Non-negligible contributions to human health from increased household air pollution exposure during the COVID-19 lockdown in China

Indoor PM from residential coal combustion: Levels, chemical composition, and toxicity

Indoor air quality is crucial for human health due to the significant time people spend at home, and it is mainly affected by internal sources such as solid fuel combustion for heating. This study investigated the indoor air quality and health implications associated with residential coal burning covering gaseous pollutants (CO, CO2 and total volatile organic compounds), particulate matter, and toxicity. The PM10 chemical composition was obtained by ICP-MS/OES (elements), ion chromatography (water-soluble ions) and thermal-optical analysis (organic and elemental carbon). During coal combustion, PM10 levels were higher (up to 8.8 times) than background levels and the indoor-to-outdoor ratios were, on average, greater than unity, confirming the existence of a significant indoor source. The chemical characterisation of PM10 revealed increased concentrations of organic carbon and elemental carbon during coal combustion as well as arsenic, cadmium and lead. Carcinogenic risks associated with exposure to arsenic exceeded safety thresholds. Indoor air quality fluctuated during the study, with varying toxicity levels assessed using the Aliivibrio fischeri bioluminescence inhibition assay. These findings underscore the importance of mitigating indoor air pollution associated with coal burning and highlight the potential health risks from long-term exposure. Effective interventions are needed to improve indoor air quality and reduce health risks in coal-burning households.

Response of organic aerosol in Beijing to emission reductions during the XXIV Olympic Winter Games

Organic aerosol (OA) serves as a crucial component of fine particulate matter. However, the response of OA to changes in anthropogenic emissions remains unclear due to its complexity. The XXIV Olympic Winter Games (OWG) provided real atmospheric experimental conditions on studying the response of OA to substantial emission reductions in winter. Here, we explored the sources and variations of OA based on the observation of aerosol mass spectrometer (AMS) combined with positive matrix factorization (PMF) analysis in urban Beijing during the 2022 Olympic Winter Games. The influences of meteorological conditions on OA concentrations were corrected by CO and verified by deweathered model. The CO-normalized primary OA (POA) concentrations from traffic, cooking, coal and biomass burning during the OWG decreased by 39.8 %, 23.2 % and 65.0 %, respectively. Measures controlling coal and biomass burning were most effective in reducing POA during the OWG. For the CO-normalized concentration of secondary OA (SOA), aqueous-phase related oxygenated OA decreased by 51.8 % due to the lower relative humidity and emission reduction in precursors, while the less oxidized‑oxygenated OA even slightly increased as the enhanced atmospheric oxidation processes may partially offset the efficacy of emission control. Therefore, more targeted reduction of organic precursors shall be enhanced to lower atmospheric oxidation capacity and mitigate SOA pollution.

Indoor exposure to ultrafine particles related to domestic activities: A systematic review and meta-analysis

Ultrafine particles (< 100 nm) are of increasing concern because of their toxicological potential. Emission processes suggest their presence in all environments, including at home, where particularly at-risk populations may be exposed. However, knowledge of their impact on health is still limited, due to difficulties in properly assessing exposure in epidemiological studies. In this context, the objective of this study was to provide a complete summary of indoor exposure to ultrafine particles in highly industrialised countries by examining the domestic activities that influence such exposure. We conducted a systematic review, according to PRISMA guidelines using PubMed, Web of Science and Scopus up to and including 2021. We carried out a qualitative and quantitative analysis of the selected studies with a standardised template. Exposure circumstances, measurement methods, and results were analysed. Finally, a meta-analysis of the measured concentrations was performed to study exposure levels during domestic activities. The review included 69 studies resulting in the analysis of 346 exposure situations. Nine main groups of activities were identified: cooking, which was the most studied, smoking, the use of air-fresheners, cleaning, heating, personal care, printing, do-it-yourself activities, and others. Over 50 different processes were involved in these activities. Based on available particle number concentrations, the highest average of mean concentrations was associated with grilling (14,400 × 103 cm-3), and the lowest with wood stove (18 × 103 cm-3). The highest average of peak concentrations was that for the use of hair dryers (695 × 103 cm-3), and the lowest for the use of air cleaners (11 × 103 cm-3). A hierarchy of domestic activities and related processes leading to ultrafine particle exposure is provided, along with average exposure concentrations at home. However, more extensive measurement campaigns are needed under real-life conditions to improve assessments of indoor exposure to ultrafine particles.

