• The association of the pandemic with the fires may have aggravated the health situation of the legal Amazon's populations.
 

A study by Fiocruz and WWF-Brazil points out that the wildfires in the Amazon were responsible for the increase in the percentage of hospitalizations due to respiratory disorders in the last 10 years (2010-2020) in the states with the highest number of fire outbreaks: Pará, Mato Grosso, Rondônia, Amazonas and Acre. These hospitalizations increased public spending by 1 billion. The survey suggests that the association of the pandemic situation with forest fires in the Amazon may have worsened the health situation of the population of the legal Amazon, since pollutants from the fires can cause a persistent inflammatory response and, thus, increase the risk of infection by viruses that reach the respiratory tract.¹
 

The study shows that even with the possible underreporting, due to inconsistencies in the Unified Health System's Database (DataSUS), the daily pollutant values are extremely high and contributed to increase by up to twice the risk of hospitalization for respiratory diseases attributable to the concentration of fine inhalable particles (smoke) in the analyzed states.
 

In Amazonas state, 87% of hospital admissions in the analyzed period are related to high concentrations of smoke (breathable and inhalable particles). The percentage was 68% in Pará state, 70% in Mato Grosso state and 70% in Rondônia state. Respiratory diseases associated with high concentrations of pollutant particles emitted by wildfires account for 70% of hospital admissions recorded in Pará, Mato Grosso, Rondônia and Amazonas states.
 

Researcher Sandra Hacon, from Ensp / Fiocruz, says that although the percentages of hospital admissions for respiratory diseases in the region have remained stable between 2010 and 2020, a considerable part of these admissions can be attributed to the concentrations of respirable and inhalable fine particles emitted by forest fires. “The microparticles that make up the smoke are deposited in the cavities of the lungs, worsening respiratory problems. They are a risk factor for people who already have comorbidities. We see, therefore, an impact on health and loss of quality of well-being for people, in addition to the high economic cost of respiratory diseases for SUS”, she explains. "The fragility of the respiratory system is extremely worrying in the current scenario of a pandemic that also causes respiratory problems. This overlap suggests that the region of the legal Amazon will tend to have its health system under pressure, as the fires are more intense in the dry months, which will start in a few weeks", she warns.
 

It is important to note that in 2020, Brazil reached the highest number of fires in the decade. According to INPE (National Institute for Space Research), the Amazon rainforest registered 103,161 fire outbreaks compared to 89,171 in 2019, an increase of 15.7%. This continuous trend of destruction has a direct impact not only on people's health, but on the entire ecosystem, which suffers every year during the intensified burning cycle all along the dry season, points out Edegar de Oliveira, WWF-Brazil's Director of Conservation and Restoration. He points out that “the fires are part of the dynamics of destruction in the Amazon. The deforested areas are subsequently burned to 'clean' the land, making room for pasture, agriculture, or simple land speculation. The association between deforestation, burning and forest degradation brings a very high cost for all of us, especially for the peoples of the forest, and for the climate of the planet”, he says.
 

- The official health surveillance and monitoring systems need evolution and systematic improvements, especially those aimed at indigenous populations in the Amazon;
 

- Consistent policies to reduce deforestation and fires in the Amazon are critical and immediate, as combating deforestation and degradation of the Amazon biome is fundamental to guarantee basic rights of local populations, such as access to health and to a healthy and sustainable environment;
 

- Development and implementation of effective epidemiological and environmental surveillance programs, aimed at the Amazonian population exposed to forest fires, especially the most vulnerable groups, such as pregnant women, children, the elderly, and those who have comorbidities and need dedicated attention;
 

- Imminent need for preventive effort in the control of zoonoses, as the costs associated with preventive efforts are substantially lower, compared with the economic, social and health costs in the control of potential epidemics and or pandemics.
 

The study analyzed the association between trends in hospital morbidity (the rate of hospitalizations recorded in hospitals) due to respiratory diseases in the period 2010 to 2020 and the estimated concentrations of fine respirable particles (PM2.5) present in the smoke from wildfires in the same period, investigating the potential health impacts in the states with the highest records, according to INPE, of heat spots from burning in the Brazilian Amazon. Pará, Mato Grosso, Rondônia, Amazonas and Acre had the highest number of fires recorded in the analyzed period - 2010-2020.
 

The study looked at the daily time series of hospital morbidity due to diseases of the respiratory system obtained at the Informatics Department of the Unified Health System (DATASUS), by the Hospitalization Information System (SIH) and analyzed by day, month and year in the period of January 1, 2010 to October 31, 2020, according to the federation unit of residence. Hospital admissions for COVID-19-related respiratory diseases to calculate the retrospective trend were excluded. Therefore, hospital admissions derived from COVID-19, did not enter the set of causes of hospitalizations.
 

The researchers selected information regarding the amount in reais (BRL) spent on low and high complexity hospitalizations (Intensive Care Units - ICU) for diseases of the respiratory system, in order to estimate the economic health cost of these hospitalizations that could be attributable to pollution resulting from the wildfires.
 

Estimates of the concentration of particulate material (PM2.5) were obtained using satellite data from NASA, with the aerosol optical depth (AOD) information converted by mathematical modeling into PM2.5 concentration estimates, and made available for public access by the Copernicus Atmosphere Monitoring Service (CAMS), which is the most recent set of global reanalysis data on atmospheric composition produced by the European Centre for Medium-Range Weather Forecasts (ECMWF).

^[1]  Travaglio, M., Yu, Y., Popovic, R., Selley, L., Leal, N. S., & Martins, L. M. (2021). Links between air pollution and COVID-19 in England. Environmental Pollution, 268, 115859.

 

Fiocruz is an institution linked to the Ministry of Health, whose mission is to produce, disseminate and share knowledge and technologies aimed at strengthening and consolidating the Unified Health System (SUS) and contributing to the promotion of health and quality of life of the Brazilian population. Access at: https://portal.fiocruz.br/

 

 

WWF-Brazil is a Brazilian non-governmental and non-profit organization that works to change the current trajectory of environmental degradation and to promote a future in which society and nature live in harmony. Created in 1996, it operates throughout Brazil and is part of the WWF Network. Support our work in:  wwf.org.br/doe