151
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Meng Y, Lu Y, Xiang H, Liu S. Short-term effects of ambient air pollution on the incidence of influenza in Wuhan, China: A time-series analysis. ENVIRONMENTAL RESEARCH 2021; 192:110327. [PMID: 33075359 DOI: 10.1016/j.envres.2020.110327] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Evidence suggests that air pollution is associated with many adverse health outcomes such as cardiovascular diseases (CVD), respiratory diseases, cancer, and birth defects. Yet few studies dig into the relationship between air pollution and airborne infectious diseases. METHODS Daily data on influenza incidence were obtained from Hubei Provincial Center for Disease Control and Prevention (Hubei CDC). Data on air pollutants including nitrogen dioxide (NO2), sulfur dioxide (SO2), ground-level ozone (O3), particulate matter (PM) with aerodynamic diameter ≤ 2.5 μm (PM2.5), and PM with aerodynamic diameter ≤ 10 μm (PM10) were retrieved from ten national air sampling stations located at Wuhan. We applied generalized additive model (GAM) to estimate the associations between air pollution and the risk of influenza in Wuhan, China during 2015-2017. RESULTS In the single-day lag model, the largest effect estimates were observed at lag 0. An increased relative risk (RR) of influenza was significantly associated with a 10 μg/m3 increase in SO2 (RR: 1.099; 95% confidence interval [CI]: 1.011-1.195), NO2 (RR: 1.039; 95% CI: 1.013-1.065), and O3 (RR: 1.005; 95% CI: 0.994-1.016), respectively. In the multi-day lag model, concentrations of SO2, NO2, and O3 were statistically significantly associated with the risk of influenza at lag 0-1. The seasonal analysis suggests that the influence of air pollution on influenza is greater in the cold season as compared in the warm season in the early lag days. The multi-pollutant model indicates that NO2 may be a potential confounder for co-pollutants. CONCLUSIONS Our study shows that air pollution may be associated with the risk of influenza in a broad sense. Therefore, when formulating policies to deal with influenza outbreaks in the future, factors regarding air pollution should be taken into consideration.
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Affiliation(s)
- Yongna Meng
- School of Health Sciences, Wuhan University, 115 Donghu Road, 430071, Wuhan, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, 1960 East West Rd, Biomed Bldg, D105, Honolulu, USA
| | - Hao Xiang
- School of Health Sciences, Wuhan University, 115 Donghu Road, 430071, Wuhan, China.
| | - Suyang Liu
- School of Health Sciences, Wuhan University, 115 Donghu Road, 430071, Wuhan, China.
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152
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Shahbaz MA, Martikainen MV, Rönkkö TJ, Komppula M, Jalava PI, Roponen M. Urban air PM modifies differently immune defense responses against bacterial and viral infections in vitro. ENVIRONMENTAL RESEARCH 2021; 192:110244. [PMID: 32980306 PMCID: PMC7516585 DOI: 10.1016/j.envres.2020.110244] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 05/05/2023]
Abstract
Epidemiological evidence has shown the association between exposure to ambient fine particulate matter (PM) and increased susceptibility to bacterial and viral respiratory infections. However, to date, the underlying mechanisms of immunomodulatory effects of PM remain unclear. Our objective was to explore how exposure to relatively low doses of urban air PM alters innate responses to bacterial and viral stimuli in vitro. We used secondary alveolar epithelial cell line along with monocyte-derived macrophages to replicate innate lung barrier in vitro. Co-cultured cells were first exposed for 24 h to PM2.5-1 (particle aerodynamic diameter between 1 and 2.5 μm) and subsequently for an additional 24 h to lipopolysaccharide (TLR4), polyinosinic-polycytidylic acid (TLR3), and synthetic single-stranded RNA oligoribonucleotides (TLR7/8) to mimic bacterial or viral stimulation. Toxicological endpoints included pro-inflammatory cytokines (IL-8, IL-6, and TNF-α), cellular metabolic activity, and cell cycle phase distribution. We show that cells exposed to PM2.5-1 produced higher levels of pro-inflammatory cytokines following stimulation with bacterial TLR4 ligand than cells exposed to PM2.5-1 or bacterial ligand alone. On the contrary, PM2.5-1 exposure reduced pro-inflammatory responses to viral ligands TLR3 and TLR7/8. Cell cycle analysis indicated that viral ligands induced cell cycle arrest at the G2-M phase. In PM-primed co-cultures, however, they failed to induce the G2-M phase arrest. Contrarily, bacterial stimulation caused a slight increase in cells in the sub-G1 phase but in PM2.5-1 primed co-cultures the effect of bacterial stimulation was masked by PM2.5-1. These findings indicate that PM2.5-1 may alter responses of immune defense differently against bacterial and viral infections. Further studies are required to explain the mechanism of immune modulation caused by PM in altering the susceptibility to respiratory infections.
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Affiliation(s)
- Muhammad Ali Shahbaz
- University of Eastern Finland, Department of Environmental and Biological Sciences, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Maria-Viola Martikainen
- University of Eastern Finland, Department of Environmental and Biological Sciences, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Teemu J Rönkkö
- University of Eastern Finland, Department of Environmental and Biological Sciences, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Mika Komppula
- Finnish Meteorological Institute, Yliopistonranta 1F, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Pasi I Jalava
- University of Eastern Finland, Department of Environmental and Biological Sciences, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Marjut Roponen
- University of Eastern Finland, Department of Environmental and Biological Sciences, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland
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153
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Tanwar V, Adelstein JM, Wold LE. Double trouble: combined cardiovascular effects of particulate matter exposure and coronavirus disease 2019. Cardiovasc Res 2021; 117:85-95. [PMID: 33084879 PMCID: PMC7665323 DOI: 10.1093/cvr/cvaa293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/05/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly grown into a pandemic. According to initial reports, the lungs were thought to be the primary target, but recent case studies have shown its reach can extend to other organs including the heart and blood vessels. The severity of cardiac complications of COVID-19 depends on multiple underlying factors, with air pollutant exposure being one of them, as reported by several recent studies. Airborne particulate matter (PM) attracts heightened attention due to its implication in various diseases, especially respiratory and cardiovascular diseases. Inhaled PM not only carries microorganisms inside the body but also elicits local and systemic inflammatory responses resulting in altering the host's immunity and increasing susceptibility to infection. Previous and recent studies have documented that PM acts as a 'carrier' for the virus and aids in spreading viral infections. This review presents the mechanisms and effects of viral entry and how pollution can potentially modulate pathophysiological processes in the heart. We aimed to concisely summarize studies examining cardiovascular outcomes in COVID-19 patients and postulate on how PM can influence these outcomes. We have also reviewed evidence on the use of renin-angiotensin system inhibitors, namely angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in patients with COVID-19. The interplay of pollution and SARS-CoV-2 is essential to understanding the effects of accentuated cardiovascular effects of COVID-19 and deserves in-depth experimental investigations.
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Affiliation(s)
- Vineeta Tanwar
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, 473 W. 12th Avenue, Columbus, OH 43210, USA
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Jeremy M Adelstein
- Medical Student Research Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Loren E Wold
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, 473 W. 12th Avenue, Columbus, OH 43210, USA
- College of Nursing, The Ohio State University, Columbus, OH, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH, USA
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154
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Bigdeli M, Taheri M, Mohammadian A. Spatial sensitivity analysis of COVID-19 infections concerning the satellite-based four air pollutants levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL SCIENCE AND TECHNOLOGY : IJEST 2021; 18:751-760. [PMID: 33456479 PMCID: PMC7794616 DOI: 10.1007/s13762-020-03112-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/05/2020] [Accepted: 12/21/2020] [Indexed: 05/09/2023]
Abstract
The novel coronavirus (COVID-19), first reported in late December 2019, has affected the lives of many people throughout the world. Significant studies have been conducted on this pandemic, some of which have addressed understanding the relationship between different air pollutants and confirmed cases. In this study, the effects of four air pollutants (carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide) were assessed from February 19 to March 22, 2020 to explore how they can affect COVID-19 contagion in Iran. The mean concentrations of air pollutants were extracted from Sentinel 5P data. The COVID-19 confirmed case densities of two provinces, Semnan and Qom, were more than all other provinces. The effect of pollutants on the confirmed case densities was analyzed using multiple linear regression in order to estimate the impact coefficients for individual provinces. The impact coefficients determine the level of each pollutant's contribution to the density of total confirmed cases. Carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone had both considerable negative and positive correlations with the density of confirmed COVID-19 cases, although sulfur dioxide was correlated more negatively than positively. In Semnan, a high hot spot province, nitrogen dioxide had the most significant effect on the density of confirmed cases among all pollutants, while the effect of carbon monoxide was greater in Qom. The results indicated that even short-term exposure to higher concentrations of the pollutants could lead to an increased risk of COVID-19 outbreaks, which should be considered in adopting adequate and appropriate control policies to manage the disease.
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Affiliation(s)
- M. Bigdeli
- Department of Environmental Engineering, School of Environment, College of Engineering, University of Tehran, Tehran, Iran
| | - M. Taheri
- School of Civil Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - A. Mohammadian
- Department of Civil Engineering, University of Ottawa, Ottawa, ON K1N6N5 Canada
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155
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Sarmadi M, Moghanddam VK, Dickerson AS, Martelletti L. Association of COVID-19 distribution with air quality, sociodemographic factors, and comorbidities: an ecological study of US states. AIR QUALITY, ATMOSPHERE, & HEALTH 2021; 14:455-465. [PMID: 33078068 PMCID: PMC7556602 DOI: 10.1007/s11869-020-00949-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/29/2020] [Indexed: 05/18/2023]
Abstract
This ecological study investigated the association between COVID-19 distribution and air quality index (AQI), comorbidities and sociodemographic factors in the USA. The AQI factors included in the study are total AQI, ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide (NO2). Other demographic, socioeconomic, and geographic variables were included as covariates. The correlations of COVID-19 variables-proportion of cases and deaths in each population, as well as case fatality rate with independent variables were determined by Pearson and Spearman correlation and multiple linear regression analyses. The results revealed that AQI-NO2, population density, longitude, gross domestic product per capita, median age, total death of disease, and pneumonia per population were significantly associated with the COVID-19 variables (P < 0.05). Air pollutants, especially NO2 in the US case, could be addressed as an important factor linked with COVID-19 susceptibility and mortality.
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Affiliation(s)
- Mohammad Sarmadi
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Vahid Kazemi Moghanddam
- Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Aisha S. Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Luigi Martelletti
- Energy and Environmental Technology and Economics, City University of London, London, UK
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156
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Hutter HP, Poteser M, Moshammer H, Lemmerer K, Mayer M, Weitensfelder L, Wallner P, Kundi M. Air Pollution Is Associated with COVID-19 Incidence and Mortality in Vienna, Austria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9275. [PMID: 33322456 PMCID: PMC7764269 DOI: 10.3390/ijerph17249275] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 12/23/2022]
Abstract
We determined the impact of air pollution on COVID-19-related mortality and reported-case incidence, analyzing the correlation of infection case numbers and outcomes with previous-year air pollution data from the populations of 23 Viennese districts. Time at risk started in a district when the first COVID-19 case was diagnosed. High exposure levels were defined as living in a district with an average (year 2019) concentration of nitrogen dioxide (NO2) and/or particulate matter (PM10) higher than the upper quartile (30 and 20 µg/m3, respectively) of all districts. The total population of the individual districts was followed until diagnosis of or death from COVID-19, or until 21 April 2020, whichever came first. Cox proportional hazard regression was performed after controlling for percentage of population aged 65 and more, percentage of foreigners and of persons with a university degree, unemployment rate, and population density. PM10 and NO2 were significantly and positively associated with the risk of a COVID-19 diagnosis (hazard ratio (HR) = 1.44 and 1.16, respectively). NO2 was also significantly associated with death from COVID-19 (HR = 1.72). Even within a single city, higher levels of air pollution are associated with an adverse impact on COVID-19 risk.
