Efectos en la salud del PM2.5 por incendios forestales en ciudades de Latinoamérica: revisión sistemática rápida y síntesis comparativa
Resumen
Introducción. La actividad de incendios forestales se está intensificando en América Latina debido al cambio climático y al uso del suelo, pero los impactos en la salud del material particulado fino (PM2.5) derivado de estos incendios en áreas urbanas siguen estando poco cuantificados y reconocidos.
Objetivo. Evaluar la evidencia sobre el PM2.5 relacionado con incendios forestales y su asociación con la mortalidad y morbilidad en ciudades latinoamericanas.
Materiales y métodos. Se realizó una revisión sistemática rápida y un metaanálisis siguiendo las directrices PRISMA, utilizando datos de PubMed, Scopus y BIREME. Un revisor examinó de forma independiente 163 artículos y extrajo datos de 14 estudios elegibles. Se llevó a cabo una evaluación del riesgo de sesgo utilizando la escala de Newcastle–Ottawa.
Resultados. La mayoría de los estudios se realizaron en Brasil (n=12) y emplearon diseños de series temporales o modelos para estimar los riesgos para la salud. La exposición a PM2.5 específico de incendios se asoció con mortalidad por todas las causas, cardiovascular y respiratoria. Las estimaciones de efecto reportadas oscilaron entre aumentos del 1.7% al 7.7% en el riesgo por cada incremento de 10 µg/m³ de exposición. Otros estudios evaluaron parto prematuro, desenlaces por COVID-19 y cánceres específicos por sitio. Aunque dos estudios proporcionaron estimaciones armonizadas de riesgo relativo para la mortalidad por todas las causas, la alta heterogeneidad y las diferencias metodológicas impidieron realizar un meta-análisis formal.
Conclusiones. El humo de incendios forestales contribuye de manera significativa a la mortalidad prematura en América Latina, pero la evidencia actual está distribuida de forma desigual entre regiones, períodos de tiempo y subgrupos poblacionales. Rara vez se capturan los riesgos desproporcionados que enfrentan las comunidades indígenas y rurales, o las disparidades intraurbanas vinculadas a la pobreza y la geografía. Las investigaciones futuras deberían centrarse en la carga de morbilidad asociada al PM2.5 de incendios forestales.
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Datos de los fondos
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Yale Institute for Global Health, Yale School of Medicine
Números de la subvención NIH FIC D43TW010540
