Long-term exposure to fine particulate matter air pollution: An ecological study of its effect on COVID-19 cases and fatality in Germany

Short-term effects of PM2.5 components on the respiratory infectious disease: a global perspective

Although previous research has reached agreement on the significant impact of particulate matter (PM2.5) on respiratory infectious diseases, PM2.5 acts as an aggregation of miscellaneous pollutants and the individual effect of each component has not been examined. Here, we investigate the effects of PM2.5 components, including black carbon (BC), organic carbon (OC), sulfate ion (SO4), dust, and sea salt (SS), on the morbidity and mortality of the recent respiratory disease, i.e. COVID-19. The daily data of 236 countries and provinces/states (e.g., in the United States and China) worldwide during 2020-2022 are utilized. To derive the pollutant-specific causal effects, optimal instrumental variables for each pollutant are selected from a large set of atmospheric variables. We find that one µg/m3 increase in OC increases the number of cases and death by about 3% to 6% from the mean worldwide during a lag of one day up to three days. Our findings remain consistent and robust when we change control variables such as the flight index and weather proxies, and also when applying a sine transformation to the positivity and death rate. When analyzing health effects among different areas, we find stronger impact in China, for its higher local OC concentration, as opposed to the impact in the United States. Health benefits from PM2.5 pollution reduction are comparatively high for developed regions, yet decreases in cases and deaths number are rather overt in less developing regions. Our research provides inspiration and reference for dealing with other respiratory diseases in the post-pandemic era.

The effects of COVID-19 on agriculture supply chain, food security, and environment: a review

COVID-19 has a deep impact on the economic, environmental, and social life of the global population. Particularly, it disturbed the entire agriculture supply chain due to a shortage of labor, travel restrictions, and changes in demand during lockdowns. Consequently, the world population faced food insecurity due to a reduction in food production and booming food prices. Low-income households face food security challenges because of limited income generation during the pandemic. Thus, there is a need to understand comprehensive strategies to meet the complex challenges faced by the food industry and marginalized people in developing countries. This research is intended to review the agricultural supply chain, global food security, and environmental dynamics of COVID-19 by exploring the most significant literature in this domain. Due to lockdowns and reduced industrial production, positive environmental effects are achieved through improved air and water quality and reduced noise pollution globally. However, negative environmental effects emerged due to increasing medical waste, packaging waste, and plastic pollution due to disruptions in recycling operations. There is extensive literature on the effects of COVID-19 on the environment and food security. This study is an effort to review the existing literature to understand the net effects of the pandemic on the environment and food security. The literature suggested adopting innovative policies and strategies to protect the global food supply chain and achieve economic recovery with environmental sustainability. For instance, food productivity should be increased by using modern agriculture technologies to ensure food security. The government should provide food to vulnerable populations during the pandemic. Trade restrictions should be removed for food trade to improve international collaboration for food security. On the environmental side, the government should increase recycling plants during the pandemic to control waste and plastic pollution.

[Global environmental changes and the epithelial barrier hypothesis]

BACKGROUND

The global burden of noncommunicable diseases (NCD) has seen a strong increase in recent decades and attributable to the influence of environmental factors. For a multitude of diseases an association with epithelial barrier damage has been reported.

OBJECTIVE

This article provides an overview of the health effects of environmental pollution in the context of the epithelial barrier hypothesis of Cezmi Akdis. Additionally, exemplary mechanisms of a barrier damage are described. Finally, possible preventive and therapeutic consequences are discussed.

MATERIAL AND METHODS

The PubMed database was searched for the relevant topics and selected literature was reviewed.

RESULTS

A wide variety of substances can damage the epithelial barriers of the skin, lungs and gastrointestinal tract. The rise in the prevalences of atopic diseases could (partly) be due to an increased exposure to barrier-damaging substances, such as particulate matter and laundry detergents. A possible pathogenetic mechanism is the initiation and maintenance of an immune response by subepithelial penetration of microorganisms through damaged epithelia.

CONCLUSION

Based on the epithelial barrier hypothesis new therapeutic and prevention strategies can be developed. The regulation of hazardous chemicals and the fight against environmental pollution and climate change are necessary to reduce the burden of disease.

