The aim of this study was to investigate the health implications of schoolchildren from the evaluation of drinking water quality and the characteristics of the inhalable Atmospheric Particulate Matter (MPA) that they are exposed in tree schools in Santarém and one in Mojuí dos Campos, Pará, Amazonia. A questionnaire was applied to collect sociodemographic characteristics and information about water and atmospheric pollution exposure. Microbiological, physical-chemical and chemical analyses were performed in 36 water samples during dry and rainy seasons. The MPA was collected during the dry and rainy season, with an eight - stage cascade impactor, to determine the MPA mass concentration and the inorganic composition of the coarse and fine fractions in two schools. Epidemiological data on children's morbidity and mortality about water consumption and exposure to air pollution were collected in the study municipalities between 2014 and 2016. The analytical results of water were compared with the Ministry of Health Ordinance 2914 and the human health risk quantification was estimated based on the methodology proposed by the American Environmental Protection Agency (USEPA). The analytical results of air quality were compared with the standards established by State Decree of SP 59113 and investigated the implications for health. The results of the questionnaires showed that the majority of schoolchildren are children who live in families with more than five people, receive from one to two minimum wages per month, reside in the school district and receive at your home water from deep wells. The majority of schoolchildren claimed to treat drinking water before daily consumption with hypochlorite and reported having infrequently diseases related to the intestinal and respiratory gastric system. The water analysis showed contamination by total coliforms and Echechiria coli in 28 samples and 16 of the analysed samples, respectively and confirmed that the water in the schools is acidic (pH between 3.8 and 5.9), which may imply in gastric and intestinal disorders in exposed schoolchildren. Most of the chemical compounds in the water had concentrations lower than the recommended one, except for aluminium, which was shown up to five times higher than the value established by Ordinance 2914 in the water samples evaluated from shallow wells from the schools of Santarém (maximum value of 1045 ng/mL). Long-term exposure to high aluminium concentration in water is associated with neurological implications such as dementia and Alzheimer's disease. The nitrate concentrations, although with values within the recommended (<10 mg/L), presented higher values (mean value between 1.9 and 8.0 mg/L) in water samples taken from shallow wells of Santarém schools when compared to samples taken from deep wells (mean value 0.1-0.5 mg/L), appointing the importance of its periodic monitoring in water, in order to prevent disturbances associated with its ingestion, such as infant methaemoglobinemia. The quantification of the health risk of children was significant (>1) only for schoolchildren from Santarém who consume water from schools with shallow wells. Aluminium and nitrate in water were the compounds that most contributed to the formation of risk. The MPA analytical results showed that there was a predominance of coarse fraction particles in the atmosphere, with values of mass concentration between 55.28 and 76.30 μg/m3 during the dry season and from 26.08 to 31.90 μg/m3 during collection in the rainy season, however, with a low concentration of soluble chemical compounds and traces, with predominance of terrigenous elements such as Ca, Na, Mg, Al, Fe. The fine fraction of MPA, more dangerous for the health due to deposition in the lower airways, showed low mass concentrations in schools in both stations with values between 8.10 and 20.85 μg/m3 during the dry season and from 0.11 to 2.05 μg/m3 during collection held in the rainy season. The concentrations of MPA were lower than the air quality standards established by the SP State Decree in both schools and collection periods. The acidic chemical analysis of the fine fraction revealed the predominance of potassium, especially in the school of Mojuí dos Campos during
the dry season (90.7 ng/m3), which may indicate material originating from burning the forest biomass in the school. Epidemiological results about morbidity and mortality in children under 10 years of age showed that the prevalence and hospitalization rate for acute diarrheal diseases and respiratory diseases were higher in children under one year of age and during the rainy season. The municipality of Santarém presented a higher prevalence of diarrheal and respiratory diseases when compared to Mojuí dos Campos. Mortality rates were higher for respiratory diseases when compared to diarrheal diseases. The results obtained on drinking water and air quality by this thesis are pioneers in schools in the Santarém region and indicate that the quality of groundwater should be periodically monitored, especially those collected by shallow wells in order to guarantee smaller effects adverse health outcomes. Although air quality has proved to be good, the increased prevalence of hospitalizations and deaths in children due to respiratory diseases suggests that new assessments of exposure to air pollutants should be performed to ensure health promotion.
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