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Affiliation(s)
- Hans-Peter Hutter
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
| | - Michael Poteser
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
| | - Hanns Moshammer
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
- Department of Hygiene, Medical University of Karakalpakstan, Nukus 230100, Uzbekistan
| | - Kathrin Lemmerer
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
| | - Monika Mayer
- Institute of Meteorology and Climatology, University of Natural Resources and Life Sciences Vienna, 1180 Vienna, Austria;
| | - Lisbeth Weitensfelder
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
| | - Peter Wallner
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
| | - Michael Kundi
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (H.-P.H.); (H.M.); (K.L.); (L.W.); (P.W.); (M.K.)
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157
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Saez M, Tobias A, Barceló MA. Effects of long-term exposure to air pollutants on the spatial spread of COVID-19 in Catalonia, Spain. ENVIRONMENTAL RESEARCH 2020; 191:110177. [PMID: 32931792 PMCID: PMC7486876 DOI: 10.1016/j.envres.2020.110177] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/17/2020] [Accepted: 08/30/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND The risk of infection and death by COVID-19 could be associated with a heterogeneous distribution at a small area level of environmental, socioeconomic and demographic factors. Our objective was to investigate, at a small area level, whether long-term exposure to air pollutants increased the risk of COVID-19 incidence and death in Catalonia, Spain, controlling for socioeconomic and demographic factors. METHODS We used a mixed longitudinal ecological design with the study population consisting of small areas in Catalonia for the period February 25 to May 16, 2020. We estimated Generalized Linear Mixed models in which we controlled for a wide range of observed and unobserved confounders as well as spatial and temporal dependence. RESULTS We have found that long-term exposure to nitrogen dioxide (NO2) and, to a lesser extent, to coarse particles (PM10) have been independent predictors of the spatial spread of COVID-19. For every 1 μm/m3 above the mean the risk of a positive test case increased by 2.7% (95% credibility interval, ICr: 0.8%, 4.7%) for NO2 and 3.0% (95% ICr: -1.4%,7.44%) for PM10. Regions with levels of NO2 exposure in the third and fourth quartile had 28.8% and 35.7% greater risk of a death, respectively, than regions located in the first two quartiles. CONCLUSION Although it is possible that there are biological mechanisms that explain, at least partially, the association between long-term exposure to air pollutants and COVID-19, we hypothesize that the spatial spread of COVID-19 in Catalonia is attributed to the different ease with which some people, the hosts of the virus, have infected others. That facility depends on the heterogeneous distribution at a small area level of variables such as population density, poor housing and the mobility of its residents, for which exposure to pollutants has been a surrogate.
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Affiliation(s)
- Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Maria A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. http://www.udg.edu/grecs.htm
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158
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Cazzolla Gatti R, Velichevskaya A, Tateo A, Amoroso N, Monaco A. Machine learning reveals that prolonged exposure to air pollution is associated with SARS-CoV-2 mortality and infectivity in Italy. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 267:115471. [PMID: 32882464 PMCID: PMC7442434 DOI: 10.1016/j.envpol.2020.115471] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/28/2020] [Accepted: 08/19/2020] [Indexed: 05/18/2023]
Abstract
Air pollution can increase the risk of respiratory diseases, enhancing the susceptibility to viral and bacterial infections. Some studies suggest that small air particles facilitate the spread of viruses and also of the new coronavirus, besides the direct person-to-person contagion. However, the effects of the exposure to particulate matter and other contaminants on SARS-CoV-2 has been poorly explored. Here we examined the possible reasons why the new coronavirus differently impacted on Italian regional and provincial populations. With the help of artificial intelligence, we studied the importance of air pollution for mortality and positivity rates of the SARS-CoV-2 outbreak in Italy. We discovered that among several environmental, health, and socio-economic factors, air pollution and fine particulate matter (PM2.5), as its main component, resulted as the most important predictors of SARS-CoV-2 effects. We also found that the emissions from industries, farms, and road traffic - in order of importance - might be responsible for more than 70% of the deaths associated with SARS-CoV-2 nationwide. Given the major contribution played by air pollution (much more important than other health and socio-economic factors, as we discovered), we projected that, with an increase of 5-10% in air pollution, similar future pathogens may inflate the epidemic toll of Italy by 21-32% additional cases, whose 19-28% more positives and 4-14% more deaths. Our findings, demonstrating that fine-particulate (PM2.5) pollutant level is the most important factor to predict SARS-CoV-2 effects that would worsen even with a slight decrease of air quality, highlight that the imperative of productivity before health and environmental protection is, indeed, a short-term/small-minded resolution.
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Affiliation(s)
- Roberto Cazzolla Gatti
- Biological Institute, Tomsk State University, Russia; Konrad Lorenz Institute for Evolution and Cognition Research, Austria.
| | | | - Andrea Tateo
- Università degli Studi di Bari "A. Moro", Dipartimento Interateneo di Fisica, Bari, Italy
| | - Nicola Amoroso
- Università degli Studi di Bari "A. Moro", Dipartimento Interateneo di Fisica, Bari, Italy; Università degli Studi di Bari "A. Moro", Dipartimento di Farmacia - Scienze del Farmaco, Bari, Italy
| | - Alfonso Monaco
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, Bari, Italy
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159
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Copiello S, Grillenzoni C. The spread of 2019-nCoV in China was primarily driven by population density. Comment on "Association between short-term exposure to air pollution and COVID-19 infection: Evidence from China" by Zhu et al. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 744:141028. [PMID: 32711328 PMCID: PMC7365069 DOI: 10.1016/j.scitotenv.2020.141028] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 04/13/2023]
Abstract
Recently, an article published in the journal Science of the Total Environment and authored by Zhu et al. has claimed the "Association between short-term exposure to air pollution and COVID-19 infection" (doi: https://doi.org/10.1016/j.scitotenv.2020.138704). This note shows that the stated dependence between the diffusion of the infection and air pollution may be the result of spurious correlation due to the omission of a common factor, namely, population density. To this end, the relationship between demographic, socio-economic, and environmental conditions and the spread of the novel coronavirus in China is analyzed with spatial regression models on variables deflated by population size. The infection rate - as measured by the number of cases per 100 thousand inhabitants - is found to be strongly related to the population density. At the same time, the association with air pollution is detected with a negative sign, which is difficult to interpret.
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Affiliation(s)
- Sergio Copiello
- IUAV University of Venice, Dorsoduro 2206, 30123 Venice, Italy.
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160
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Merk R, Heßelbach K, Osipova A, Popadić D, Schmidt-Heck W, Kim GJ, Günther S, Piñeres AG, Merfort I, Humar M. Particulate Matter (PM 2.5) from Biomass Combustion Induces an Anti-Oxidative Response and Cancer Drug Resistance in Human Bronchial Epithelial BEAS-2B Cells. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8193. [PMID: 33171923 PMCID: PMC7664250 DOI: 10.3390/ijerph17218193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023]
Abstract
Nearly half of the world's population relies on combustion of solid biofuels to cover fundamental energy demands. Epidemiologic data demonstrate that particularly long-term emissions adversely affect human health. However, pathological molecular mechanisms are insufficiently characterized. Here we demonstrate that long-term exposure to fine particulate matter (PM2.5) from biomass combustion had no impact on cellular viability and proliferation but increased intracellular reactive oxygen species (ROS) levels in bronchial epithelial BEAS-2B cells. Exposure to PM2.5 induced the nuclear factor erythroid 2-related factor 2 (Nrf2) and mediated an anti-oxidative response, including enhanced levels of intracellular glutathione (GSH) and nuclear accumulation of heme oxygenase-1 (HO-1). Activation of Nrf2 was promoted by the c-Jun N-terminal kinase JNK1/2, but not p38 or Akt, which were also induced by PM2.5. Furthermore, cells exposed to PM2.5 acquired chemoresistance to doxorubicin, which was associated with inhibition of apoptosis and elevated levels of GSH in these cells. Our findings propose that exposure to PM2.5 induces molecular defense mechanisms, which prevent cellular damage and may thus explain the initially relative rare complications associated with PM2.5. However, consistent induction of pro-survival pathways may also promote the progression of diseases. Environmental conditions inducing anti-oxidative responses may have the potential to promote a chemoresistant cellular phenotype.
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Affiliation(s)
- Regina Merk
- Department of Pharmaceutical Biology and Biotechnology, Institute of Pharmaceutical Sciences, Albert Ludwigs University Freiburg, 79104 Freiburg, Germany; (R.M.); (K.H.); (A.O.); (D.P.)
| | - Katharina Heßelbach
- Department of Pharmaceutical Biology and Biotechnology, Institute of Pharmaceutical Sciences, Albert Ludwigs University Freiburg, 79104 Freiburg, Germany; (R.M.); (K.H.); (A.O.); (D.P.)
| | - Anastasiya Osipova
- Department of Pharmaceutical Biology and Biotechnology, Institute of Pharmaceutical Sciences, Albert Ludwigs University Freiburg, 79104 Freiburg, Germany; (R.M.); (K.H.); (A.O.); (D.P.)
| | - Désirée Popadić
- Department of Pharmaceutical Biology and Biotechnology, Institute of Pharmaceutical Sciences, Albert Ludwigs University Freiburg, 79104 Freiburg, Germany; (R.M.); (K.H.); (A.O.); (D.P.)
| | - Wolfgang Schmidt-Heck
- Department of Systems Biology and Bioinformatics, Leibniz Institute for Natural Product Research and Infection Biology-Hans-Knöll Institute (HKI), 07745 Jena, Germany;
| | - Gwang-Jin Kim
- Department of Pharmaceutical Bioinformatics, Institute of Pharmaceutical Sciences, Albert-Ludwigs University Freiburg, 79104 Freiburg, Germany; (G.-J.K.); (S.G.)
| | - Stefan Günther
- Department of Pharmaceutical Bioinformatics, Institute of Pharmaceutical Sciences, Albert-Ludwigs University Freiburg, 79104 Freiburg, Germany; (G.-J.K.); (S.G.)
| | - Alfonso García Piñeres
- Centro de Investigación en Biología Celular y Molecular (CIBCM), Universidad de Costa Rica, 11501-2060 San José, Costa Rica;
- Escuela de Química, Universidad de Costa Rica, 11501-2060 San José, Costa Rica
| | - Irmgard Merfort
- Department of Pharmaceutical Biology and Biotechnology, Institute of Pharmaceutical Sciences, Albert Ludwigs University Freiburg, 79104 Freiburg, Germany; (R.M.); (K.H.); (A.O.); (D.P.)
- Spemann Graduate School of Biology and Medicine (SGBM), Albert-Ludwigs University Freiburg, 79104 Freiburg, Germany
| | - Matjaz Humar
- Department of Pharmaceutical Biology and Biotechnology, Institute of Pharmaceutical Sciences, Albert Ludwigs University Freiburg, 79104 Freiburg, Germany; (R.M.); (K.H.); (A.O.); (D.P.)