Exposure to outdoor particulate matter and risk of respiratory diseases: a systematic review and meta-analysis

According to epidemiological studies, particulate matter (PM) is an important air pollutant that poses a significant threat to human health. The relationship between particulate matter and respiratory diseases has been the subject of numerous studies, but these studies have produced inconsistent findings. The purpose of this systematic review was to examine the connection between outdoor particulate matter (PM2.5 and PM10) exposure and respiratory disorders (COPD, lung cancer, LRIs, and COVID-19). For this purpose, we conducted a literature search between 2012 and 2022 in PubMed, Web of Science, and Scopus. Out of the 58 studies that were part of the systematic review, meta-analyses were conducted on 53 of them. A random effect model was applied separately for each category of study design to assess the pooled association between exposure to PM2.5 and PM10 and respiratory diseases. Based on time-series and cohort studies, which are the priorities of the strength of evidence, a significant relationship between the risk of respiratory diseases (COPD, lung cancer, and COVID-19) was observed (COPD: pooled HR = 1.032, 95% CI: 1.004-1.061; lung cancer: pooled HR = 1.017, 95% CI: 1.015-1.020; and COVID-19: pooled RR = 1.004, 95% CI: 1.002-1.006 per 1 μg/m3 increase in PM2.5). Also, a significant relationship was observed between PM10 and respiratory diseases (COPD, LRIs, and COVID-19) based on time-series and cohort studies. Although the number of studies in this field is limited, which requires more investigations, it can be concluded that outdoor particulate matter can increase the risk of respiratory diseases.

Linkage between Airborne Particulate Matter and Viral Pandemic COVID-19 in Bucharest

The long-distance spreading and transport of airborne particulate matter (PM) of biogenic or chemical compounds, which are thought to be possible carriers of SARS-CoV-2 virions, can have a negative impact on the incidence and severity of COVID-19 viral disease. Considering the total Aerosol Optical Depth at 550 nm (AOD) as an atmospheric aerosol loading variable, inhalable fine PM with a diameter ≤2.5 µm (PM2.5) or coarse PM with a diameter ≤10 µm (PM10) during 26 February 2020-31 March 2022, and COVID-19's five waves in Romania, the current study investigates the impact of outdoor PM on the COVID-19 pandemic in Bucharest city. Through descriptive statistics analysis applied to average daily time series in situ and satellite data of PM2.5, PM10, and climate parameters, this study found decreased trends of PM2.5 and PM10 concentrations of 24.58% and 18.9%, respectively compared to the pre-pandemic period (2015-2019). Exposure to high levels of PM2.5 and PM10 particles was positively correlated with COVID-19 incidence and mortality. The derived average PM2.5/PM10 ratios during the entire pandemic period are relatively low (<0.44), indicating a dominance of coarse traffic-related particles' fraction. Significant reductions of the averaged AOD levels over Bucharest were recorded during the first and third waves of COVID-19 pandemic and their associated lockdowns (~28.2% and ~16.4%, respectively) compared to pre-pandemic period (2015-2019) average AOD levels. The findings of this research are important for decision-makers implementing COVID-19 safety controls and health measures during viral infections.

Combining aggregate and individual-level data to estimate individual-level associations between air pollution and COVID-19 mortality in the United States

Imposing stricter regulations for PM2.5 has the potential to mitigate damaging health and climate change effects. Recent evidence establishing a link between exposure to air pollution and COVID-19 outcomes is one of many arguments for the need to reduce the National Ambient Air Quality Standards (NAAQS) for PM2.5. However, many studies reporting a relationship between COVID-19 outcomes and PM2.5 have been criticized because they are based on ecological regression analyses, where area-level counts of COVID-19 outcomes are regressed on area-level exposure to air pollution and other covariates. It is well known that regression models solely based on area-level data are subject to ecological bias, i.e., they may provide a biased estimate of the association at the individual-level, due to within-area variability of the data. In this paper, we augment county-level COVID-19 mortality data with a nationally representative sample of individual-level covariate information from the American Community Survey along with high-resolution estimates of PM2.5 concentrations obtained from a validated model and aggregated to the census tract for the contiguous United States. We apply a Bayesian hierarchical modeling approach to combine county-, census tract-, and individual-level data to ultimately draw inference about individual-level associations between long-term exposure to PM2.5 and mortality for COVID-19. By analyzing data prior to the Emergency Use Authorization for the COVID-19 vaccines we found that an increase of 1 μg/m3 in long-term PM2.5 exposure, averaged over the 17-year period 2000-2016, is associated with a 3.3% (95% credible interval, 2.8 to 3.8%) increase in an individual's odds of COVID-19 mortality. Code to reproduce our study is publicly available at https://github.com/NSAPH/PM_COVID_ecoinference. The results confirm previous evidence of an association between long-term exposure to PM2.5 and COVID-19 mortality and strengthen the case for tighter regulations on harmful air pollution and greenhouse gas emissions.