Is the economic uncertainty- human health relationship nonlinear? An empirical analysis for the China

The health costs of economic uncertainty always remain a major concern among policymakers of China. The theoretical and empirical literature on the economic uncertainty-human health nexus is still in its infancy stage. This study is firmly rooted in the economic uncertainty theory advanced by Baker, Bloom, & Davis. In this study, the primary objective of the analysis is to estimate the asymmetric impact of economic uncertainty on human health in China's economy. In order to evaluate the short and long-run estimates of economic uncertainty on human health across various quantiles, we have employed the linear and nonlinear QARDL models. The linear QARDL model shows that the long-run relationship between economic uncertainty and the infant mortality rate is positive and significant at all quantiles, while the long-run relationship between economic uncertainty and the death rate is positive and significant at higher quantiles. The nonlinear QARDL model reveals that, in the long run, the relationship between the positive shock of economic uncertainty and the infant mortality rate is positive and significant at quantiles 0.30 to 0.95, while the long-run relationship between the positive shock of economic uncertainty and the death rate is positive and significant at higher quantiles. The relationship between the negative shock of economic uncertainty and the infant mortality rate is negative and significant at the highest quantiles, while the relationship between the negative shock of economic uncertainty and death rate is negative and significant at higher quantiles in the long run. The findings indicate a positive relationship between economic uncertainty in China and higher rates of infant mortality and death. Thus, adopting suitable policies for controlling economic uncertainty can help in improving human health in China.

A comprehensive review of microbial contamination in the indoor environment: sources, sampling, health risks, and mitigation strategies

The quality of the indoor environment significantly impacts human health and productivity, especially given the amount of time individuals spend indoors globally. While chemical pollutants have been a focus of indoor air quality research, microbial contaminants also have a significant bearing on indoor air quality. This review provides a comprehensive overview of microbial contamination in built environments, covering sources, sampling strategies, and analysis methods. Microbial contamination has various origins, including human occupants, pets, and the outdoor environment. Sampling strategies for indoor microbial contamination include air, surface, and dust sampling, and various analysis methods are used to assess microbial diversity and complexity in indoor environments. The review also discusses the health risks associated with microbial contaminants, including bacteria, fungi, and viruses, and their products in indoor air, highlighting the need for evidence-based studies that can relate to specific health conditions. The importance of indoor air quality is emphasized from the perspective of the COVID-19 pandemic. A section of the review highlights the knowledge gap related to microbiological burden in indoor environments in developing countries, using India as a representative example. Finally, potential mitigation strategies to improve microbiological indoor air quality are briefly reviewed.

Attribution of Air Quality Benefits to Clean Winter Heating Policies in China: Combining Machine Learning with Causal Inference

Heating is a major source of air pollution. To improve air quality, a range of clean heating policies were implemented in China over the past decade. Here, we evaluated the impacts of winter heating and clean heating policies on air quality in China using a novel, observation-based causal inference approach. During 2015-2021, winter heating causally increased annual PM2.5, daily maximum 8-h average O3, and SO2 by 4.6, 2.5, and 2.3 μg m-3, respectively. From 2015 to 2021, the impacts of winter heating on PM2.5 in Beijing and surrounding cities (i.e., "2 + 26" cities) decreased by 5.9 μg m-3 (41.3%), whereas that in other northern cities only decreased by 1.2 μg m-3 (12.9%). This demonstrates the effectiveness of stricter clean heating policies on PM2.5 in "2 + 26" cities. Overall, clean heating policies caused the annual PM2.5 in mainland China to reduce by 1.9 μg m-3 from 2015 to 2021, potentially avoiding 23,556 premature deaths in 2021.

Drivers of High Concentrations of Secondary Organic Aerosols in Northern China during the COVID-19 Lockdowns

During the COVID-19 lockdown in early 2020, observations in Beijing indicate that secondary organic aerosol (SOA) concentrations increased despite substantial emission reduction, but the reasons are not fully explained. Here, we integrate the two-dimensional volatility basis set into a state-of-the-art chemical transport model, which unprecedentedly reproduces organic aerosol (OA) components resolved by the positive matrix factorization based on aerosol mass spectrometer observations. The model shows that, for Beijing, the emission reduction during the lockdown lowered primary organic aerosol (POA)/SOA concentrations by 50%/18%, while deteriorated meteorological conditions increased them by 30%/119%, resulting in a net decrease in the POA concentration and a net increase in the SOA concentration. Emission reduction and meteorological changes both led to an increased OH concentration, which accounts for their distinct effects on POA and SOA. SOA from anthropogenic volatile organic compounds and organics with lower volatility contributed 28 and 62%, respectively, to the net SOA increase. Different from Beijing, the SOA concentration decreased in southern Hebei during the lockdown because of more favorable meteorology. Our findings confirm the effectiveness of organic emission reductions and meanwhile reveal the challenge in controlling SOA pollution that calls for large organic precursor emission reductions to rival the adverse impact of OH increase.