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161
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Benmarhnia T. Linkages Between Air Pollution and the Health Burden From COVID-19: Methodological Challenges and Opportunities. Am J Epidemiol 2020; 189:1238-1243. [PMID: 32676643 PMCID: PMC7454309 DOI: 10.1093/aje/kwaa148] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic revealed and exacerbated existing social and economic health disparities and actionable epidemiological evidence is needed to identify potential vulnerability factors to help inform targeted responses. In this commentary, methodological challenges and opportunities regarding the links between air pollution and COVID-19 are discussed with a focus on: i) the role of differential exposure to air pollution across populations and explain spatio-temporal variability of the epidemic spread and resultant mortality; ii) the indirect impacts of interventions treated as natural experiments to control COVID-19 person-to-person spread on air pollution and population health. I first discuss the potential mechanisms between exposure to air pollution and COVID-19 and the opportunity to clearly formulate causal questions of interest through the target trial framework. Then, I discuss challenges regarding the use of quasi-experimental designs that capitalize on the differential timing of COVID-19 policies including the selection of control groups and potential violations of the common shock assumption. Finally, I discuss environmental justice implications of this many-headed beast of a crisis.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, CA, USA
- Address correspondence to Tarik Benmarhnia, Department of Family Medicine and Public Health & Scripps Institution of Oceanography University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA. Tel: +18589991428, E-mail:
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162
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Zhao X, Lu M, An Z, Li J, Li H, Zhao Q, Wu Z, Wu W, Liu Y, Song J. Acute effects of ambient air pollution on hospital outpatients with chronic pharyngitis in Xinxiang, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1923-1931. [PMID: 32780156 DOI: 10.1007/s00484-020-01980-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/19/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
We present results on a time-series study that analyzed the acute effects of six criteria air pollutants on hospital outpatient with chronic pharyngitis (CP) in Xinxiang, China. Data on the concentration of air pollutants and CP outpatient records were collected daily in Xinxiang, China, from January 1, 2015 to December 31, 2018. This study identified 62,823 outpatients with CP. The annual average concentrations of PM2.5, PM10, SO2, NO2, CO, and O3 are 75.7, 132.1, 33.2, 48.4, 1377, and 59.4 μg/m3, respectively. Further, a 10 μg/m3 increment in the concentration of PM10, SO2, NO2, and CO corresponds to an increase of 0.28% (95% confidence interval (CI): 0.03-0.53%), 1.10% (95% CI: 0.09-2.11%), 1.82% (95% CI: 0.84-2.80%), and 0.03% (95% CI: 0.01-0.06%) in daily CP hospital outpatients, respectively. Furthermore, results indicated that outpatients under the age of 15 are more susceptible to the air pollutants, excluding O3. Meanwhile, males might be more susceptible, and effect estimates appear slightly stronger in the cool season. Therefore, we should implement effective measures to manage air pollutants and reinforce protection of the high-risk population.
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Affiliation(s)
- Xiangmei Zhao
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Mengxue Lu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Huijun Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Qian Zhao
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Zhineng Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China.
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163
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Raciti L, Calabrò RS. Can volcanic trace elements facilitate Covid-19 diffusion? A hypothesis stemming from the Mount Etna area, Sicily. Med Hypotheses 2020; 144:110058. [PMID: 32758894 PMCID: PMC7320851 DOI: 10.1016/j.mehy.2020.110058] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022]
Abstract
In December 2019, severe cases of pneumonia of unknown aetiology were reported in Wuhan city, in China. Lately, the pneumonia was related to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and the diseases was termed coronavirus disease-2019 (COVID-19). At the end of January 2020, the infection spread all over Italy, but with high infection rates and mortality in the northern part, especially in Lombardy, the most industrialized and polluted region of the country. It is noteworthy that a strong association between severe viral respiratory disease and air pollution has been described. Air pollutant could be solid particles, liquid droplets, or gases and can be of natural origin (such as ash from a volcanic eruption) or released from motor vehicle depletes (carbon monoxide gas) or factories (sulfur dioxide). Volcanic eruptions release large amounts of sulphuric acid, hydrogen sulfide, and hydrochloric acid into the atmosphere. Pulmunary diseases spreadby means of small droplets in thebreath, also called aerosols, and air pollution may facilitate the outside survival of viruses. We suppose that ash and gases emitted from the Mount Etna contributed to air pollution, potentially favouring the major contagion of COVID-19 in the eastern flank of the mountain, as in Catania city. In fact, ash and gases (with regard to radon) are usually particularly intense in winter, with a reduction of emission of specific metals with warmer weather. This is the first paper that elaborates the hypothesis of a potential role of volcanic gases and heavy metals-related air pollution, combined to specific climatic conditions and regional topography, in favouring severe COVID-19 diffusion in Sicily. Clinical and epidemiological studies are needed to support the hypothesis and plan the due prevention and awareness-raising campaigns.
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Affiliation(s)
- Loredana Raciti
- G.C.A.- Spoke Center, A.O. Cannizzaro Catania, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Rocco Salvatore Calabrò
- Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.
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164
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Marmett B, Carvalho RB, Dorneles GP, Nunes RB, Rhoden CR. Should I stay or should I go: Can air pollution reduce the health benefits of physical exercise? Med Hypotheses 2020; 144:109993. [DOI: 10.1016/j.mehy.2020.109993] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 12/16/2022]
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165
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Bellocchio L, Bordea IR, Ballini A, Lorusso F, Hazballa D, Isacco CG, Malcangi G, Inchingolo AD, Dipalma G, Inchingolo F, Piscitelli P, Logroscino G, Miani A. Environmental Issues and Neurological Manifestations Associated with COVID-19 Pandemic: New Aspects of the Disease? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8049. [PMID: 33139595 PMCID: PMC7663018 DOI: 10.3390/ijerph17218049] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023]
Abstract
Coronavirus (SARS-CoV-2) emerged in China in December 2019 and rapidly caused a global health pandemic. Current evidence seems to suggest a possible link with ecosystem disequilibrium and even air pollution. The primary manifestations affect respiratory and circulatory systems, but neurological features are also being reported through case reports and case series. We summarize neurological symptoms and complications associated with COVID-19. We have searched for original articles published in PubMed/Medline, PubMed Central and Google Scholar using the following keywords: "COVID-19", "Coronavirus", "pandemic", "SARS-COV-2", "neurology", "neurological", "complications" and "manifestations". We found around 1000 publications addressing the issue of neurological conditions associated with COVID-19 infection. Amongst those, headache and dizziness are the most common reported symptoms followed by encephalopathy and delirium, while the most frequent complications are cerebrovascular accidents, Guillain-Barré syndrome, acute transverse myelitis, and acute encephalitis. Specific symptoms affecting the peripheral nervous system such as hyposmia and dysgeusia are the most common manifestations recorded in the selected studies. Interestingly, it was noted that these kinds of neurological symptoms might precede the typical features, such as fever and cough, in COVID patients. Neurological symptoms and complications associated with COVID-19 should be considered as a part of the clinical features of this novel global pandemic.
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Affiliation(s)
- Luigi Bellocchio
- INSERM, U1215 NeuroCentre Magendie, Endocannabinoids and Neuroadaptation, University of Bordeaux, 33000 Bordeaux, France;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario “Ernesto Quagliariello” University of Bari “Aldo Moro”, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Denisa Hazballa
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania;
| | - Ciro Gargiulo Isacco
- Embryology and Regenerative Medicine and Immunology at Pham Chau Trinh University of Medicine Hoi An, Ho Chi Minh 70000, Vietnam;
- Regenerative Medicine and Metabolic Disorders at Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy; (G.M.); (A.D.I.); (G.D.); (F.I.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy; (G.M.); (A.D.I.); (G.D.); (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy; (G.M.); (A.D.I.); (G.D.); (F.I.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy; (G.M.); (A.D.I.); (G.D.); (F.I.)
| | - Prisco Piscitelli
- Staff UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80138 Naples, Italy
| | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Alessandro Miani
- Department of Environmental Sciences and Policy, University of Milan, 20068 Milan, Italy;
- Italian Society of Environmental Medicine, SIMA, 20068 Milan, Italy
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166
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Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. SCIENCE ADVANCES 2020; 6:eabd4049. [PMID: 33148655 PMCID: PMC7673673 DOI: 10.1126/sciadv.abd4049] [Citation(s) in RCA: 536] [Impact Index Per Article: 134.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 05/17/2023]
Abstract
Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.
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Affiliation(s)
- X Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - R C Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M B Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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167
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Lin S, Wei D, Sun Y, Chen K, Yang L, Liu B, Huang Q, Paoliello MMB, Li H, Wu S. Region-specific air pollutants and meteorological parameters influence COVID-19: A study from mainland China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 204:111035. [PMID: 32768746 PMCID: PMC7406240 DOI: 10.1016/j.ecoenv.2020.111035] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/11/2020] [Accepted: 07/12/2020] [Indexed: 05/20/2023]
Abstract
Coronavirus disease 2019 (COVID-19) was first detected in December 2019 in Wuhan, China, with 11,669,259 positive cases and 539,906 deaths globally as of July 8, 2020. The objective of the present study was to determine whether meteorological parameters and air quality affect the transmission of COVID-19, analogous to SARS. We captured data from 29 provinces, including numbers of COVID-19 cases, meteorological parameters, air quality and population flow data, between Jan 21, 2020 and Apr 3, 2020. To evaluate the transmissibility of COVID-19, the basic reproductive ratio (R0) was calculated with the maximum likelihood "removal" method, which is based on chain-binomial model, and the association between COVID-19 and air pollutants or meteorological parameters was estimated by correlation analyses. The mean estimated value of R0 was 1.79 ± 0.31 in 29 provinces, ranging from 1.08 to 2.45. The correlation between R0 and the mean relative humidity was positive, with coefficient of 0.370. In provinces with high flow, indicators such as carbon monoxide (CO) and 24-h average concentration of carbon monoxide (CO_24 h) were positively correlated with R0, while nitrogen dioxide (NO2), 24-h average concentration of nitrogen dioxide (NO2_24 h) and daily maximum temperature were inversely correlated to R0, with coefficients of 0.644, 0.661, -0.636, -0.657, -0.645, respectively. In provinces with medium flow, only the weather factors were correlated with R0, including mean/maximum/minimum air pressure and mean wind speed, with coefficients of -0.697, -0.697, -0.697 and -0.841, respectively. There was no correlation with R0 and meteorological parameters or air pollutants in provinces with low flow. Our findings suggest that higher ambient CO concentration is a risk factor for increased transmissibility of the novel coronavirus, while higher temperature and air pressure, and efficient ventilation reduce its transmissibility. The effect of meteorological parameters and air pollutants varies in different regions, and requires that these issues be considered in future modeling disease transmissibility.
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Affiliation(s)
- Shaowei Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Donghong Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Department of Preventive Medicine, School of Inspection and Prevention, Quanzhou Medical College, Quanzhou, 362011, China.
| | - Yi Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Kun Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Le Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Bang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Qing Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
| | - Monica Maria Bastos Paoliello
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA; Graduate Program in Public Health, Center of Health Sciences, State University of Londrina, PR, 86038-350, Brazil.
| | - Huangyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
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168
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Azuma K, Kagi N, Kim H, Hayashi M. Impact of climate and ambient air pollution on the epidemic growth during COVID-19 outbreak in Japan. ENVIRONMENTAL RESEARCH 2020; 190:110042. [PMID: 32800895 PMCID: PMC7420955 DOI: 10.1016/j.envres.2020.110042] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 05/19/2023]
Abstract
Coronavirus disease 2019 (COVID-19) rapidly spread worldwide in the first quarter of 2020 and resulted in a global crisis. Investigation of the potential association of the spread of the COVID-19 infection with climate or ambient air pollution could lead to the development of preventive strategies for disease control. To examine this association, we conducted a longitudinal cohort study of 28 geographical areas of Japan with documented outbreaks of COVID-19. We analyzed data obtained from March 13 to April 6, 2020, before the Japanese government declared a state of emergency. The results revealed that the epidemic growth of COVID-19 was significantly associated with increase in daily temperature or sunshine hours. This suggests that an increase in person-to-person contact due to increased outing activities on a warm and/or sunny day might promote the transmission of COVID-19. Our results also suggested that short-term exposure to suspended particles might influence respiratory infections caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Further research by well-designed or well-controlled study models is required to ascertain this effect. Our findings suggest that weather has an indirect role in the transmission of COVID-19 and that daily adequate preventive behavior decreases the transmission.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, 589-8511, Japan.
| | - Naoki Kagi
- Department of Architecture and Building Engineering, School of Environment and Society, Tokyo Institute of Technology, Tokyo, 152-8550, Japan.
| | - Hoon Kim
- Department of Environmental Health, National Institute of Public Health, Wako, 351-0197, Japan.
| | - Motoya Hayashi
- Laboratory of Environmental Space Design, Division of Architecture, Faculty of Engineering, Hokkaido University, Sapporo, 060-6826, Japan.