Conducting quantitative mask fit tests: application details and affecting factors

Introduction

Respirators chosen based on their assigned protection factor (APF) enable wearers to effectively reduce particulate matter concentrations to safe levels when used correctly. As a crucial factor in achieving the intended APF, the fit test has become a necessary procedure in respiratory disease protection.

Methods

This study involved 225 participants who underwent a fit test using two reusable types of half masks and two types of full masks. Condensation nuclei counting (CNC) and controlled negative pressure (CNP) were performed.

Results

The results revealed that the passing rate of full masks was higher compared to half masks. Specifically, the passing rate for the half masks and the full masks were 84.7 and 91.6%, respectively. Gender exerted a statistically significant effect on the passing rate. Nevertheless, age, educational background, and training exhibited relatively negligible effects. Certain movements, such as facing forward, were identified as key actions with strong correlation. Additionally, talking was considered a key action with a high failure rate due to instantaneous leakages. Most participants failed at the initial step of CNP, but nearly all of them passed the fit test using CNC.

Discussion

Therefore, putting on full masks, especially for women, provides optimal protection during work. Furthermore, attention should be given to the displacement and deformation of the respirator during the key actions. When it comes to fit test methods, CNC was found to be more practical and comprehensive compared to CNP. Moreover, additional physiological characteristics, such as double chins, could be explored as potential influential factors.

Long-Term Exposure to Ambient Air Pollution and Mortality among Four Million COVID-19 Cases in Italy: The EpiCovAir Study

BACKGROUND

The role of chronic exposure to ambient air pollutants in increasing COVID-19 fatality is still unclear.

OBJECTIVES

The study aimed to investigate the association between long-term exposure to air pollutants and mortality among 4 million COVID-19 cases in Italy.

METHODS

We obtained individual records of all COVID-19 cases identified in Italy from February 2020 to June 2021. We assigned 2016-2019 mean concentrations of particulate matter (PM) with aerodynamic diameter ≤10μm (PM10), PM with aerodynamic diameter ≤2.5μm (PM2.5), and nitrogen dioxide (NO2) to each municipality (n=7,800) as estimates of chronic exposures. We applied a principal component analysis (PCA) and a generalized propensity score (GPS) approach to an extensive list of area-level covariates to account for major determinants of the spatial distribution of COVID-19 case-fatality rates. Then, we applied generalized negative binomial models matched on GPS, age, sex, province, and month. As additional analyses, we fit separate models by pandemic periods, age, and sex; we quantified the numbers of COVID-19 deaths attributable to exceedances in annual air pollutant concentrations above predefined thresholds; and we explored associations between air pollution and alternative outcomes of COVID-19 severity, namely hospitalizations or accesses to intensive care units.

RESULTS

We analyzed 3,995,202 COVID-19 cases, which generated 124,346 deaths. Overall, case-fatality rates increased by 0.7% [95% confidence interval (CI): 0.5%, 0.9%], 0.3% (95% CI: 0.2%, 0.5%), and 0.6% (95% CI: 0.5%, 0.8%) per 1 μg/m3 increment in PM2.5, PM10, and NO2, respectively. Associations were higher among elderly subjects and during the first (February 2020-June 2020) and the third (December 2020-June 2021) pandemic waves. We estimated ∼8% COVID-19 deaths were attributable to pollutant levels above the World Health Organization 2021 air quality guidelines.

DISCUSSION

We found suggestive evidence of an association between long-term exposure to ambient air pollutants with mortality among 4 million COVID-19 cases in Italy. https://doi.org/10.1289/EHP11882.

Peculiar weather patterns effects on air pollution and COVID-19 spread in Tokyo metropolis