Air quality change and public perception during the COVID-19 lockdown in India

This study aims at analyzing the change in air quality following the COVID-19 lockdown in India and its perception by the general public. Air quality data for 100 days recorded at 193 stations throughout India were analyzed between 25th March to 17th May 2020. A nationwide online survey was conducted to obtain public perceptions of air quality improvement (n = 1750). On average, approximately 40% improvement in the air quality index was observed, contributed by a reduction in 40% of PM₁₀, 44% of PM_2.5, 51% of NO₂ and 21% of SO₂. There was a significant difference between the levels of all the pollutants before and after the lockdown (p < 0.05), except ozone. The correlation between PM₁₀ and PM_2.5 with ozone was significant after the lockdown period, indicating that a significant portion of the particulates present in the atmosphere after the lockdown period is secondary. The values of PM_2.5/PM₁₀ were found to be >0.5 in North East states and this observation points to the long-distance transport of PM_2.5 from other places. The survey for public perception showed that 60% of the respondents perceived improvement in air quality. Household emissions were perceived to be a significant source of pollution after the lockdown. An odds ratio (OR) of 17 (95%, CI: 6.42, 47.04) indicated a very high dependence of perception on actual air quality. OR between air quality and health improvement was 5.2 (95%, CI: 2.69, 10.01), indicating significant health improvement due to air quality improvement. Google Trends analysis showed that media did not influence shaping the perception. There was a significant improvement in the actual and perceived air quality in India after the COVID-19-induced lockdown. PM₁₀ levels had the most decisive influence in shaping public perception.

Biomass fuel usage for cooking and frailty among older adults in China: a population-based cohort study

Background

Although outdoor air pollution is reported to have a negative effect on frailty, evidence involving household air pollution is sparse.

Methods

A cohort study on older participants aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey was conducted between 2011/2012 and 2014. Household cooking fuel types were determined by self-reported questionaries, and were dichotomized into clean or biomass fuels. The frailty status was evaluated via a 46-item frailty index (FI) and the FRAIL scale, respectively. Frailty was identified if FI >0.21 or FRAIL score ≥3. Cox proportional hazards models were employed to examine the relationship between cooking fuels and incident frailty. And the effects of swapping cooking fuels on frailty risk were also explored.

Results

Among 4,643 participants (mean age at baseline 80.9 ± 9.6 years, 53.7% male) totaling 11,340 person-years, 923 (19.9%) incident frailty was identified using FI. Compared to clean fuels, cooking with biomass fuels was intricately linked to a 23% rise in frailty risk (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.06-1.43). A similar association was detected between biomass cooking fuels and frailty measured by the FRAIL scale (HR 1.24, 95% CI 1.04-1.50). Sensitive analyses supported the independent relationship between biomass fuels and frailty. Stratified analyses revealed that the frailty risk was higher among town residents (HR 1.44, 95% CI 1.13-1.84) and participants not exercising regularly (HR 1.35, 95% CI 1.11-1.64). In comparison with persistent biomass fuels usage, switching to clean fuels had a trend to reduce the frailty risk, and the opposite effect was observed when swapping from clean to biomass fuels.

Conclusion

Cooking with biomass fuels was associated with an increased frailty risk in older adults, especially amongst those living in town and those lacking regular exercise. More studies are needed to confirm our findings and to evaluate the potential benefits of reducing indoor biomass fuel usage.

Indoor air pollution and human ocular diseases: Associated contaminants and underlying pathological mechanisms

People spend a long time indoors, especially young children. The risk of indoor pollution on human health is one of the current hotspots in environmental and public health. The human ocular surface is highly susceptible to indoor environment quality. Epidemiological data have linked human ophthalmological disorders with exposure to indoor pollution. In this review, we summarized the adverse impacts of indoor pollution on the human ocular surface. Several studies demonstrated that indoor contaminants including particulate matter, volatile/semi-volatile organic compounds, heavy metals, and fuel combustion and cigarette smoke exposure were associated with the incidence of human dry eye, conjunctivitis, glaucoma, cataracts, age-related macular degeneration, and keratitis. In addition, toxicological investigations revealed that indoor pollution-induced induced chronic inflammation, oxidative damage, and disruption of tight junctions are the main underlying pathological mechanisms for ocular surface diseases. Taken together, this review may expand the understanding of pollution-induced eye disorder and highlight the importance of reducing associated contaminants to decrease their detrimental effects on human eyes.

