An Exploratory Analysis of the Effect of Regulatory Policies for Pre-Harvesting Sugarcane Straw Burning on Hospital Admissions for Respiratory Diseases in the State of Sao Paulo, Brazil

摘要

Emissions generated by sugarcane burning have been associated with acute respiratory effects and increase in hospital admissions, among other health effects. In 2002 the State of Sao Paulo (SP) approved a law that was adopted in 2003 that foresees the elimination of the practice of pre-harvesting sugarcane burn progressively up to the year 2031. This process has been accelerated through voluntary protocol agreements between the State and the producers, with incentives provided by the State, and pre-harvest sugarcane straw burn could have been eliminated in 2017. We analysed the trends in annual rates of hospital admissions for respiratory diseases in cities with the highest sugarcane plantations areas in the period 2000-2017. Data from hospitalization were obtained from the Hospital Information System (SIH/SUS) for respiratory diseases (J40, J44-47). Data from population were obtained from the Brazilian Institute of Geographic Statistics. Hospitalization rates were calculated for general population. To estimate sugar-cane plantation areas data, enhanced vegetation index from MODIS MOQ13 images was used. Ten cities with the largest plantation areas were selected. Data for pre-harvesting sugarcane burn were obtained from Spatial Research Institute and only the burns occurred in the sugar-cane plantation areaswere included. All datasets were for the period 2000-2017. Trends in hospitalizations rates for all study cities were assessed by Prains-Winsten regression models. The time-series of pre-harvesting sugarcane burn, sugarcane plantation areas, and hospitalization rates did not present any trend (p>0.05) in the study period. These preliminary results showed that legal measures to eliminate pre-harvesting sugarcane burn were not effective in any study city. Moreover, the period coincides with an expansion of the sugarcane plantation areas in Sao Paulo State. Thus, legal and voluntary measures have not proved to be sufficient to protect public health in the study area.