Assessment of the Possible Association of Air Pollutants PM(10), O(3), NO(2) With an Increase in Cardiovascular, Respiratory, and Diabetes Mortality in Panama City: A 2003 to 2013 Data Analysis

In recent years, Panama has experienced a marked economic growth, and this, in turn, has been associated with rapid urban development and degradation of air quality. This study is the first evaluation done in Panama on the association between air pollution and mortality. Our objective was to assess the possible association between monthly levels of PM(10), O(3), and NO(2,) and cardiovascular, respiratory, and diabetes mortality, as well as the seasonal variation of mortality in Panama City, Panama. The study was conducted in Panama City, using air pollution data from January 2003 to December 2013. We utilized a Poisson regression model based on generalized linear models, to evaluate the association between PM(10), NO(2), and O(3) exposure and mortality from diabetes, cardiovascular, and respiratory diseases. The sample size for PM(10), NO(2), and O(2) was 132, 132, and 108 monthly averages, respectively. We found that levels of PM(10), O(3), and NO(2) were associated with increases in cardiovascular, respiratory, and diabetes mortality. For PM(10) levels ≥ 40 μg/m(3), we found an increase in cardiovascular mortality of 9.7% (CI 5.8–13.6%), and an increase of 12.6% (CI 0.2–24.2%) in respiratory mortality. For O(3) levels ≥ 20 μg/m(3) we found an increase of 32.4% (IC 14.6–52.9) in respiratory mortality, after a 2-month lag period following exposure in the 65 to <74 year-old age group. For NO(2) levels ≥20 μg/m(3) we found an increase in respiratory mortality of 11.2% (IC 1.9–21.3), after a 2-month lag period following exposure among those aged between 65 and <74 years. There could be an association between the air pollution in Panama City and an increase in cardiovascular, respiratory, and diabetes mortality. This study confirms the urgent need to improve the measurement frequency of air pollutants in Panama.