A review of indoor Gaseous organic compounds and human chemical Exposure: Insights from Real-time measurements

Gaseous organic compounds, mainly volatile organic compounds (VOCs), have become a wide concern in various indoor environments where we spend the majority of our daily time. The sources, compositions, variations, and sinks of indoor VOCs are extremely complex, and their potential impacts on human health are less understood. Owing to the deployment of the state-of-the-art real-time mass spectrometry during the last two decades, our understanding of the sources, dynamic changes and chemical transformations of VOCs indoors has been significantly improved. This review aims to summarize the key findings from mass spectrometry measurements in recent indoor studies including residence, classroom, office, sports center, etc. The sources and sinks, compositions and distributions of indoor VOCs, and the factors (e.g., human activities, air exchange rate, temperature and humidity) driving the changes in indoor VOCs are discussed. The physical and chemical processes of gas-particle partitioning and secondary oxidation processes of VOCs, and their impacts on human health are summarized. Finally, the recommendations for future research directions on indoor VOCs measurements and indoor chemistry are proposed.

Cleaning the Flue in Wood-Burning Stoves Is a Key Factor in Reducing Household Air Pollution

In experimental settings, replacing old wood stoves with new wood stoves results in reduced personal exposure to household air pollution. We tested this assumption by measuring PM2.5 and levoglucosan concentrations inside homes and correlated them with wood stove age. Methods: Thirty homes in the Albuquerque, NM area were monitored over a seven-day period using in-home particulate monitors placed in a common living area during the winter months. Real-time aerosol monitoring was performed, and filter samples were analyzed gravimetrically to calculate PM2.5 concentrations and chemically to determine concentrations of levoglucosan. A linear regression model with backward stepwise elimination was performed to determine the factors that would predict household air pollution measures. Results: In this sample, 73.3% of the households used wood as their primary source of heating, and 60% burned daily or almost daily. The mean burn time over the test week was 50 ± 38 h, and only one household burned wood 24/day (168 h). The average PM2.5 concentration (standard deviation) for the 30 homes during the seven-day period was 34.6 µg/m3 (41.3 µg/m3), and median (min, max) values were 15.5 µg/m3 (7.3 µg/m3, 193 µg/m3). Average PM2.5 concentrations in 30 homes ranged from 0−15 μg/m3 to >100 μg/m3. Maximum PM2.5 concentrations ranged from 100−200 μg/m3 to >3000 μg/m3. The levoglucosan levels showed a linear correlation with the total PM2.5 collected by the filters (R2 = 0.92). However, neither mean nor peak PM2.5 nor levoglucosan levels were correlated with the age (10.85 ± 8.54 years) of the wood stove (R2 ≤ 0.07, p > 0.23). The final adjusted linear regression model showed that average PM2.5 was associated with reports of cleaning the flue with a beta estimate of 35.56 (3.47−67.65) and R2 = 0.16 (p = 0.04). Discussion: Cleaning the flue and not the wood stove age was associated with household air pollution indices. Education on wood stove maintenance and safe burning practices may be more important in reducing household air pollution than the purchase of new stoves.

Modeling the impact of the COVID‐19 outbreak on environment, health sector and energy market

The global outbreak of COVID‐19 disease had a significant impact on the entire globe. Such a notable public health event can be seen as a “black swan” that brings unpredictable and unusual forces into the economic context and that it could typically lead to a chain of adverse reactions and market disruptions. Hence, the purpose of this study is to examine how COVID‐19 affects the environment, health, and the oil and energy markets. To achieve this objective, we used daily data for several measures that refer to the environment, health, and oil and energy, for the first wave of the COVID‐19 pandemic (December 31, 2019–May 22, 2020). The variable integration mix led to the approach of the ARDL model, and the Granger causality test was also employed. These empirical techniques allowed us to examine the cointegration between variables and causal relationships. The econometric results of the ARDL models exhibited that the global new cases and new deaths of COVID‐19 have short and long‐term effects on the environment, the health sector, the oil, and energy measures. However, no significant causal connection was found between the pandemic and the environment, the health sector, or the oil and energy industry, according to the Granger causality test. The uniqueness of current approach consists in the investigation of pandemic impact on the health, environment, oil, and energy sector by applying the ARDL model that permits the analysis of cointegration both in the long run and in the short term. This study provides important insights for investors and policy makers.