As a pandemic hotspot in Japan, between March 1, 2020-October 1, 2022, Tokyo metropolis experienced seven COVID-19 waves. Motivated by the high rate of COVID-19 incidence and mortality during the seventh wave, and environmental/health challenges we conducted a time-series analysis to investigate the long-term interaction of air quality and climate variability with viral pandemic in Tokyo. Through daily time series geospatial and observational air pollution/climate data, and COVID-19 incidence and death cases, this study compared the environmental conditions during COVID-19 multiwaves. In spite of five State of Emergency (SOEs) restrictions associated with COVID-19 pandemic, during (2020-2022) period air quality recorded low improvements relative to (2015-2019) average annual values, namely: Aerosol Optical Depth increased by 9.13% in 2020 year, and declined by 6.64% in 2021, and 12.03% in 2022; particulate matter PM2.5 and PM10 decreased during 2020, 2021, and 2022 years by 10.22%, 62.26%, 0.39%, and respectively by 4.42%, 3.95%, 5.76%. For (2021-2022) period the average ratio of PM2.5/PM10 was (0.319 ± 0.1640), showing a higher contribution to aerosol loading of traffic-related coarse particles in comparison with fine particles. The highest rates of the daily recorded COVID-19 incidence and death cases in Tokyo during the seventh COVID-19 wave (1 July 2022-1 October 2022) may be attributed to accumulation near the ground of high levels of air pollutants and viral pathogens due to: 1) peculiar persistent atmospheric anticyclonic circulation with strong positive anomalies of geopotential height at 500 hPa; 2) lower levels of Planetary Boundary Layer (PBL) heights; 3) high daily maximum air temperature and land surface temperature due to the prolonged heat waves (HWs) in summer 2022; 4) no imposed restrictions. Such findings can guide public decision-makers to design proper strategies to curb pandemics under persistent stable anticyclonic weather conditions and summer HWs in large metropolitan areas.

Dual-bionic nano-groove structured nanofibers for breathable and moisture-wicking protective respirators

Coronavirus disease 2019 (COVID-19) pandemic makes protective respirators highly demanded. The respirator materials should filter out viral fine aerosols effectively, allow airflow to pass through easily, and wick away the exhalant moisture timely. However, the commonly used melt-blown nonwovens perform poorly in meeting these requirements simultaneously. Herein, dual-bionic nano-groove structured (NGS) nanofibers are fabricated to serve as protective, breathable and moisture-wicking respirator materials. The creativity of this design is that the tailoring of dual-bionic nano-groove structure, combined with the strong polarity and hydrophilicity of electrospinning polymer, not only endows the nanofibrous materials with improved particle capture ability but also enable them to wick away and transmit breathing moisture. Benefitting from the synthetic effect of hierarchical structure and the intrinsic property of polymers, the resulting NGS nanofibrous membranes show a high filtration efficiency of 99.96%, a low pressure drop of 110 Pa, and a high moisture transmission rate of 5.67 kg m^-2 d^-1 at the same time. More importantly, the sharp increase of breathing resistance caused by the condensation of exhaled moisture is avoided, overcoming the bottleneck faced by traditional nonwovens and paving a new way for developing protective respirators with high wear comfortability.

Discussion about the Latest Findings on the Possible Relation between Air Particulate Matter and COVID-19

Since SARS-CoV-2 was identified, the scientific community has tried to understand the variables that can influence its spread. Several studies have already highlighted a possible link between particulate matter (PM) and COVID-19. This work is a brief discussion about the latest findings on this topic, highlighting the gaps in the current results and possible tips for future studies. Based on the literature outcomes, PM is suspected to play a double role in COVID-19: a chronic and an acute one. The chronic role is related to the possible influence of long-term and short-term exposure to high concentrations of PM in developing severe forms of COVID-19, including death. The acute role is linked to the possible carrier function of PM in SARS-CoV-2. The scientific community seems sure that the inflammatory effect on the respiratory system of short-term exposure to a high concentration of PM, and other additional negative effects on human health in cases of longer exposure, increases the risk of developing a more severe form of COVID-19 in cases of contagion. On the contrary, the results regarding PM acting as a carrier of SARS-CoV-2 are more conflicting, especially regarding the possible inactivation of the virus in the environment, and no final explanation on the possible acute role of PM in the spread of COVID-19 can be inferred.

Unanswered questions on the airborne transmission of COVID-19

Policies and measures to control pandemics are often failing. While biological factors controlling transmission are usually well explored, little is known about the environmental drivers of transmission and infection. For instance, respiratory droplets and aerosol particles are crucial vectors for the airborne transmission of the severe acute respiratory syndrome coronavirus 2, the causation agent of the coronavirus 2019 pandemic (COVID-19). Once expectorated, respiratory droplets interact with atmospheric particulates that influence the viability and transmission of the novel coronavirus, yet there is little knowledge on this process or its consequences on virus transmission and infection. Here we review the effects of atmospheric particulate properties, vortex zones, and air pollution on virus survivability and transmission. We found that particle size, chemical constituents, electrostatic charges, and the moisture content of airborne particles can have notable effects on virus transmission, with higher survival generally associated with larger particles, yet some viruses are better preserved on small particles. Some chemical constituents and surface-adsorbed chemical species may damage peptide bonds in viral proteins and impair virus stability. Electrostatic charges and water content of atmospheric particulates may affect the adherence of virion particles and possibly their viability. In addition, vortex zones and human thermal plumes are major environmental factors altering the aerodynamics of buoyant particles in air, which can strongly influence the transport of airborne particles and the transmission of associated viruses. Insights into these factors may provide explanations for the widely observed positive correlations between COVID-19 infection and mortality with air pollution, of which particulate matter is a common constituent that may have a central role in the airborne transmission of the novel coronavirus.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10311-022-01557-z.