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169
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Kim JM, Jeon JS, Kim JK. Climate and Human coronaviruses 229E and Human coronaviruses OC43 Infections: Respiratory Viral Infections Prevalence in Hospitalized Children in Cheonan, Korea. J Microbiol Biotechnol 2020; 30:1495-1499. [PMID: 32807752 PMCID: PMC9728399 DOI: 10.4014/jmb.2004.04052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Abstract
The study of climate and respiratory viral infections using big data may enable the recognition and interpretation of relationships between disease occurrence and climatic variables. In this study, realtime reverse transcription quantitative PCR (qPCR) methods were used to identify Human respiratory coronaviruses (HCoV). infections in patients below 10 years of age with respiratory infections who visited Dankook University Hospital in Cheonan, South Korea, from January 1, 2012, to December 31, 2018. Out of the 9010 patients who underwent respiratory virus real-time reverse transcription qPCR test, 364 tested positive for HCoV infections. Among these 364 patients, 72.8% (n = 265) were below 10 years of age. Data regarding the frequency of infections was used to uncover the seasonal pattern of the two viral strains, which was then compared with local meteorological data for the same time period. HCoV-229E and HCoV-OC43 showed high infection rates in patients below 10 years of age. There was a negative relationship between HCoV-229E and HCoV-OC43 infections with air temperature and wind-chill temperatures. Both HCoV-229E and HCoV-OC43 rates of infection were positively related to atmospheric pressure, while HCoV-229E was also positively associated with particulate matter concentrations. Our results suggest that climatic variables affect the rate in which children below 10 years of age are infected with HCoV. These findings may help to predict when prevention strategies may be most effective.
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Affiliation(s)
- Jang Mook Kim
- Department of Health Administration, College of Health Sciences, Dankook University, Cheonan 31116, Republic of Korea
| | - Jae Sik Jeon
- Department of Biomedical Laboratory Science, College of Health Sciences, Dankook University, Cheonan 31116, Republic of Korea
| | - Jae Kyung Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Dankook University, Cheonan 31116, Republic of Korea,Corresponding author Phone: +82-41-550-1451 Fax: +82-41-559-7934 E-mail:
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170
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Gallo M, Street ME, Guerra F, Fanos V, Marcialis MA. A review of current knowledge on Pollution, Cigarette Smoking and COVID-19 diffusion and their relationship with inflammation. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020148. [PMID: 33525222 PMCID: PMC7927491 DOI: 10.23750/abm.v91i4.10263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 01/08/2023]
Abstract
Coronavirus disease (COVID-19) is an infectious disease caused by the newly discovered coronavirus, Sars-Cov-2. This infection can cause mild to very severe respiratory and systemic illness mainly related with a cytokine storm. The epidemiology of COVID-19 is under continuous evolution, and studies are ongoing aiming at identifying the possible factors facilitating the diffusion of this infection. (www.actabiomedica.it)
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Affiliation(s)
- Manuela Gallo
- School of Pediatrics, University of Cagliari, Italy.
| | | | | | - Vassilios Fanos
- Department of Surgery, University of Cagliari, Italy; Neonatal Intensive Care Unit, AOU Cagliari, Italy.
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171
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Zoran MA, Savastru RS, Savastru DM, Tautan MN. Assessing the relationship between ground levels of ozone (O 3) and nitrogen dioxide (NO 2) with coronavirus (COVID-19) in Milan, Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 740:140005. [PMID: 32559534 PMCID: PMC7274116 DOI: 10.1016/j.scitotenv.2020.140005] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 04/14/2023]
Abstract
This paper investigates the correlation between the high level of coronavirus SARS-CoV-2 infection accelerated transmission and lethality, and surface air pollution in Milan metropolitan area, Lombardy region in Italy. For January-April 2020 period, time series of daily average inhalable gaseous pollutants ozone (O3) and nitrogen dioxide (NO2), together climate variables (air temperature, relative humidity, wind speed, precipitation rate, atmospheric pressure field and Planetary Boundary Layer) were analyzed. In spite of being considered primarily transmitted by indoor bioaerosols droplets and infected surfaces or direct human-to-human personal contacts, it seems that high levels of urban air pollution, and climate conditions have a significant impact on SARS-CoV-2 diffusion. Exhibited positive correlations of ambient ozone levels and negative correlations of NO2 with the increased rates of COVID-19 infections (Total number, Daily New positive and Total Deaths cases), can be attributed to airborne bioaerosols distribution. The results show positive correlation of daily averaged O3 with air temperature and inversely correlations with relative humidity and precipitation rates. Viral genome contains distinctive features, including a unique N-terminal fragment within the spike protein, which allows coronavirus attachment on ambient air pollutants. At this moment it is not clear if through airborne diffusion, in the presence of outdoor and indoor aerosols, this protein "spike" of the new COVID-19 is involved in the infectious agent transmission from a reservoir to a susceptible host during the highest nosocomial outbreak in some agglomerated industrialized urban areas like Milan is. Also, in spite of collected data for cold season (winter-early spring) period, when usually ozone levels have lower values than in summer, the findings of this study support possibility as O3 can acts as a COVID-19 virus incubator. Being a novel pandemic coronavirus version, it might be ongoing during summer conditions associated with higher air temperatures, low relative humidity and precipitation levels.
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Affiliation(s)
- Maria A Zoran
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest 077125, Romania.
| | - Roxana S Savastru
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest 077125, Romania
| | - Dan M Savastru
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest 077125, Romania
| | - Marina N Tautan
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest 077125, Romania
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172
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Gorini F, Chatzianagnostou K, Mazzone A, Bustaffa E, Esposito A, Berti S, Bianchi F, Vassalle C. "Acute Myocardial Infarction in the Time of COVID-19": A Review of Biological, Environmental, and Psychosocial Contributors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7371. [PMID: 33050220 PMCID: PMC7600622 DOI: 10.3390/ijerph17207371] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has quickly become a worldwide health crisis.Although respiratory disease remains the main cause of morbidity and mortality in COVID patients,myocardial damage is a common finding. Many possible biological pathways may explain therelationship between COVID-19 and acute myocardial infarction (AMI). Increased immune andinflammatory responses, and procoagulant profile have characterized COVID patients. All theseresponses may induce endothelial dysfunction, myocardial injury, plaque instability, and AMI.Disease severity and mortality are increased by cardiovascular comorbidities. Moreover, COVID-19has been associated with air pollution, which may also represent an AMI risk factor. Nonetheless,a significant reduction in patient admissions following containment initiatives has been observed,including for AMI. The reasons for this phenomenon are largely unknown, although a real decreasein the incidence of cardiac events seems highly improbable. Instead, patients likely may presentdelayed time from symptoms onset and subsequent referral to emergency departments because offear of possible in-hospital infection, and as such, may present more complications. Here, we aim todiscuss available evidence about all these factors in the complex relationship between COVID-19and AMI, with particular focus on psychological distress and the need to increase awareness ofischemic symptoms.
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Affiliation(s)
- Francesca Gorini
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (F.G.); (E.B.); (F.B.)
| | - Kyriazoula Chatzianagnostou
- Ospedale del Cuore G Pasquinucci Fondazione Toscana Gabriele Monasterio di Massa, via Aurelia Sud, 54100 Massa, Italy; (K.C.); (A.M.); (A.E.); (S.B.)
| | - Annamaria Mazzone
- Ospedale del Cuore G Pasquinucci Fondazione Toscana Gabriele Monasterio di Massa, via Aurelia Sud, 54100 Massa, Italy; (K.C.); (A.M.); (A.E.); (S.B.)
| | - Elisa Bustaffa
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (F.G.); (E.B.); (F.B.)
| | - Augusto Esposito
- Ospedale del Cuore G Pasquinucci Fondazione Toscana Gabriele Monasterio di Massa, via Aurelia Sud, 54100 Massa, Italy; (K.C.); (A.M.); (A.E.); (S.B.)
| | - Sergio Berti
- Ospedale del Cuore G Pasquinucci Fondazione Toscana Gabriele Monasterio di Massa, via Aurelia Sud, 54100 Massa, Italy; (K.C.); (A.M.); (A.E.); (S.B.)
| | - Fabrizio Bianchi
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (F.G.); (E.B.); (F.B.)
| | - Cristina Vassalle
- Ospedale del Cuore G Pasquinucci Fondazione Toscana Gabriele Monasterio di Massa, via Aurelia Sud, 54100 Massa, Italy; (K.C.); (A.M.); (A.E.); (S.B.)
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173
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Impact on Air Quality of the COVID-19 Lockdown in the Urban Area of Palermo (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207375. [PMID: 33050278 PMCID: PMC7599871 DOI: 10.3390/ijerph17207375] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023]
Abstract
At the end of 2019, the first cases of coronavirus disease (COVID-19) were reported in Wuhan, China. Thereafter, the number of infected people increased rapidly, and the outbreak turned into a national crisis, with infected individuals all over the country. The COVID-19 global pandemic produced extreme changes in human behavior that affected air quality. Human mobility and production activities decreased significantly, and many regions recorded significant reductions in air pollution. The goal of our investigation was to evaluate the impact of the COVID-19 lockdown on the concentrations of the main air pollutants in the urban area of Palermo (Italy). In this study, the trends in the average concentrations of CO, NO2, O3, and PM10 in the air from 1 January 2020 to 31 July 2020 were compared with the corresponding average values detected at the same monitoring stations in Palermo during the previous five years (2015–2019). During the lockdown period (10 March–30 April), we observed a decrease in the concentrations of CO, NO2, and particulate matter (PM)10, calculated to be about 51%, 50%, and 45%, respectively. This confirms that air pollution in an urban area is predominantly linked to vehicular traffic.
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174
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Zeng W, Zhao H, Liu R, Yan W, Qiu Y, Yang F, Shu C, Zhan Y. Association between NO 2 cumulative exposure and influenza prevalence in mountainous regions: A case study from southwest China. ENVIRONMENTAL RESEARCH 2020; 189:109926. [PMID: 32980014 PMCID: PMC7354378 DOI: 10.1016/j.envres.2020.109926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/01/2020] [Accepted: 07/07/2020] [Indexed: 05/29/2023]
Abstract
While accumulating evidence shows that air pollution exposure is an important risk factor to influenza prevalence, their association has been inadequately investigated in mountainous regions with dense populations and high humidity. We aim to estimate the association and exposure-outcome effects between exposure to nitrogen dioxide (NO2) and influenza prevalence in a mountainous region with a dense population and high humidity. We investigated 14,993 patients with confirmed influenza cases from January 2013 to December 2017 in Chongqing, a mountainous city in southwest China. We developed distributed lag non-linear models with quasi-Poisson link to take into account the lag and non-linear effects of NO2 exposure on influenza prevalence. We estimated that the cumulative effect of a 10 μg/m3 increase in NO2 with seven-day lag (i.e., summing all the contributions up to seven days) corresponded to relative risk of 1.24 (95% CI: 1.17-1.31) in daily influenza prevalence. Comparing to annual mean of the World Health Organization air quality guidelines of 40 μg/m3 for NO2, we estimated that 14.01% (95% CI: 10.69-17.08%) of the influenza cases were attributable to excessive NO2 exposure. Our results suggest that NO2 exposure could worsen the risk of influenza infection in this mountainous city, filling the gap of relevant researches in densely populated and mountainous cities. Our findings provide evidence for developing influenza surveillance and early warning systems.
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Affiliation(s)
- Wen Zeng
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Han Zhao
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Rui Liu
- Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Wei Yan
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yang Qiu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Fumo Yang
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China; National Engineering Research Center for Flue Gas Desulfurization, Chengdu, Sichuan, 610065, China
| | - Chang Shu
- Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; Children's Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China; National Engineering Research Center for Flue Gas Desulfurization, Chengdu, Sichuan, 610065, China; Medical Big Data Center, Sichuan University, Chengdu, Sichuan, 610041, China; Sino-German Centre for Water and Health Research, Sichuan University, Chengdu, Sichuan, 610065, China.