Field measurements of indoor and community air quality in rural Beijing before, during, and after the COVID-19 lockdown

The coronavirus (COVID-19) lockdown in China is thought to have reduced air pollution emissions due to reduced human mobility and economic activities. Few studies have assessed the impacts of COVID-19 on community and indoor air quality in environments with diverse socioeconomic and household energy use patterns. The main goal of this study was to evaluate whether indoor and community air pollution differed before, during, and after the COVID-19 lockdown in homes with different energy use patterns. Using calibrated real-time PM_2.5 sensors, we measured indoor and community air quality in 147 homes from 30 villages in Beijing over 4 months including periods before, during, and after the COVID-19 lockdown. Community pollution was higher during the lockdown (61 ± 47 μg/m³ ) compared with before (45 ± 35 μg/m³ , p < 0.001) and after (47 ± 37 μg/m³ , p < 0.001) the lockdown. However, we did not observe significantly increased indoor PM_2.5 during the COVID-19 lockdown. Indoor-generated PM_2.5 in homes using clean energy for heating without smokers was the lowest compared with those using solid fuel with/without smokers, implying air pollutant emissions are reduced in homes using clean energy. Indoor air quality may not have been impacted by the COVID-19 lockdown in rural settings in China and appeared to be more impacted by the household energy choice and indoor smoking than the COVID-19 lockdown. As clean energy transitions occurred in rural households in northern China, our work highlights the importance of understanding multiple possible indoor sources to interpret the impacts of interventions, intended or otherwise.

Variations and Sources of Organic Aerosol in Winter Beijing under Markedly Reduced Anthropogenic Activities During COVID-2019

The COVID-19 outbreak provides a "controlled experiment" to investigate the response of aerosol pollution to the reduction of anthropogenic activities. Here we explore the chemical characteristics, variations, and emission sources of organic aerosol (OA) based on the observation of air pollutants and combination of aerosol mass spectrometer (AMS) and positive matrix factorization (PMF) analysis in Beijing in early 2020. By eliminating the impacts of atmospheric boundary layer and the Spring Festival, we found that the lockdown effectively reduced cooking-related OA (COA) but influenced fossil fuel combustion OA (FFOA) very little. In contrast, both secondary OA (SOA) and O3 formation was enhanced significantly after lockdown: less-oxidized oxygenated OA (LO-OOA, 37% in OA) was probably an aged product from fossil fuel and biomass burning emission with aqueous chemistry being an important formation pathway, while more-oxidized oxygenated OA (MO-OOA, 41% in OA) was affected by regional transport of air pollutants and related with both aqueous and photochemical processes. Combining FFOA and LO-OOA, more than 50% of OA pollution was attributed to combustion activities during the whole observation period. Our findings highlight that fossil fuel/biomass combustion are still the largest sources of OA pollution, and only controlling traffic and cooking emissions cannot efficiently eliminate the heavy air pollution in winter Beijing.

Synergistic improvement of sensing performance in ferroelectric transistor gas sensors using remnant polarization

Gaseous pollutants, including nitrogen oxides, pose a severe threat to ecosystems and human health; therefore, developing reliable gas-sensing systems to detect them is becoming increasingly important. Among the various options, metal-oxide-based gas sensors have attracted attention due to their capability for real-time monitoring and large response. In particular, in the field of materials science, there has been extensive research into controlling the morphological properties of metal oxides. However, these approaches have limitations in terms of controlling the response, sensitivity, and selectivity after the sensing material is deposited. In this study, we propose a novel method to improve the gas-sensing performance by utilizing the remnant polarization of ferroelectric thin-film transistor (FeTFT) gas sensors. The proposed FeTFT gas sensor has IGZO and HZO as the conducting channel and ferroelectric layer, respectively. It is demonstrated that the response and sensitivity of FeTFT gas sensors can be modulated by engineering the polarization of the ferroelectric layer. The amount of reaction sites in IGZO, including electrons and oxygen vacancy-induced negatively charged oxygen, is changed depending on upward and downward polarization. The results of this study provide an essential foundation for further development of gas sensors with tunable sensing properties.

