CONTEXTO E OBJETIVO: Pouco se tem discutido sobre o aumento do risco de acidente vascular cerebral após exposição a poluentes do ar, principalmente no Brasil. Os mecanismos pelos quais a poluição pode influenciar a ocorrência de eventos vasculares, tais como acidente vascular cerebral, ainda são pouco compreendidos. O objetivo deste estudo foi estimar a associação entre exposição a alguns poluentes do ar e risco de morte por acidente vascular cerebral.TIPO DE ESTUDO E LOCAL: Estudo ecológico de séries temporais com dados de São José dos Campos, Brasil.MÉTODOS: Dados sobre mortes por acidente vascular cerebral em indivíduos de todas as idades que vivem em São José dos Campos e sobre material particulado, dióxido de enxofre e ozônio foram utilizados. A análise estatística utilizou modelo aditivo generalizado de regressão de Poisson com o software Statistica, em modelos "unipollutant" e "multipollutant". Foi calculado o percentual de aumento no risco para o aumento da diferença interquartil.RESULTADOS: Houve 1.032 mortes por acidente vascular cerebral, que variou de 0 a 5 por dia. A significância estatística da exposição ao material particulado em modelo "unipoluente" e a importância do material particulado e dióxido de enxofre no modelo "multipoluente" foram verificadas. O aumento do risco foi de 10% e 7%, respectivamente para material particulado e dióxido de enxofre.CONCLUSÃO: Foi possível identificar exposição a poluentes do ar como um fator de risco para morte por acidente vascular cerebral, mesmo em uma cidade com baixos níveis de poluição do ar.

CONTEXT AND OBJECTIVE: Little has been discussed about the increased risk of stroke after exposure to air pollutants, particularly in Brazil. The mechanisms through which air pollution can influence occurrences of vascular events such as stroke are still poorly understood. The aim of this study was to estimate the association between exposure to some air pollutants and risk of death due to stroke.DESIGN AND SETTING: Ecological time series study with data from São José dos Campos, Brazil.METHODS: Data on deaths due to stroke among individuals of all ages living in São José dos Campos and on particulate matter, sulfur dioxide and ozone were used. Statistical analysis was performed using a generalized additive model of Poisson regression with the Statistica software, in unipollutant and multipollutant models. The percentage increase in the risk of increased interquartile difference was calculated.RESULTS: There were 1,032 deaths due to stroke, ranging from 0 to 5 per day. The statistical significance of the exposure to particulate matter was ascertained in the unipollutant model and the importance of particulate matter and sulfur dioxide, in the multipollutant model. The increases in risk were 10% and 7%, for particulate matter and sulfur dioxide, respectively.CONCLUSION: It was possible to identify exposure to air pollutants as a risk factor for death due to stroke, even in a city with low levels of air pollution.

BACKGROUND:Cutaneous melanoma is a skin cancer with low incidence but high mortality rates. Several factors are associated with increased risk of melanoma, such as excessive sun exposure, fair skin, and family history, among others. Little is known about the spatial distribution of this cancer in Brazil.OBJECTIVE:To identify, through the use of geostatistical tools, spatial clusters of municipalities in the state of São Paulo based on their incidence of cutaneous melanoma.METHODS:This was an ecological and exploratory study of data on new cases obtained from Fundação Oncocentro for the period 1 January 2006-31 December 2011. Cases were separated by gender and rates per 100,000 inhabitants were calculated and used to compile thematic maps, Moran maps and kernel maps, using TerraView software.RESULTS:There were 3,172 new cases of cutaneous melanoma in the study period. High rates were identified in the North, Northwest, Southwest, and Southeast regions of São Paulo state. Global Moran's I values were statistically significant (p<0.05) at 0.12, 0.08, and 0.16, respectively, for males, females, and all cases. Areas such as the Southeast, North, and Northwest of São Paulo were identified as being of high priority for intervention.CONCLUSION: Spatial clusters of municipalities with high incidence rates of cutaneous melanoma in the state of São Paulo were identified. These data can serve as an important input for public health agencies.