Association between long-term air pollution exposure and COVID-19 mortality in Latin America

Recent studies have shown a relationship between air pollution and increased vulnerability and mortality due to COVID-19. Most of these studies have looked at developed countries. This study examines the relationship between long-term exposure to air pollution and COVID-19-related deaths in four countries of Latin America that have been highly affected by the pandemic: Brazil, Chile, Colombia, and Mexico. Our results suggest that an increase in long-term exposure of 1 μg/m3 of fine particles is associated with a 2.7 percent increase in the COVID-19 mortality rate. This relationship is found primarily in municipalities of metropolitan areas, where urban air pollution sources dominate, and air quality guidelines are usually exceeded. By focusing the analysis on Latin America, we provide a first glimpse on the role of air pollution as a risk factor for COVID-19 mortality within a context characterized by weak environmental institutions, limited health care capacity and high levels of inequality.

Experimental and numerical analysis of indoor air quality affected by outdoor air particulate levels (PM1.0, PM2.5 and PM10), room infiltration rate, and occupants' behaviour

This study conducted an experimental analysis of how indoor air quality (IAQ) is influenced by the outdoor air pollutants levels, infiltration rate, and occupants' behaviours. The impacts of these factors on IAQ were analyzed using on-site measurements and numerical simulations. The results contribute to a better understanding of how to control the Indoor Particulate Level (IPL) for the specific conditions of the studied building. Results showed that occupant behaviour was the primary factor in determining the IPL, significantly changing the number of outdoor particles introduced to the building. Moreover, it was found that the IPL was exponentially correlated to the Outdoor Particulate Level (OPL). Based on numerical simulations, this study concluded that smaller particles do not always have more chance than larger particles of accessing the indoor environment through the building envelope. Meanwhile, a steady-state indoor particle concentration numerical model was established and verified using the 4-fold cross-validation method. Finally, simulation results identified that the room infiltration rate had a positive linear impact on IAQ if the OPL was under 30 μg/m³. This is because the increased air exchange rate can help to dilute indoor air pollutants when the outdoor air is relatively clean.

Cumulative effects of air pollution and climate drivers on COVID-19 multiwaves in Bucharest, Romania

Over more than two years of global health crisis due to ongoing COVID-19 pandemic, Romania experienced a five-wave pattern. This study aims to assess the potential impact of environmental drivers on COVID-19 transmission in Bucharest, capital of Romania during the analyzed epidemic period. Through descriptive statistics and cross-correlation tests applied to time series of daily observational and geospatial data of major outdoor inhalable particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) or ≤ 10 µm (PM10), nitrogen dioxide (NO₂), ozone (O₃), sulfur dioxide (SO₂), carbon monoxide (CO), Aerosol Optical Depth at 550 nm (AOD) and radon (²²²Rn), we investigated the COVID-19 waves patterns under different meteorological conditions. This study examined the contribution of individual climate variables on the ground level air pollutants concentrations and COVID-19 disease severity. As compared to the long-term average AOD over Bucharest from 2015 to 2019, for the same year periods, this study revealed major AOD level reduction by ~28 % during the spring lockdown of the first COVID-19 wave (15 March 2020-15 May 2020), and ~16 % during the third COVID-19 wave (1 February 2021-1 June 2021). This study found positive correlations between exposure to air pollutants PM2.5, PM10, NO₂, SO₂, CO and ²²²Rn, and significant negative correlations, especially for spring-summer periods between ground O₃ levels, air temperature, Planetary Boundary Layer height, and surface solar irradiance with COVID-19 incidence and deaths. For the analyzed time period 1 January 2020-1 April 2022, before and during each COVID-19 wave were recorded stagnant synoptic anticyclonic conditions favorable for SARS-CoV-2 virus spreading, with positive Omega surface charts composite average (Pa/s) at 850 mb during fall- winter seasons, clearly evidenced for the second, the fourth and the fifth waves. These findings are relevant for viral infections controls and health safety strategies design in highly polluted urban environments.