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175
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Carraturo F, Del Giudice C, Morelli M, Cerullo V, Libralato G, Galdiero E, Guida M. Persistence of SARS-CoV-2 in the environment and COVID-19 transmission risk from environmental matrices and surfaces. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 265:115010. [PMID: 32570023 PMCID: PMC7280109 DOI: 10.1016/j.envpol.2020.115010] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 05/17/2023]
Abstract
The Coronavirus disease 2019 (COVID-19) is spreading around the world, representing a global pandemic, counting, as of June 5th, 2020, over 6,600,000 confirmed cases and more than 390,000 deaths, with exponentially increasing numbers. In the first half of 2020, because of the widespread of the COVID-19, researches were focused on the monitoring of SARS-CoV-2 in water, wastewater, sludge, air, and on surfaces, in order to assess the risk of contracting the viral infection from contaminated environments. So far, the survival of the novel Coronavirus out of the human body has been reported for short time periods (from hours to few days, in optimized in vitro conditions), mainly because of the need of an host organism which could consent the viral attack, and due to the weak external membrane of the virus. SARS-CoV-2 viral shedding strategies in the environment, either through animate and unanimate matrices, or exploiting the organic matter in water, wastewater, and waste in general, have been discussed in the present article. We concluded that, besides the high infectuousness of the novel Coronavirus, the transmission of the pathogen may be efficiently contained applying the adequate preventive measures (e.g., personal protection equipments, and disinfecting agents), indicated by national and international health authories.
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Affiliation(s)
- Federica Carraturo
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy.
| | - Carmela Del Giudice
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy
| | - Michela Morelli
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy
| | - Valeria Cerullo
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy
| | - Giovanni Libralato
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy
| | - Emilia Galdiero
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy
| | - Marco Guida
- Department of Biology, University of Naples Federico II, via Cintia 21, 80126, Naples, Italy
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176
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Farhangrazi ZS, Sancini G, Hunter AC, Moghimi SM. Airborne Particulate Matter and SARS-CoV-2 Partnership: Virus Hitchhiking, Stabilization and Immune Cell Targeting - A Hypothesis. Front Immunol 2020; 11:579352. [PMID: 33072124 PMCID: PMC7543093 DOI: 10.3389/fimmu.2020.579352] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/18/2020] [Indexed: 12/30/2022] Open
Affiliation(s)
- Z. Shadi Farhangrazi
- S. M. Discovery Group Inc., Denver, CO, United States
- S. M. Discovery Group Ltd., Durham, United Kingdom
| | - Giulio Sancini
- Department of Experimental Medicine, University of Milano-Bicocca, Monza, Italy
| | - A. Christy Hunter
- School of Pharmacy, College of Science, University of Lincoln, Lincoln, United Kingdom
| | - Seyed Moein Moghimi
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom
- Translational and Clinical Research Institute, Faculty of Health and Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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177
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Liang D, Shi L, Zhao J, Liu P, Sarnat JA, Gao S, Schwartz J, Liu Y, Ebelt ST, Scovronick N, Chang HH. Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States. Innovation (N Y) 2020; 1:100047. [PMID: 32984861 PMCID: PMC7505160 DOI: 10.1016/j.xinn.2020.100047] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/17/2020] [Indexed: 01/16/2023] Open
Abstract
Background The novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 600,000 lives worldwide, causing tremendous public health, social, and economic damages. Although the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis. Methods We conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010–2016) county-level exposures to NO2, PM2.5, and O3 and county-level COVID-19 case-fatality and mortality rates in the United States. We used both single- and multi-pollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level health care capacity, phase of epidemic, population mobility, population density, sociodemographics, socioeconomic status, race and ethnicity, behavioral risk factors, and meteorology. Results From January 22, 2020, to July 17, 2020, 3,659,828 COVID-19 cases and 138,552 deaths were reported in 3,076 US counties, with an overall observed case-fatality rate of 3.8%. County-level average NO2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models. When adjusted for co-pollutants, per interquartile-range (IQR) increase in NO2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 11.3% (95% CI 4.9%–18.2%) and 16.2% (95% CI 8.7%–24.0%), respectively. We did not observe significant associations between COVID-19 case-fatality rate and long-term exposure to PM2.5 or O3, although per IQR increase in PM2.5 (2.6 μg/m3) was marginally associated, with a 14.9% (95% CI 0.0%–31.9%) increase in COVID-19 mortality rate when adjusted for co-pollutants. Discussion Long-term exposure to NO2, which largely arises from urban combustion sources such as traffic, may enhance susceptibility to severe COVID-19 outcomes, independent of long-term PM2.5 and O3 exposure. The results support targeted public health actions to protect residents from COVID-19 in heavily polluted regions with historically high NO2 levels. Continuation of current efforts to lower traffic emissions and ambient air pollution may be an important component of reducing population-level risk of COVID-19 case fatality and mortality. One of the first US studies on air pollution exposures and COVID-19 death outcomes Urban air pollutants, especially NO2, may enhance population susceptibility to death fromCOVID-19 Reduction in air pollution would have avoided over 14,000 COVID-19 deaths in the US as of July 17, 2020 Public health actions needed to protect populations from COVID-19 in areas with historically high NO2 exposure Expansion of efforts to lower air pollution may reduce population-level risk of COVID-19
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Affiliation(s)
- Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Jingxuan Zhao
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, USA
| | - Pengfei Liu
- School of Earth and Atmospheric Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jeremy A Sarnat
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Song Gao
- GeoDS Lab, Department of Geography, University of Wisconsin-Madison, Madison, WI, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Stefanie T Ebelt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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178
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The Impacts of the COVID-19 Lockdown on Air Quality in the Guanzhong Basin, China. REMOTE SENSING 2020. [DOI: 10.3390/rs12183042] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Corona Virus Disease 2019 (COVID-19) appeared in Wuhan, China, at the end of 2019, spreading from there across China and within weeks across the whole world. In order to control the rapid spread of the virus, the Chinese government implemented a national lockdown policy. It restricted human mobility and non-essential economic activities, which, as a side effect, resulted in the reduction of the emission of pollutants and thus the improvement of the air quality in many cities in China. In this paper, we report on a study on the changes in air quality in the Guanzhong Basin during the COVID-19 lockdown period. We compared the concentrations of PM2.5, PM10, SO2, NO2, CO and O3 obtained from ground-based monitoring stations before and after the COVID-19 outbreak. The analysis confirmed that the air quality in the Guanzhong Basin was significantly improved after the COVID-19 outbreak. During the emergency response period with the strictest restrictions (Level-1), the concentrations of PM2.5, PM10, SO2, NO2 and CO were lower by 37%, 30%, 29%, 52% and 33%, respectively, compared with those before the COVID-19 outbreak. In contrast, O3 concentrations increased substantially. The changes in the pollutant concentrations varied between cities during the period of the COVID-19 pandemic. The highest O3 concentration changes were observed in Xi’an, Weinan and Xianyang city; the SO2 concentration decreased substantially in Tongchuan city; the air quality had improved the most in Baoji City. Next, to complement the sparsely distributed air quality ground-based monitoring stations, the geographic and temporally weighted regression (GTWR) model, combined with satellite observations of the aerosol optical depth (AOD) and meteorological factors was used to estimate the spatial and temporal distributions of PM2.5 and PM10 concentrations with a resolution of 6 km × 6 km before and after the COVID-19 outbreak. The model was validated by a comparison with ground-based observations from the air quality monitoring network in five cities in the Guanzhong Basin with excellent statistical metrics. For PM2.5 and PM10 the correlation coefficients R2 were 0.86 and 0.80, the root mean squared errors (RMSE) were 11.03 µg/m3 and 14.87 µg/m3 and the biases were 0.19 µg/m3 and −0.27 µg/m3, which led to the conclusion that the GTWR model could be used to estimate the PM concentrations in locations where monitoring data were not available. Overall, the PM concentrations in the Guanzhong Basin decreased substantially during the lockdown period, with a strong initial decrease and a slower one thereafter, although the spatial distributions remained similar.
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179
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Riccò M, Ranzieri S, Balzarini F, Bragazzi NL, Corradi M. SARS-CoV-2 infection and air pollutants: Correlation or causation? THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 734:139489. [PMID: 32425256 PMCID: PMC7229444 DOI: 10.1016/j.scitotenv.2020.139489] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 04/13/2023]
Affiliation(s)
- Matteo Riccò
- AUSL - IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza negli ambienti di Lavoro (SPSAL), Via Amendola n.2, Reggio Emilia, RE, Italy.
| | - Silvia Ranzieri
- University of Parma, Department of Medicine and Surgery, Via Gramsci n.14, 43123 Parma, PR, Italy
| | - Federica Balzarini
- University "Vita e Salute", San Raffaele Hospital, Via Olgettina n. 58, 20132 Milan, MI, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Massimo Corradi
- University of Parma, Department of Medicine and Surgery, Via Gramsci n.14, 43123 Parma, PR, Italy
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180
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Villeneuve PJ, Goldberg MS. Methodological Considerations for Epidemiological Studies of Air Pollution and the SARS and COVID-19 Coronavirus Outbreaks. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:95001. [PMID: 32902328 PMCID: PMC7480171 DOI: 10.1289/ehp7411] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Studies have reported that ambient air pollution is associated with an increased risk of developing or dying from coronavirus-2 (COVID-19). Methodological approaches to investigate the health impacts of air pollution on epidemics should differ from those used for chronic diseases, but the methods used in these studies have not been appraised critically. OBJECTIVES Our study aimed to identify and critique the methodological approaches of studies of air pollution on infections and mortality due to COVID-19 and to identify and critique the methodological approaches of similar studies concerning severe acute respiratory syndrome (SARS). METHODS Published and unpublished papers of associations between air pollution and developing or dying from COVID-19 or SARS that were reported as of 10 May 2020 were identified through electronic databases, internet searches, and other sources. RESULTS All six COVID-19 studies and two of three SARS studies reported positive associations. Two were time series studies that estimated associations between daily changes in air pollution, one was a cohort that assessed associations between air pollution and the secondary spread of SARS, and six were ecological studies that used area-wide exposures and outcomes. Common shortcomings included possible cross-level bias in ecological studies, underreporting of health outcomes, using grouped data, the lack of highly spatially resolved air pollution measures, inadequate control for confounding and evaluation of effect modification, not accounting for regional variations in the timing of outbreaks' temporal changes in at-risk populations, and not accounting for nonindependence of outcomes. DISCUSSION Studies of air pollution and novel coronaviruses have relied mainly on ecological measures of exposures and outcomes and are susceptible to important sources of bias. Although longitudinal studies with individual-level data may be imperfect, they are needed to adequately address this topic. The complexities involved in these types of studies underscore the need for careful design and for peer review. https://doi.org/10.1289/EHP7411.
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Affiliation(s)
- Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Mark S Goldberg
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Hospital Centre, Montreal, Canada
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181
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Fattorini D, Regoli F. Role of the chronic air pollution levels in the Covid-19 outbreak risk in Italy. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 264:114732. [PMID: 32387671 PMCID: PMC7198142 DOI: 10.1016/j.envpol.2020.114732] [Citation(s) in RCA: 341] [Impact Index Per Article: 85.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 05/18/2023]
Abstract
After the initial outbreak in China, the diffusion in Italy of SARS-CoV-2 is exhibiting a clear regional trend with more elevated frequency and severity of cases in Northern areas. Among multiple factors possibly involved in such geographical differences, a role has been hypothesized for atmospheric pollution. We provide additional evidence on the possible influence of air quality, particularly in terms of chronicity of exposure on the spread viral infection in Italian regions. Actual data on Covid-19 outbreak in Italian provinces and corresponding long-term air quality evaluations, were obtained from Italian and European agencies, elaborated and tested for possible interactions. Our elaborations reveal that, beside concentrations, the chronicity of exposure may influence the anomalous variability of SARS-CoV-2 in Italy. Data on distribution of atmospheric pollutants (NO2, O3, PM2.5 and PM10) in Italian regions during the last 4 years, days exceeding regulatory limits, and years of the last decade (2010-2019) in which the limits have been exceeded for at least 35 days, highlight that Northern Italy has been constantly exposed to chronic air pollution. Long-term air-quality data significantly correlated with cases of Covid-19 in up to 71 Italian provinces (updated April 27, 2020) providing further evidence that chronic exposure to atmospheric contamination may represent a favourable context for the spread of the virus. Pro-inflammatory responses and high incidence of respiratory and cardiac affections are well known, while the capability of this coronavirus to bind particulate matters remains to be established. Atmospheric and environmental pollution should be considered as part of an integrated approach for sustainable development, human health protection and prevention of epidemic spreads but in a long-term and chronic perspective, since adoption of mitigation actions during a viral outbreak could be of limited utility.
