Revisão sistemática e metanálise sobre associação entre exposição ao mofo e umidade na habitação e asma: estimativa do impacto econômico para a sociedade brasileira

Abstract

Asthma is one of the most common non-communicable diseases in the world, affecting approximately 339 million people of all ages and in all parts of the world. In Brazil, in 2018 alone, it was the cause of 87,092 hospitalizations, with a total value of R$ 49,797,711.15 and 273,131 days of hospitalization, in the public or complementary networks of the Brazilian health system which represented, as of December 2018, 67.4% of the beds for hospitalization and complementary treatments in the country. The private network not affiliated to SUS (Brazilian Publicly Funded Health System), making up the supplementary health system, held the remaining 32.6%. Considering that hospitalizations are only part of the direct costs with asthma and that there are still indirect costs (lost work or study days, reduced productivity at work or learning, among others), the research shows that the total costs with asthma in 2018 were R$ 397 million in direct costs and R$ 798 million in direct and indirect costs, only considering data from the basic and complementary networks of the Brazilian health system, SUS. Through a systematic review carried out on the Web Of Science and PubMed databases, with MeSH and other descriptors, followed by a meta-analysis, adopting the PECOS strategy, PRISMA guidelines and the Joanna Briggs Institute protocols, it was identified that the odds ratio between exposure to mold and humidity and the outcome of interest, asthma, is 1.525. From this, and by stipulating an estimate of the prevalence of mold and dampness in Brazilian households, it was possible to identify the share of total direct and indirect asthma costs in Brazil attributable to exposure to mold and dampness. In 2018 alone, direct asthma costs specifically attributable to exposure to mold and dampness in homes were R$ 66.7 million, and, if added to the indirect costs, the total amount would be R$ 133.8 million, considering only data from the basic and complementary networks of the Brazilian health system. This denotes significant expenses for asthma treatments over the course of a few years, especially when we sum up the values of the supplementary network to the costs of the basic and complementary networks of the Brazilian health system. Part of these expenses could be invested in providing adequate housing, without the exposure factor, mainly to the group that already have asthma associated with mold or dampness, or to the vulnerable populations exposed to mold or dampness, which have not presented asthma symptoms yet.