Research on COVID-19 and air pollution: A path towards advancing exposure science

The COVID-19 pandemic has resulted in an extraordinary incidence of morbidity and mortality, with almost 6 million deaths worldwide at the time of this writing (https://covid19.who.int/). There has been a pressing need for research that would shed light on factors - especially modifiable factors - that could reduce risks to human health. At least several hundred studies addressing the complex relationships among transmission of SARS-CoV-2, air pollution, and human health have been published. However, these investigations are limited by available and consistent data. The project goal was to seek input into opportunities to improve and fund exposure research on the confluence of air pollution and infectious agents such as SARS-CoV-2. Thirty-two scientists with expertise in exposure science, epidemiology, risk assessment, infectious diseases, and/or air pollution responded to the outreach for information. Most of the respondents expressed value in developing a set of common definitions regarding the extent and type of public health lockdown. Traffic and smoking ranked high as important sources of air pollution warranting source-specific research (in contrast with assessing overall ambient level exposures). Numerous important socioeconomic factors were also identified. Participants offered a wide array of inputs on what they considered to be essential studies to improve our understanding of exposures. These ranged from detailed mechanistic studies to improved air quality monitoring studies and prospective cohort studies. Overall, many respondents indicated that these issues require more research and better study design. As an exercise to solicit opinions, important concepts were brought forth that provide opportunities for scientific collaboration and for consideration for funding prioritization. Further conversations on these concepts are needed to advance our thinking on how to design research that moves us past the documented limitations in the current body of research and prepares us for the next pandemic.

Impacts of exposure to air pollution, radon and climate drivers on the COVID-19 pandemic in Bucharest, Romania: A time series study

During the ongoing global COVID-19 pandemic disease, like several countries, Romania experienced a multiwaves pattern over more than two years. The spreading pattern of SARS-CoV-2 pathogens in the Bucharest, capital of Romania is a multi-factorial process involving among other factors outdoor environmental variables and viral inactivation. Through descriptive statistics and cross-correlation analysis applied to daily time series of observational and geospatial data, this study aims to evaluate the synergy of COVID-19 incidence and lethality with air pollution and radon under different climate conditions, which may exacerbate the coronavirus' effect on human health. During the entire analyzed period 1 January 2020-21 December 2021, for each of the four COVID-19 waves were recorded different anomalous anticyclonic synoptic meteorological patterns in the mid-troposphere, and favorable stability conditions during fall-early winter seasons for COVID-19 disease fast-spreading, mostly during the second, and the fourth waves. As the temporal pattern of airborne SARS-CoV-2 and its mutagen variants is affected by seasonal variability of the main air pollutants and climate parameters, this paper found: 1) the daily outdoor exposures to air pollutants (particulate matter PM2.5 and PM10, nitrogen dioxide-NO₂, sulfur dioxide-SO₂, carbon monoxide-CO) and radon - ²²²Rn, are directly correlated with the daily COVID-19 incidence and mortality, and may contribute to the spread and the severity of the pandemic; 2) the daily ground ozone-O₃ levels, air temperature, Planetary Boundary Layer height, and surface solar irradiance are anticorrelated with the daily new COVID-19 incidence and deaths, averageingful for spring-summer periods. Outdoor exposure to ambient air pollution associated with radon is a non-negligible driver of COVID-19 transmission in large metropolitan areas, and climate variables are risk factors in spreading the viral infection. The findings of this study provide useful information for public health authorities and decision-makers to develop future pandemic diseases strategies in high polluted metropolitan environments.

Proximity to livestock farms and COVID-19 in the Netherlands, 2020-2021

Objectives

In the Netherlands, during the first phase of the COVID-19 epidemic, the hotspot of COVID-19 overlapped with the country's main livestock area, while in subsequent phases this distinct spatial pattern disappeared. Previous studies show that living near livestock farms influence human respiratory health and immunological responses. This study aimed to explore whether proximity to livestock was associated with SARS-CoV-2 infection.

Methods

The study population was the population of the Netherlands excluding the very strongly urbanised areas and border areas, on January 1, 2019 (12, 628, 244 individuals). The cases are the individuals reported with a laboratory-confirmed positive SARS-CoV-2 test with onset before January 1, 2022 (2, 223, 692 individuals). For each individual, we calculated distance to nearest livestock farm (cattle, goat, sheep, pig, poultry, horse, rabbit, mink). The associations between residential (6-digit postal-code) distance to the nearest livestock farm and individuals' SARS-CoV-2 status was studied with multilevel logistic regression models. Models were adjusted for individuals' age categories, the social status of the postal code area, particulate matter (PM₁₀)- and nitrogen dioxide (NO₂)-concentrations. We analysed data for the entire period and population as well as separately for eight time periods (Jan–Mar, Apr–Jun, Jul–Sep and Oct–Dec in 2020 and 2021), four geographic areas of the Netherlands (north, east, west and south), and for five age categories (0–14, 15–24, 25–44, 45–64 and > 65 years).