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Affiliation(s)
- Daniele Fattorini
- Dipartimento di Scienze della Vita e dell'Ambiente (Disva), Università Politecnica delle Marche (Univpm), Via Brecce Bianche, 60100, Ancona, Italy
| | - Francesco Regoli
- Dipartimento di Scienze della Vita e dell'Ambiente (Disva), Università Politecnica delle Marche (Univpm), Via Brecce Bianche, 60100, Ancona, Italy.
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Chirico F, Sacco A, Bragazzi NL, Magnavita N. Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6052. [PMID: 32825303 PMCID: PMC7503634 DOI: 10.3390/ijerph17176052] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 12/23/2022]
Abstract
The airborne transmission of SARS-CoV-2 is still debated. The aim of this rapid review is to evaluate the COVID-19 risk associated with the presence of air-conditioning systems. Original studies (both observational and experimental researches) written in English and with no limit on time, on the airborne transmission of SARS-CoV, MERS-CoV, and SARS-CoV-2 coronaviruses that were associated with outbreaks, were included. Searches were made on PubMed/MEDLINE, PubMed Central (PMC), Google Scholar databases, and medRxiv. A snowball strategy was adopted to extend the search. Fourteen studies reporting outbreaks of coronavirus infection associated with the air-conditioning systems were included. All studies were carried out in the Far East. In six out the seven studies on SARS, the role of Heating, Ventilation, and Air Conditioning (HVAC) in the outbreak was indirectly proven by the spatial and temporal pattern of cases, or by airflow-dynamics models. In one report on MERS, the contamination of HVAC by viral particles was demonstrated. In four out of the six studies on SARS-CoV-2, the diffusion of viral particles through HVAC was suspected or supported by computer simulation. In conclusion, there is sufficient evidence of the airborne transmission of coronaviruses in previous Asian outbreaks, and this has been taken into account in the guidelines released by organizations and international agencies for controlling the spread of SARS-CoV-2 in indoor environments. However, the technological differences in HVAC systems prevent the generalization of the results on a worldwide basis. The few COVID-19 investigations available do not provide sufficient evidence that the SARS-CoV-2 virus can be transmitted by HVAC systems.
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Affiliation(s)
- Francesco Chirico
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
- Health Service Department, State Police, Ministry of Interior, 20125 Milan, Italy
| | - Angelo Sacco
- Local Healthcare Unit Roma 2, 00155 Roma, Italy;
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada;
| | - Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
- Department of Woman/Child & Public Health, Fondazione Policlinico A. Gemelli IRCCS, 00168 Roma, Italy
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183
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Alternative Methods of Sterilization in Dental Practices Against COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165736. [PMID: 32784414 PMCID: PMC7459510 DOI: 10.3390/ijerph17165736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 02/01/2023]
Abstract
SARS-CoV-2, and several other microorganisms, may be present in nasopharyngeal and salivary secretions in patients treated in dental practices, so an appropriate clinical behavior is required in order to avoid the dangerous spread of infections. COVID-19 could also be spread when patients touches a contaminated surface with infected droplets and then touch their nose, mouth, or eyes. It is time to consider a dental practice quite similar to a hospital surgery room, where particular attention should be addressed to problems related to the spreading of infections due to air and surface contamination. The effectiveness of conventional cleaning and disinfection procedures may be limited by several factors; first of all, human operator dependence seems to be the weak aspect of all procedures. The improvement of these conventional methods requires the modification of human behavior, which is difficult to achieve and sustain. As alternative sterilization methods, there are some that do not depend on the operator, because they are based on devices that perform the entire procedure on their own, with minimal human intervention. In conclusion, continued efforts to improve the traditional manual disinfection of surfaces are needed, so dentists should consider combining the use of proper disinfectants and no-touch decontamination technologies to improve sterilization procedures.
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184
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Smit AJ, Fitchett JM, Engelbrecht FA, Scholes RJ, Dzhivhuho G, Sweijd NA. Winter Is Coming: A Southern Hemisphere Perspective of the Environmental Drivers of SARS-CoV-2 and the Potential Seasonality of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5634. [PMID: 32764257 PMCID: PMC7459895 DOI: 10.3390/ijerph17165634] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 01/09/2023]
Abstract
SARS-CoV-2 virus infections in humans were first reported in December 2019, the boreal winter. The resulting COVID-19 pandemic was declared by the WHO in March 2020. By July 2020, COVID-19 was present in 213 countries and territories, with over 12 million confirmed cases and over half a million attributed deaths. Knowledge of other viral respiratory diseases suggests that the transmission of SARS-CoV-2 could be modulated by seasonally varying environmental factors such as temperature and humidity. Many studies on the environmental sensitivity of COVID-19 are appearing online, and some have been published in peer-reviewed journals. Initially, these studies raised the hypothesis that climatic conditions would subdue the viral transmission rate in places entering the boreal summer, and that southern hemisphere countries would experience enhanced disease spread. For the latter, the COVID-19 peak would coincide with the peak of the influenza season, increasing misdiagnosis and placing an additional burden on health systems. In this review, we assess the evidence that environmental drivers are a significant factor in the trajectory of the COVID-19 pandemic, globally and regionally. We critically assessed 42 peer-reviewed and 80 preprint publications that met qualifying criteria. Since the disease has been prevalent for only half a year in the northern, and one-quarter of a year in the southern hemisphere, datasets capturing a full seasonal cycle in one locality are not yet available. Analyses based on space-for-time substitutions, i.e., using data from climatically distinct locations as a surrogate for seasonal progression, have been inconclusive. The reported studies present a strong northern bias. Socio-economic conditions peculiar to the 'Global South' have been omitted as confounding variables, thereby weakening evidence of environmental signals. We explore why research to date has failed to show convincing evidence for environmental modulation of COVID-19, and discuss directions for future research. We conclude that the evidence thus far suggests a weak modulation effect, currently overwhelmed by the scale and rate of the spread of COVID-19. Seasonally modulated transmission, if it exists, will be more evident in 2021 and subsequent years.
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Affiliation(s)
- Albertus J. Smit
- Department of Biodiversity and Conservation Biology, University of the Western Cape, Cape Town 7535, South Africa
- Elwandle Coastal Node, South African Environmental Observation Network (SAEON), Port Elizabeth 6031, South Africa
| | - Jennifer M. Fitchett
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg 2050, South Africa;
| | - Francois A. Engelbrecht
- Global Change Institute, University of the Witwatersrand, Johannesburg 2050, South Africa; (F.A.E.); (R.J.S.)
| | - Robert J. Scholes
- Global Change Institute, University of the Witwatersrand, Johannesburg 2050, South Africa; (F.A.E.); (R.J.S.)
| | - Godfrey Dzhivhuho
- Department of Microbiology, Immunology and Cancer Biology, Myles H. Thaler Center for AIDS and Human Retrovirus Research, University of Virginia, Charlottesville, VA 22903, USA;
| | - Neville A. Sweijd
- Alliance for Collaboration on Climate and Earth Systems Science (ACCESS), Council for Scientific and Industrial Research (CSIR), Pretoria 0001, South Africa;
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185
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Coker ES, Cavalli L, Fabrizi E, Guastella G, Lippo E, Parisi ML, Pontarollo N, Rizzati M, Varacca A, Vergalli S. The Effects of Air Pollution on COVID-19 Related Mortality in Northern Italy. ENVIRONMENTAL & RESOURCE ECONOMICS 2020; 76:611-634. [PMID: 32836855 PMCID: PMC7399615 DOI: 10.1007/s10640-020-00486-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 05/19/2023]
Abstract
Long-term exposure to ambient air pollutant concentrations is known to cause chronic lung inflammation, a condition that may promote increased severity of COVID-19 syndrome caused by the novel coronavirus (SARS-CoV-2). In this paper, we empirically investigate the ecologic association between long-term concentrations of area-level fine particulate matter (PM2.5) and excess deaths in the first quarter of 2020 in municipalities of Northern Italy. The study accounts for potentially spatial confounding factors related to urbanization that may have influenced the spreading of SARS-CoV-2 and related COVID-19 mortality. Our epidemiological analysis uses geographical information (e.g., municipalities) and negative binomial regression to assess whether both ambient PM2.5 concentration and excess mortality have a similar spatial distribution. Our analysis suggests a positive association of ambient PM2.5 concentration on excess mortality in Northern Italy related to the COVID-19 epidemic. Our estimates suggest that a one-unit increase in PM2.5 concentration (µg/m3) is associated with a 9% (95% confidence interval: 6-12%) increase in COVID-19 related mortality.
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Affiliation(s)
- Eric S. Coker
- College of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | | | - Enrico Fabrizi
- Department of Economics and Social Sciences, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - Gianni Guastella
- Fondazione Eni Enrico Mattei, Milan, Italy
- Department of Mathematics and Physics, Università Cattolica del Sacro Cuore, Brescia, Italy
| | | | - Maria Laura Parisi
- Department of Economics and Management, Università degli Studi di Brescia, Brescia, Italy
| | - Nicola Pontarollo
- Department of Economics and Management, Università degli Studi di Brescia, Brescia, Italy
| | | | - Alessandro Varacca
- Department of Agricultural Economics, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - Sergio Vergalli
- Fondazione Eni Enrico Mattei, Milan, Italy
- Department of Economics and Management, Università degli Studi di Brescia, Brescia, Italy
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186
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Moccia F, Gerbino A, Lionetti V, Miragoli M, Munaron LM, Pagliaro P, Pasqua T, Penna C, Rocca C, Samaja M, Angelone T. COVID-19-associated cardiovascular morbidity in older adults: a position paper from the Italian Society of Cardiovascular Researches. GeroScience 2020; 42:1021-1049. [PMID: 32430627 PMCID: PMC7237344 DOI: 10.1007/s11357-020-00198-w] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/28/2020] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells following binding with the cell surface ACE2 receptors, thereby leading to coronavirus disease 2019 (COVID-19). SARS-CoV-2 causes viral pneumonia with additional extrapulmonary manifestations and major complications, including acute myocardial injury, arrhythmia, and shock mainly in elderly patients. Furthermore, patients with existing cardiovascular comorbidities, such as hypertension and coronary heart disease, have a worse clinical outcome following contraction of the viral illness. A striking feature of COVID-19 pandemics is the high incidence of fatalities in advanced aged patients: this might be due to the prevalence of frailty and cardiovascular disease increase with age due to endothelial dysfunction and loss of endogenous cardioprotective mechanisms. Although experimental evidence on this topic is still at its infancy, the aim of this position paper is to hypothesize and discuss more suggestive cellular and molecular mechanisms whereby SARS-CoV-2 may lead to detrimental consequences to the cardiovascular system. We will focus on aging, cytokine storm, NLRP3/inflammasome, hypoxemia, and air pollution, which is an emerging cardiovascular risk factor associated with rapid urbanization and globalization. We will finally discuss the impact of clinically available CV drugs on the clinical course of COVID-19 patients. Understanding the role played by SARS-CoV2 on the CV system is indeed mandatory to get further insights into COVID-19 pathogenesis and to design a therapeutic strategy of cardio-protection for frail patients.
