,080 schools in Brazil, which includes more than 40 million students. We estimated that about 46,000 of Brazil's schools (~25%; about 9 million students in total) are located in regions with high greenness exposure. We also found that public schools, low-income areas, low-population areas, and areas with good educational indicators were more likely to have high levels of green space around schools. Information about schools exposure to environmental features has prompted public and private policy to promote health by making schools healthier. Our findings can inform public policy to enable targeted interventions that protect Brazilian students from environmental hazards and improve their safety, health, and learning performance. This study provides new insights into a particular aspect of the school environment (green spaces) that may be relevant to urban planners and policy makers in both developed and developing countries.
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    Air quality around schools and school-level academic performance in Brazil
    (Atmospheric Environment, 2022) Réquia Júnior, Weeberb João; Saenger, Claúdia Costa; Cicerelli, Rejane Ennes; Abreu, Lucijane Monteiro de; Cruvinel, Vanessa R.N.
    High levels of air pollution surrounding schools may be posing a risk to children’s health, including cardiorespiratory diseases and cognitive deficits. The literature on the effects of air pollution outside schools on cognitive outcomes (e.g., cognitive development, working memory, and academic performance) is still limited. Most of the studies are from high-income countries. In this paper, we performed a nationwide assessment to estimate the association between air pollution (PM2.5 and NO2) and school-level academic performance in Brazil. We assessed academic performance data (high school national e am) from 25,390 high schools in Brazil. Air pollution data was derived from satellite remote sensing observations. Then we used mixed-effects regression models adjusted for several variables (e.g., school characteristics, spatio temporal factors, and socioeconomic status) to estimate the association between air pollution (PM2.5 and NO2) and school-level academic performance. We found that an increase of 10 μg/m3 in the long-term average PM2.5 around the Brazilian schools is associated with 2.98 points lower (95%CI: 0.37; 5.58) in the school-level academic performance (considering that the performance score varies from 0 to 1000). For NO2, an increase of 10 ppb corresponds to 55.73 points lower (95%CI: 34.98; 76.48) in the school-level academic performance. This represents 0.05 and 1.02% lower points in academic performance, respectively for the exposure to PM2.5 and NO2.
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    Schools exposure to air pollution sources in Brazil: A nationwide assessment of more than 180 thousand schools
    (Science of the Total Environment, 2021) Réquia Júnior, Weeberb João; Roig, Henrique L.; Schwartz, Joel D.
    A growing body of evidence demonstrates that children at schools who are exposed to increased concentrations of air pollutants may have a higher risk for several health problems, including cognitive deficits. In this paper we estimate the exposure to air pollution sources at 186,080 schools in Brazil. Specifically, we accounted for the exposure to three proxies of air pollution source emissions, including distance to roadways, the extent of roadways within a buffer around each school, and the number of wildfire occurrences within a buffer around each school. About 25% of the Brazilian schools evaluated in our study are located within a distance ≤250 m of a major roadway, have ≥2 km of roadway within a buffer of 1 km, and have ≥7 wildfires records within a buffer of 10 km. Our results indicate significant prevalence ratio of these schools exposed to air pollution sources when we stratified the analyses by socioeconomic factors, including geographic (public schools had an increased likelihood of being exposed), economic (low-income areas had an increased likelihood of being exposed), health (overall, areas with low public health status had an increased likelihood of being exposed), and educational conditions (overall, areas with low educational indicator had an increased likelihood of being exposed). For example, we estimated that private schools were 15% (95% CI: 13–17%) less likely to be located within 250 m of a major roadway compared with public schools; schools in areas with low child mortality were 35% (95% CI: 34–37%) less likely to be within 250 m of a major roadway; and schools in regions with low expected years of schooling were 25% (95% CI: 22–28%) more likely to be located within 250 m of a major roadway. The analysis of the spatial patterns shows that a substantial number of schools (36–54%, depending on the air pollution source) has a positive autocorrelation, suggesting that exposure level at these schools are similar to their neighbors. Estimating children's exposure to air pollutants at school is crucial for future public policies to develop effective environmental, transportation, educational, and urban planning interventions that may protect students from exposure to environmental hazards and improve their safety, health, and learning performance.
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    The association of maternal exposure to ambient temperature with low birth weight in term pregnancies varies by location: In Brazil, positive associations may occur only in the Amazon region
    (Environmental Research, 2022) Réquia Júnior, Weeberb João; Papatheodorou, Stefania; Koutrakis, Petros
    Exposure to ambient temperature has been linked to adverse birth outcomes in several regions, including the USA, Australia, China, countries in the Middle East, and European countries. To date, no studies were performed in South America, a region with serious challenges related to climate change. Our investigation addresses this literature lack by examining the association between Low Birth Weight (LBW) and ambient temperature exposure in the largest county in South America, Brazil. We applied a nationwide case-control study design using a logistic regression model to estimate the odds ratio (OR) for LBW associated with ambient temperature during a specific trimester of pregnancy (1–3 trimester). Our sample size includes 5,790,713 birth records nationwide over 18 years (2001–2018), of which 264,967 infants were included in the model as cases of LBW, representing 4.6% of our total sample. We adjusted our model for several confounding variables, including weather factors, air pollution, seasonality, and SES variables at the individual level. Our findings indicate that North was the only region with positive and statistically significant associations in the primary analysis and most of the sensitivity analysis, which is the region where the Amazon is located. In this region, we estimated an increase of 5.16% (95%CI: 3.60; 6.74) in the odds of LBW per 1 ◦C increase in apparent temperature when the exposure occurred in the second trimester. Our results may be explained by the climate conditions in the Amazon region in the past years. A large body of literature indicates that the Amazon region has been facing serious climate challenges including issues related to policy, governance, and deforestation. Specifically, regarding deforestation, it is suggested that land use change and deforestation is projected to increase heat stress in the Amazon region, because of Amazon savannization, increasing the risk of heat stress exposure in Northern Brazil. Our study can assist public sectors and clinicians in mitigating the risk and vulnerability of the Amazonian population.