Results

Over the period 2020–2021, individuals' SARS-CoV-2 status was associated with living closer to livestock farms. This association increased from an Odds Ratio (OR) of 1.01 (95% Confidence Interval [CI] 1.01–1.02) for patients living at a distance of 751–1000 m to a farm to an OR of 1.04 (95% CI 1.04–1.04), 1.07 (95% CI 1.06–1.07) and 1.11 (95% CI 1.10–1.12) for patients living in the more proximate 501–750 m, 251–500m and 0–250 m zones around farms, all relative to patients living further than 1000 m around farms. This association was observed in three out of four quarters of the year in both 2020 and 2021, and in all studied geographic areas and age groups.

Conclusions

In this exploratory study with individual SARS-CoV-2 notification data and high-resolution spatial data associations were found between living near livestock farms and individuals' SARS-CoV-2 status in the Netherlands. Verification of the results in other countries is warranted, as well as investigations into possible underlying exposures and mechanisms.

The Challenge of Reaching Undocumented Migrants with COVID-19 Vaccination

Access to vaccination against a health threat such as that presented by the COVID-19 pandemic is an imperative driven, in principle, by at least three compelling factors: (1) the right to health of all people, irrespective of their status; (2) humanitarian need of undocumented migrants, as well as of others including documented migrants, refugees and displaced people who are sometimes vulnerable and living in precarious situations; and (3) the need to ensure heath security globally and nationally, which in the case of a global pandemic requires operating on the basis that, for vaccination strategies to succeed in fighting a pandemic, the highest possible levels of vaccine uptake are required. Yet some population segments have had limited access to mainstream health systems, both prior to as well as during the COVID-19 pandemic. People with irregular resident status are among those who face extremely high barriers in accessing both preventative and curative health care. This is due to a range of factors that drive exclusion, both on the supply side (e.g., systemic and practical restrictions in service delivery) and the demand side (e.g., in uptake, including due to fears that personal data would be transmitted to immigration authorities). Moreover, undocumented people have often been at increased risk of infection due to their role as "essential workers", including those experiencing higher exposure to the SARS-CoV-2 virus due to frontline occupations while lacking protective equipment. Often, they have also been largely left out of social protection measures granted by governments to their populations during successive lockdowns. This article reviews the factors that serve as supply-side and demand-side barriers to vaccination for undocumented migrants and considers what steps need to be taken to ensure that inclusive approaches operate in practice.

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.

The effect of known and unknown confounders on the relationship between air pollution and Covid-19 mortality in Italy: A sensitivity analysis of an ecological study based on the E-value

Back in December 2019, the novel coronavirus disease 2019 (Covid-19) started rapidly spreading worldwide, especially in Italy that was among the most affected countries. The geographical distribution of air pollution and Covid-19 mortality in Italy suggested atmospheric pollution as a worsening factor of severe Covid-19 health outcomes. The present nationwide ecological study focused on all 107 Italian territorial areas, aiming to assess the potential association between Particulate Matter concentration, less than 2.5 μm in diameter (exposure), and Covid-19 mortality rate (outcome) throughout 2020, by looking at 28 potential confounders. A potential positive association between exposure and outcome was observed when performing a multivariate regression analysis with a Negative Binomial model, suggesting that an increase of 1 μg/m³ in the exposure is associated with an increase of 9.0% (95% CI: 6.5%-11.6%) in the average Covid-19 mortality rate, conditional on all 28 potential confounders. A sensitivity analysis, based on the E-value, shows that a hypothetical unmeasured confounder would have to be associated with both PM_2.5 concentration and Covid-19 mortality rate by a rate ratio of at least 1.40-fold each to explain away the exposure-outcome association, conditional on all 28 covariates included in the main analysis model. Moreover, the Observed Covariate E-value (OCE) was reported to provide a contextualization of the E-value on the observed covariates included in the study. The OCE sensitivity analysis shows that a set of unknown confounders similar in size and magnitude to the set of the considered climatic factors could potentially explain away the estimated exposure-outcome association. Consequently, the role of climatic factors in the Covid-19 pandemic is worth of further investigation.