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Affiliation(s)
- F Moccia
- Laboratory of General Physiology, Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - A Gerbino
- CNR-Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, Bari, Italy
| | - V Lionetti
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
- UOS Anesthesiology and Intensive Care Medicine, Fondazione Toscana G. Monasterio, Pisa, Italy.
| | - M Miragoli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - L M Munaron
- Department of Life Sciences and Systems Biology, University of Turin, Turin, Italy
| | - P Pagliaro
- Clinical and Biological Sciences Department, University of Turin, Orbassano, Turin, Italy.
| | - T Pasqua
- Laboratory of Cellular and Molecular Cardiovascular Patho-physiology, Department of Biology, E. and E.S., University of Calabria, Arcavacata di Rende, CS, Italy
| | - C Penna
- Clinical and Biological Sciences Department, University of Turin, Orbassano, Turin, Italy
| | - C Rocca
- Laboratory of Cellular and Molecular Cardiovascular Patho-physiology, Department of Biology, E. and E.S., University of Calabria, Arcavacata di Rende, CS, Italy
| | - M Samaja
- Department of Health Science, University of Milano, Milan, Italy
| | - T Angelone
- Laboratory of Cellular and Molecular Cardiovascular Patho-physiology, Department of Biology, E. and E.S., University of Calabria, Arcavacata di Rende, CS, Italy
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187
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Domingo JL, Rovira J. Effects of air pollutants on the transmission and severity of respiratory viral infections. ENVIRONMENTAL RESEARCH 2020; 187:109650. [PMID: 32416357 PMCID: PMC7211639 DOI: 10.1016/j.envres.2020.109650] [Citation(s) in RCA: 178] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 05/13/2023]
Abstract
Particulate matter, sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) are among the outdoor air pollutants that are major factors in diseases, causing especially adverse respiratory effects in humans. On the other hand, the role of respiratory viruses in the pathogenesis of severe respiratory infections is an issue of great importance. The present literature review was aimed at assessing the potential effects of air pollutants on the transmission and severity of respiratory viral infections. We have reviewed the scientific literature regarding the association of outdoor air pollution and respiratory viruses on respiratory diseases. Evidence supports a clear association between air concentrations of some pollutants and human respiratory viruses interacting to adversely affect the respiratory system. Given the undoubted importance and topicality of the subject, we have paid special attention to the association between air pollutants and the transmission and severity of the effects caused by the coronavirus named SARS-CoV-2, which causes the COVID-19. Although to date, and by obvious reasons, the number of studies on this issue are still scarce, most results indicate that chronic exposure to air pollutants delays/complicates recovery of patients of COVID-19 and leads to more severe and lethal forms of this disease. This deserves immediate and in-depth experimental investigations.
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Affiliation(s)
- José L Domingo
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain.
| | - Joaquim Rovira
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain; Departament d'Enginyeria Química, Universitat Rovira i Virgili, Avd. Països Catalans 26, 43007, Tarragona, Catalonia, Spain
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188
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Frontera A, Martin C, Vlachos K, Sgubin G. Regional air pollution persistence links to COVID-19 infection zoning. J Infect 2020; 81:318-356. [PMID: 32283151 PMCID: PMC7151372 DOI: 10.1016/j.jinf.2020.03.045] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Antonio Frontera
- IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy
| | - Claire Martin
- Royal Papworth Hospital NHS Foundation Trust, Papworth Rd, Trumpington, Cambridge CB2 0AY, UK
| | - Kostantinos Vlachos
- Hôpital Haut Leveque, 1 avenue Magellan, Bordeaux, France; LIRYC institute, Pessac 33600, France
| | - Giovanni Sgubin
- Department of Climatology, Environnements et Paléoenvironnements Océaniques et Continentaux, University of Bordeaux, Bordeaux, France
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189
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Zhu Y, Xie J, Huang F, Cao L. Association between short-term exposure to air pollution and COVID-19 infection: Evidence from China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 727:138704. [PMID: 32315904 PMCID: PMC7159846 DOI: 10.1016/j.scitotenv.2020.138704] [Citation(s) in RCA: 612] [Impact Index Per Article: 153.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 04/13/2023]
Abstract
The novel coronavirus pneumonia, namely COVID-19, has become a global public health problem. Previous studies have found that air pollution is a risk factor for respiratory infection by carrying microorganisms and affecting body's immunity. This study aimed to explore the relationship between ambient air pollutants and the infection caused by the novel coronavirus. Daily confirmed cases, air pollution concentration and meteorological variables in 120 cities were obtained from January 23, 2020 to February 29, 2020 in China. We applied a generalized additive model to investigate the associations of six air pollutants (PM2.5, PM10, SO2, CO, NO2 and O3) with COVID-19 confirmed cases. We observed significantly positive associations of PM2.5, PM10, NO2 and O3 in the last two weeks with newly COVID-19 confirmed cases. A 10-μg/m3 increase (lag0-14) in PM2.5, PM10, NO2, and O3 was associated with a 2.24% (95% CI: 1.02 to 3.46), 1.76% (95% CI: 0.89 to 2.63), 6.94% (95% CI: 2.38 to 11.51), and 4.76% (95% CI: 1.99 to 7.52) increase in the daily counts of confirmed cases, respectively. However, a 10-μg/m3 increase (lag0-14) in SO2 was associated with a 7.79% decrease (95% CI: -14.57 to -1.01) in COVID-19 confirmed cases. Our results indicate that there is a significant relationship between air pollution and COVID-19 infection, which could partially explain the effect of national lockdown and provide implications for the control and prevention of this novel disease.
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Affiliation(s)
- Yongjian Zhu
- School of Management, University of Science and Technology of China, Hefei, China.
| | - Jingui Xie
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Brunel Business School, Brunel University London, Uxbridge, United Kingdom.
| | - Fengming Huang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
| | - Liqing Cao
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
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190
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Thakur M, Boudewijns EA, Babu GR, van Schayck OCP. Biomass use and COVID-19: A novel concern. ENVIRONMENTAL RESEARCH 2020; 186:109586. [PMID: 32353790 PMCID: PMC7195058 DOI: 10.1016/j.envres.2020.109586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 05/18/2023]
Abstract
Evidence supports the link between air pollution and COVID-19 and thus it is likely that exposure to biomass smoke is associated with COVID-19. The poor, including refugees and migrant workers staying in fragile conditions, are most vulnerable. An outbreak of COVID-19 in a place where the concept of physical distancing is next to impossible could easily overwhelm the public health system. It is thus essential to understand the consequences of being exposed to smoke in relation to COVID-19 infection.
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Affiliation(s)
- Megha Thakur
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Esther A Boudewijns
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Giridhara R Babu
- Public Health Foundation of India, Indian Institute of Public Health-Hyderabad, Bangalore Campus, Bangalore, 560023, India
| | - Onno C P van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
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191
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Comunian S, Dongo D, Milani C, Palestini P. Air Pollution and Covid-19: The Role of Particulate Matter in the Spread and Increase of Covid-19's Morbidity and Mortality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4487. [PMID: 32580440 PMCID: PMC7345938 DOI: 10.3390/ijerph17124487] [Citation(s) in RCA: 241] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023]
Abstract
Sars-cov-2 virus (Covid-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. Covid-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the Covid-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of Covid-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation.
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Affiliation(s)
- Silvia Comunian
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20126 Milan, Italy;
| | | | - Chiara Milani
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, 20900 Monza, Italy
| | - Paola Palestini
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, 20900 Monza, Italy
- POLARIS Research Centre, University of Milano-Bicocca, 20900 Monza, Italy
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192
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Henderson SB. The COVID-19 Pandemic and Wildfire Smoke: Potentially Concomitant Disasters. Am J Public Health 2020; 110:1140-1142. [PMID: 32552018 DOI: 10.2105/ajph.2020.305744] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sarah B Henderson
- Sarah B. Henderson is with Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, and the School of Population and Public Health, University of British Columbia, Vancouver
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193
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Pequeno P, Mendel B, Rosa C, Bosholn M, Souza JL, Baccaro F, Barbosa R, Magnusson W. Air transportation, population density and temperature predict the spread of COVID-19 in Brazil. PeerJ 2020; 8:e9322. [PMID: 32547889 PMCID: PMC7275681 DOI: 10.7717/peerj.9322] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/18/2020] [Indexed: 12/26/2022] Open
Abstract
There is evidence that COVID-19, the disease caused by the betacoronavirus SARS-CoV-2, is sensitive to environmental conditions. However, such conditions often correlate with demographic and socioeconomic factors at larger spatial extents, which could confound this inference. We evaluated the effect of meteorological conditions (temperature, solar radiation, air humidity and precipitation) on 292 daily records of cumulative number of confirmed COVID-19 cases across the 27 Brazilian capital cities during the 1st month of the outbreak, while controlling for an indicator of the number of tests, the number of arriving flights, population density, proportion of elderly people and average income. Apart from increasing with time, the number of confirmed cases was mainly related to the number of arriving flights and population density, increasing with both factors. However, after accounting for these effects, the disease was shown to be temperature sensitive: there were more cases in colder cities and days, and cases accumulated faster at lower temperatures. Our best estimate indicates that a 1 °C increase in temperature has been associated with a decrease in confirmed cases of 8%. The quality of the data and unknowns limit the analysis, but the study reveals an urgent need to understand more about the environmental sensitivity of the disease to predict demands on health services in different regions and seasons.
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Affiliation(s)
- Pedro Pequeno
- Instituto Nacional de Pesquisas da Amazônia, Boa Vista, Brazil
| | - Bruna Mendel
- Universidade Federal de Roraima, Boa Vista, Brazil
| | - Clarissa Rosa
- Instituto Nacional de Pesquisas da Amazônia, Manaus, Brazil
| | - Mariane Bosholn
- Instituto Nacional de Pesquisas da Amazônia, Boa Vista, Brazil
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194
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De Natale G, Ricciardi V, De Luca G, De Natale D, Di Meglio G, Ferragamo A, Marchitelli V, Piccolo A, Scala A, Somma R, Spina E, Troise C. The COVID-19 Infection in Italy: A Statistical Study of an Abnormally Severe Disease. J Clin Med 2020; 9:E1564. [PMID: 32455807 PMCID: PMC7291160 DOI: 10.3390/jcm9051564] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/05/2020] [Accepted: 05/19/2020] [Indexed: 01/04/2023] Open
Abstract
We statistically investigate the Coronavirus Disease 19 (COVID-19) pandemic, which became particularly invasive in Italy in March 2020. We show that the high apparent lethality or case fatality ratio (CFR) observed in Italy, as compared with other countries, is likely biased by a strong underestimation of the number of infection cases. To give a more realistic estimate of the lethality of COVID-19, we use the actual (March 2020) estimates of the infection fatality ratio (IFR) of the pandemic based on the minimum observed CFR and analyze data obtained from the Diamond Princess cruise ship, a good representation of a "laboratory" case-study from an isolated system in which all the people have been tested. From such analyses, we derive more realistic estimates of the real extent of the infection as well as more accurate indicators of how fast the infection propagates. We then isolate the dominant factors causing the abnormal severity of the disease in Italy. Finally, we use the death count-the only data estimated to be reliable enough-to predict the total number of people infected and the interval of time when the infection in Italy could end.
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Affiliation(s)
- Giuseppe De Natale
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy; (R.S.); (C.T.)
- CNR-INO, 80078 Pozzuoli, Italy
| | - Valerio Ricciardi
- Dipartimento di Medicina Sperimentale, Università della Campania ‘L.Vanvitelli’, 80138 Naples, Italy;
- Istituto Nazionale di Fisica Nucleare—Sezione di Napoli, 80126 Naples, Italy
| | - Gabriele De Luca
- Department of Physics, University of Zurich, 8057 Zurich, Switzerland;
| | - Dario De Natale
- CoronaVerus, 80136 Naples, Italy; (D.D.N.); (G.D.M.); (A.F.); (A.P.)
| | | | - Antonio Ferragamo
- CoronaVerus, 80136 Naples, Italy; (D.D.N.); (G.D.M.); (A.F.); (A.P.)
| | - Vito Marchitelli
- Department of Mobility, Public Works, Ecology, Env, Puglia Region Government, 70100 Bari, Italy;
| | - Andrea Piccolo
- CoronaVerus, 80136 Naples, Italy; (D.D.N.); (G.D.M.); (A.F.); (A.P.)
| | - Antonio Scala
- Department of Physics ”Ettore Pancini”, Università degli Studi di Napoli “Federico II”, 80126 Naples, Italy;
| | - Renato Somma
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy; (R.S.); (C.T.)