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    Green areas and students’ academic performance in the Federal District, Brazil: An assessment of three greenness metrics
    (Environmental Research, 2021) Réquia Júnior, Weeberb João; Adams, Matthew D.
    Most of the epidemiological investigations looking at the health benefits of green spaces have measured the level of green areas by using only one approach, mainly the Normalized Difference Index – NDVI (a satellite-derived indicator). We hypothesized a difference in the association between health and green space depending on the metric used to measure green exposure. This study considers students’ academic performance as a proxy of cognitive abilities (a health indicator). We estimated the relationship between green areas and students’ academic performance in the Federal District (FD), Brazil, with three different greenness metrics: NDVI, distance to green spaces (m) - obtained from land use data, and quantity of green spaces (m2 ) - also from land use data. We assessed student-level academic performance data provided by the Department of the Education in the FD. The data includes students from the public schools in the FD for 256 schools (all the public schools in the FD) and 344,175 students (all the students enrolled in the public schools in the FD in 2017–2020).). For the first metric represented by the distance to green spaces, we estimated the straight-line distance between each school and the nearest green area. For NDVI and quantity of green spaces, we estimated the area of all green spaces within buffers of 500 m, 750 m, and 1 km around the schools. We applied a cross-sectional study design using mixedeffects regression models to analyze the association exposure to green areas around schools and student-level academic performance. Our results confirmed our hypothesis showing that the impact of green areas on students’ performance varied significantly depending on the type of green metric. After adjustments for the covariates, we estimated that NDVI is positively associated with school-level academic performance, with an estimated coefficient of 0.91 (95%CI: 0.83; 0.99) for NDVI values at a school’s centroid. Distance to green areas was negatively associated with academic performance [-2.09 × 10− 5 (95CI: 3.91 × 10− 5 ; − 2.84 × 10− 6 ]. The quantity of green areas was estimated with mixed results (direction of the association), depending on the buffer size. Results from this paper suggest that epidemiological investigations must consider the different effects of greenness measures when looking at the association between green space and academic performance. More studies on residual confounding from this association with a different study design are needed to promote public health by making schools healthier.
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    Proximity of schools to roads and students’ academic performance: A cross-sectional study in the Federal District, Brazil
    (Environmental Research, 2021) Réquia Júnior, Weeberb João; Kill, Erick; Amini, Heresh
    Investigations of the educational implications of children’s exposure to air pollutants at school are crucial to enhance our understanding of the hazards for children. Most of the existing literature is based on studies performed in North America and Europe. Further investigation is required in low- and middle-income countries, where there are important challenges related to public health, transportation, environment, and education sector. In response, in this present study, we studied the association between proximity of schools to roads and the academic achievement of the students in the Federal District, Brazil. We accessed academic achievement data at the student level. The data consist of 256 schools (all the public schools in the FD) and a total of 344,175 students (all the students enrolled in the public schools in the FD in 2017–2020). We analyzed the association between the length of all roads within buffers around schools and student-level academic performance using mixed-effects regression models. After adjustments for several covariates, the results of the primary analysis indicate that the presence of roads surrounding schools is negatively associated with student-level academic performance in the FD. This association varies significantly depending on the buffer size surrounding schools. We found that the highest effects occur in the first buffer, with 250 m. While in the first buffer we estimated that an increase of 1 km of length of roads around schools was associated with a statistically significant decrease of 0.011 (95%CI: 0.008; 0.013) points in students’ grades (students’ academic performance varies from 0 to 10), in the buffer of 1 km we found a decrease of 0.002 (95%CI: 0.002; 0.002) points in the student-level academic performance. Findings from our investigation provide support for the creation of effective health, educational and urban planning policies for local intervention in the FD. This is essential to improve the environmental quality surrounding schools to protect children from exposure to environmental hazards.
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    Birth weight following pregnancy wildfire smoke exposure in more than 1.5 million newborns in Brazil: a nationwide case-control study
    (The Lancet Regional Health, 2022) Réquia Júnior, Weeberb João; Amini, Heresh; Adams, Matthew D.; Schwartz, Joel D.
    Air pollution exposure has been associated with critical neonatal morbidities, including low birth weight (LBW). However, little is known on short-term exposure to wildfire smoke and LBW. In this study, we estimated the association between birth weight following pregnancy and wildfire smoke exposure in more than 1.5 million newborns in Brazil (considered as a very fire-prone region worldwide).