Effects of short-term ambient particulate matter exposure on the risk of severe COVID-19

OBJECTIVES

Previous studies have suggested a relationship between outdoor air pollution and the risk of coronavirus disease 2019 (COVID-19). However, there is a lack of data related to the severity of disease, especially in China. This study aimed to explore the association between short-term exposure to outdoor particulate matter (PM) and the risk of severe COVID-19.

METHODS

We recruited patients diagnosed with COVID-19 during a recent large-scale outbreak in eastern China caused by the Delta variant. We collected data on meteorological factors and ambient air pollution during the same time period and in the same region where the cases occurred and applied a generalized additive model (GAM) to analyze the effects of short-term ambient PM exposure on the risk of severe COVID-19.

RESULTS

A total of 476 adult patients with confirmed COVID-19 were recruited, of which 42 (8.82%) had severe disease. With a unit increase in PM₁₀, the risk of severe COVID-19 increased by 81.70% (95% confidence interval [CI]: 35.45, 143.76) at a lag of 0-7 days, 86.04% (95% CI: 38.71, 149.53) at a lag of 0-14 days, 76.26% (95% CI: 33.68, 132.42) at a lag of 0-21 days, and 72.15% (95% CI: 21.02, 144.88) at a lag of 0-28 days. The associations remained significant at lags of 0-7 days, 0-14 days, and 0-28 days in the multipollutant models. With a unit increase in PM_2.5, the risk of severe COVID-19 increased by 299.08% (95% CI: 92.94, 725.46) at a lag of 0-7 days, 289.23% (95% CI: 85.62, 716.20) at a lag of 0-14 days, 234.34% (95% CI: 63.81, 582.40) at a lag of 0-21 days, and 204.04% (95% CI: 39.28, 563.71) at a lag of 0-28 days. The associations were still significant at lags of 0-7 days, 0-14 days, and 0-28 days in the multipollutant models.

CONCLUSIONS

Our results indicated that short-term exposure to outdoor PM was positively related to the risk of severe COVID-19, and that reducing air pollution may contribute to the control of COVID-19.

Evidence of the Relationship between Social Vulnerability and the Spread of COVID-19 in Urban Spaces

Modeling the social-spatial structure of urban spaces can facilitate the development of guidelines aimed at curbing the spread of the COVID-19 pandemic while also acting as an instrument that helps decision-making concerning mitigation policies. The modeling process starts with categorization of urban spaces based on the concept of social vulnerability. A model is created based on this concept and the theory of analysis of social areas. Statistical techniques of factor analysis and geostatistics are applied. This generates a map of social differentiation that, when related to data on the evolution of the contagion, generates a multidimensional model of social vulnerability. The application of this model towards people (social structure) and the environment where they live (spatial structure) is specified. Our model assumes the uniqueness of cities, and it is intended to be a broadly applicable model that can be extrapolated to other urban areas if pertinent revisions are made. Our work demonstrates that aspects of the social and urban structures may be validly used to analyze and explain the spatial spread of COVID-19.

Ecological studies of COVID-19 and air pollution: How useful are they?

Background:

Results from ecological studies have suggested that air pollution increases the risk of developing and dying from COVID-19. Drawing causal inferences from the measures of association reported in ecological studies is fraught with challenges given biases arising from an outcome whose ascertainment is incomplete, varies by region, time, and across sociodemographic characteristics, and cannot account for clustering or within-area heterogeneity. Through a series of analyses, we illustrate the dangers of using ecological studies to assess whether ambient air pollution increases the risk of dying from, or transmitting, COVID-19.

Methods:

We performed an ecological analysis in the continental United States using county-level ambient concentrations of fine particulate matter (PM_2.5) between 2000 and 2016 and cumulative COVID-19 mortality counts through June 2020, December 2020, and April 2021. To show that spurious associations can be obtained in ecological data, we modeled the association between PM_2.5 and the prevalence of human immunodeficiency virus (HIV). We fitted negative binomial models, with a logarithmic offset for county-specific population, to these data. Natural cubic splines were used to describe the shape of the exposure-response curves.

Results:

Our analyses revealed that the shape of the exposure-response curve between PM_2.5 and COVID-19 changed substantially over time. Analyses of COVID-19 mortality through June 30, 2021, suggested a positive linear relationship. In contrast, an inverse pattern was observed using county-level concentrations of PM_2.5 and the prevalence of HIV.

Conclusions:

Our analyses indicated that ecological analyses are prone to showing spurious relationships between ambient air pollution and mortality from COVID-19 as well as the prevalence of HIV. We discuss the many potential biases inherent in any ecological-based analysis of air pollution and COVID-19.