- CNR-IRISS, 80134 Naples, Italy
| | - Emanuele Spina
- Department of Neurosciences, Reproductive and Odontostomatology, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy;
| | - Claudia Troise
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy; (R.S.); (C.T.)
- CNR-INO, 80078 Pozzuoli, Italy
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195
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De Natale G, Ricciardi V, De Luca G, De Natale D, Di Meglio G, Ferragamo A, Marchitelli V, Piccolo A, Scala A, Somma R, Spina E, Troise C. The COVID-19 Infection in Italy: A Statistical Study of an Abnormally Severe Disease. J Clin Med 2020; 9:jcm9051564. [PMID: 32455807 DOI: 10.20944/preprints202004.0049.v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/05/2020] [Accepted: 05/19/2020] [Indexed: 05/28/2023] Open
Abstract
We statistically investigate the Coronavirus Disease 19 (COVID-19) pandemic, which became particularly invasive in Italy in March 2020. We show that the high apparent lethality or case fatality ratio (CFR) observed in Italy, as compared with other countries, is likely biased by a strong underestimation of the number of infection cases. To give a more realistic estimate of the lethality of COVID-19, we use the actual (March 2020) estimates of the infection fatality ratio (IFR) of the pandemic based on the minimum observed CFR and analyze data obtained from the Diamond Princess cruise ship, a good representation of a "laboratory" case-study from an isolated system in which all the people have been tested. From such analyses, we derive more realistic estimates of the real extent of the infection as well as more accurate indicators of how fast the infection propagates. We then isolate the dominant factors causing the abnormal severity of the disease in Italy. Finally, we use the death count-the only data estimated to be reliable enough-to predict the total number of people infected and the interval of time when the infection in Italy could end.
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Affiliation(s)
- Giuseppe De Natale
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy
- CNR-INO, 80078 Pozzuoli, Italy
| | - Valerio Ricciardi
- Dipartimento di Medicina Sperimentale, Università della Campania 'L.Vanvitelli', 80138 Naples, Italy
- Istituto Nazionale di Fisica Nucleare-Sezione di Napoli, 80126 Naples, Italy
| | - Gabriele De Luca
- Department of Physics, University of Zurich, 8057 Zurich, Switzerland
| | | | | | | | - Vito Marchitelli
- Department Mobility, Pub. Works, Ecology, Env, Puglia Region Government, 70100 Bari, Italy
| | | | - Antonio Scala
- Department of Physics "Ettore Pancini", Università degli Studi di Napoli "Federico II", 80126 Naples, Italy
| | - Renato Somma
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy
- CNR-IRISS, 80134 Naples, Italy
| | - Emanuele Spina
- Department of Neurosciences, Reproductive and Odontostomatology, Università degli Studi di Napoli "Federico II", 80131 Naples, Italy
| | - Claudia Troise
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy
- CNR-INO, 80078 Pozzuoli, Italy
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196
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Ou JY, Hanson HA, Ramsay JM, Kaddas HK, Pope CA, Leiser CL, VanDerslice J, Kirchhoff AC. Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients. Cancer Epidemiol Biomarkers Prev 2020; 29:1929-1939. [PMID: 32404444 DOI: 10.1158/1055-9965.epi-19-1363] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/28/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM2.5) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM2.5. METHODS We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM2.5 by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM2.5 and mortality. Among AYAs, we examined effect modification of PM2.5 and mortality by stage while controlling for cancer type. RESULTS Increases in PM2.5 per 5 μg/m3 were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR5-year = 1.32 (1.02-1.71)]. Among AYAs, PM2.5 per 5 μg/m3 was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR5-year = 1.06 (1.01-1.13)]. PM2.5 ≥12 μg/m3 was associated with cancer mortality among breast [HR5-year = 1.50 (1.29-1.74); HR10-year = 1.30 (1.13-1.50)] and colorectal cancers [HR5-year = 1.74 (1.29-2.35); HR10-year = 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk. CONCLUSIONS PM2.5 was associated with mortality in pediatric and AYA patients with specific cancers. IMPACT Limiting PM2.5 exposure may be important for young cancer patients with certain cancers.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
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Affiliation(s)
- Judy Y Ou
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah.
| | - Heidi A Hanson
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Joemy M Ramsay
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | - Heydon K Kaddas
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | | | - Claire L Leiser
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - James VanDerslice
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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197
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Ghio AJ, Soukup JM, Dailey LA, Madden MC. Air pollutants disrupt iron homeostasis to impact oxidant generation, biological effects, and tissue injury. Free Radic Biol Med 2020; 151:38-55. [PMID: 32092410 PMCID: PMC8274387 DOI: 10.1016/j.freeradbiomed.2020.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/27/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
Abstract
Air pollutants cause changes in iron homeostasis through: 1) a capacity of the pollutant, or a metabolite(s), to complex/chelate iron from pivotal sites in the cell or 2) an ability of the pollutant to displace iron from pivotal sites in the cell. Through either pathway of disruption in iron homeostasis, metal previously employed in essential cell processes is sequestered after air pollutant exposure. An absolute or functional cell iron deficiency results. If enough iron is lost or is otherwise not available within the cell, cell death ensues. However, prior to death, exposed cells will attempt to reverse the loss of requisite metal. This response of the cell includes increased expression of metal importers (e.g. divalent metal transporter 1). Oxidant generation after exposure to air pollutants includes superoxide production which functions in ferrireduction necessary for cell iron import. Activation of kinases and phosphatases and transcription factors and increased release of pro-inflammatory mediators also result from a cell iron deficiency, absolute or functional, after exposure to air pollutants. Finally, air pollutant exposure culminates in the development of inflammation and fibrosis which is a tissue response to the iron deficiency challenging cell survival. Following the response of increased expression of importers and ferrireduction, activation of kinases and phosphatases and transcription factors, release of pro-inflammatory mediators, and inflammation and fibrosis, cell iron is altered, and a new metal homeostasis is established. This new metal homeostasis includes increased total iron concentrations in cells with metal now at levels sufficient to meet requirements for continued function.
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Affiliation(s)
- Andrew J Ghio
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA.
| | - Joleen M Soukup
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA
| | - Lisa A Dailey
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA
| | - Michael C Madden
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA
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198
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Setti L, Passarini F, De Gennaro G, Barbieri P, Pallavicini A, Ruscio M, Piscitelli P, Colao A, Miani A. Searching for SARS-COV-2 on Particulate Matter: A Possible Early Indicator of COVID-19 Epidemic Recurrence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2986. [PMID: 32344853 PMCID: PMC7246840 DOI: 10.3390/ijerph17092986] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022]
Abstract
A number of nations were forced to declare a total shutdown due to COVID-19 infection, as extreme measure to cope with dramatic impact of the pandemic, with remarkable consequences both in terms of negative health outcomes and economic loses. However, in many countries a "Phase-2" is approaching and many activities will re-open soon, although with some differences depending on the severity of the outbreak experienced and SARS-COV-2 estimated diffusion in the general population. At the present, possible relapses of the epidemic cannot be excluded until effective vaccines or immunoprophylaxis with human recombinant antibodies will be properly set up and commercialized. COVD-19-related quarantines have triggered serious social challenges, so that decision makers are concerned about the risk of wasting all the sacrifices imposed to the people in these months of quarantine. The availability of possible early predictive indicators of future epidemic relapses would be very useful for public health purposes, and could potentially prevent the suspension of entire national economic systems. On 16 March, a Position Paper launched by the Italian Society of Environmental Medicine (SIMA) hypothesized for the first time a possible link between the dramatic impact of COVID-19 outbreak in Northern Italy and the high concentrations of particulate matter (PM10 and PM2.5) that characterize this area, along with its well-known specific climatic conditions. Thereafter, a survey carried out in the U.S. by the Harvard School of Public Health suggested a strong association between increases in particulate matter concentration and mortality rates due to COVID-19. The presence of SARS-COV-2 RNA on the particulate matter of Bergamo, which is not far from Milan and represents the epicenter of the Italian epidemic, seems to confirm (at least in case of atmospheric stability and high PM concentrations, as it usually occurs in Northern Italy) that the virus can create clusters with the particles and be carried and detected on PM10. Although no assumptions can be made concerning the link between this first experimental finding and COVID-19 outbreak progression or severity, the presence of SARS-COV-2 RNA on PM10 of outdoor air samples in any city of the world could represent a potential early indicator of COVID-19 diffusion. Searching for the viral genome on particulate matter could therefore be explored among the possible strategies for adopting all the necessary preventive measures before future epidemics start.
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Affiliation(s)
- Leonardo Setti
- Department of Industrial Chemistry, University of Bologna, 40136 Bologna, Italy;
| | - Fabrizio Passarini
- Interdepartmental Centre for Industrial Research “Renewable Sources, Environment, Blue Growth, Energy”, University of Bologna, 47921 Rimini, Italy;
| | | | - Pierluigi Barbieri
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, 34127 Trieste, Italy;
| | | | - Maurizio Ruscio
- Division of Laboratory Medicine, University Hospital Giuliano Isontina (ASU GI), 34127 Trieste, Italy;
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine (SIMA), 20149 Milan, Italy;
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy;
| | - Annamaria Colao
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy;
| | - Alessandro Miani
- Italian Society of Environmental Medicine (SIMA), 20149 Milan, Italy;
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy;
- Department of Environmental Sciences and Policy, University of Milan, Via Celoria 2, 20133 Milan, Italy
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Martelletti L, Martelletti P. Air Pollution and the Novel Covid-19 Disease: a Putative Disease Risk Factor. ACTA ACUST UNITED AC 2020; 2:383-387. [PMID: 32296757 PMCID: PMC7156797 DOI: 10.1007/s42399-020-00274-4] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Luigi Martelletti
- 1MSc in Energy and Environmental Technology and Economics, City University of London, 6 Tibberton Square, London, N1 8SF UK
| | - Paolo Martelletti
- 2Emergency Medicine CoViD-19 Unit, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
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Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 32511651 DOI: 10.1101/2020.04.05.20054502] [Citation(s) in RCA: 389] [Impact Index Per Article: 97.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES United States government scientists estimate that COVID-19 may kill tens of thousands of Americans. Many of the pre-existing conditions that increase the risk of death in those with COVID-19 are the same diseases that are affected by long-term exposure to air pollution. We investigated whether long-term average exposure to fine particulate matter (PM 2.5 ) is associated with an increased risk of COVID-19 death in the United States. DESIGN A nationwide, cross-sectional study using county-level data. DATA SOURCES COVID-19 death counts were collected for more than 3,000 counties in the United States (representing 98% of the population) up to April 22, 2020 from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. MAIN OUTCOME MEASURES We fit negative binomial mixed models using county-level COVID-19 deaths as the outcome and county-level long-term average of PM 2.5 as the exposure. In the main analysis, we adjusted by 20 potential confounding factors including population size, age distribution, population density, time since the beginning of the outbreak, time since state issuance of the stay-at-home order, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables such as obesity and smoking. We included a random intercept by state to account for potential correlation in counties within the same state. We conducted more than 68 additional sensitivity analyses. RESULTS We found that an increase of only 1 μg/m 3 in PM 2.5 is associated with an 8% increase in the COVID-19 death rate (95% confidence interval [CI]: 2%, 15%). The results were statistically significant and robust to secondary and sensitivity analyses. CONCLUSIONS A small increase in long-term exposure to PM 2.5 leads to a large increase in the COVID-19 death rate. Despite the inherent limitations of the ecological study design, our results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. The data and code are publicly available so our analyses can be updated routinely.
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