Effects of the COVID-19 Lockdown on Air Pollutant Levels and Associated Reductions in Ischemic Stroke Incidence in Shandong Province, China

Background

Local governments in China took restrictive measures after the outbreak of COVID-19 to control its spread, which unintentionally resulted in reduced anthropogenic emission sources of air pollutants. In this study, we intended to examine the effects of the COVID-19 lockdown policy on the concentration levels of particulate matter with aerodynamic diameters of ≤1 μm (PM₁), ≤2.5 μm (PM_2.5), and ≤10 μm (PM₁₀), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), and carbon monoxide (CO) and the potential subsequent reductions in the incidence of ischemic and hemorrhagic stroke in Shandong Province, China.

Methods

A difference-in-difference model combining the daily incidence data for ischemic and hemorrhagic stroke and air pollutant data in 126 counties was used to estimate the effect of the COVID-19 lockdown on the air pollutant levels and ischemic and hemorrhagic stroke incident counts. The avoided ischemic stroke cases related to the changes in air pollutant exposure levels were further estimated using concentration-response functions from previous studies.

Results

The PM₁, PM_2.5, PM₁₀, NO₂, and CO levels significantly decreased by −30.2, −20.9, −13.5, −46.3, and −13.1%, respectively. The O₃ level increased by 11.5% during the lockdown compared with that in the counterfactual lockdown phase of the past 2 years. There was a significant reduction in population-weighted ischemic stroke cases (−15,315, 95% confidence interval [CI]: −27,689, −2,942), representing a reduction of 27.6% (95% CI: −49.9%, −5.3%). The change in the number of hemorrhagic stroke cases was not statistically significant. The total avoided PM₁-, PM_2.5-, PM₁₀-, NO₂-, and CO–related ischemic stroke cases were 739 (95% CI: 641, 833), 509 (95% CI: 440, 575), 355 (95% CI: 304, 405), 1,132 (95% CI: 1,024, 1,240), and 289 (95% CI: 236, 340), respectively.

Conclusion

The COVID-19 lockdown indirectly reduced the concentration levels of PM₁, PM_2.5, PM₁₀, NO₂, and CO and subsequently reduced the associated ischemic stroke incidence. The health benefits due to the lockdown are temporary, and long-term measures should be implemented to increase air quality and related health benefits in the post-COVID-19 period.

COVID-19 and the Additional Radiological Risk during the Lockdown Period in the Province of Naples City (South Italy)

The lockdown restrictions, as a first solution to contain the spread of the COVID-19 pandemic, have affected everyone's life and habits, including the time spent at home. The latter factor has drawn attention to indoor air quality and the impact on human health, particularly for chemical pollutants. This study investigated how the increasing time indoor influenced exposure to natural radioactive substances, such as radon gas. To calculate the radiological risk, we considered the most consolidated indices used for radiation protection: annual effective dose, excess lifetime cancer risk, and the lung cancer case. Furthermore, two different exposure times were considered: pre-lockdown and post-lockdown. The lockdown increased the indoor exposure time by 4% and, consequently, the radiological risk factors by 9%. Furthermore, the reference value of 300 Bq/m3, considered acceptable for human radiation protection, may need to be lowered further in the case of conditions similar to those of the lockdown period.

Prevalence and risk factors of anxiety, depression and sleeping disturbances in china during the COVID-19 outbreak: a web-based cross-sectional study

The rapid development of the coronavirus disease 2019 (COVID-19) outbreak has brought great harm to physical and mental health of the public. This study aims to investigate the psychological status and sleep quality of the Chinese public during the outbreak of the COVID-19 and its related factors. The survey was conducted from February 17^th to February 26^th, 2020 in southwestern China. The snowball sampling method was used to invite subjects. Demographic data were collected, and mental status and sleep quality were assessed by the Generalized Anxiety Disorder-7 Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Pittsburgh Sleep Quality Index (PSQI). Descriptive, univariate, and correlation analyses were used to investigate risk factors for psychological status and sleep patterns. A total of 1509 adults (713 males and 796 females) were enrolled in this study. The overall prevalence of anxiety, depression, and decreased sleep quality were 22.3%, 32.2% and 35.4%, respectively. Compared with females, male population has witnessed a higher prevalence of anxiety symptoms (25.1% vs 20.4%, P= 0.007) and depressive symptoms (34.6% vs 30.0%, P= 0.027). In addition, age, marital status, living situation, involvement in anti-pandemic work, basic health status and work status were significant risk factors for anxiety or depression (P< 0.05). During the COVID-19 outbreak, psychological problems and sleep disorders were prevalent among the Chinese public. More attention should be paid to males, the elderly, the solitary, the unemployed, front-line workers in pandemic prevention, and patients with chronic diseases.