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Zhang J, Lim YH, So R, Mortensen LH, Napolitano GM, Cole-Hunter T, Tuffier S, Bergmann M, Maric M, Taghavi Shahri SM, Brandt J, Ketzel M, Loft S, Andersen ZJ. Long-Term Exposure to Air Pollution and Risk of Acute Lower Respiratory Infections in the Danish Nurse Cohort. Ann Am Thorac Soc 2024; 21:1129-1138. [PMID: 38513223 DOI: 10.1513/annalsats.202401-074oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/21/2024] [Indexed: 03/23/2024] Open
Abstract
Rationale: Air pollution is a major risk factor for chronic cardiorespiratory diseases, affecting the immune and respiratory systems' functionality, but epidemiological evidence in respiratory infections remains sparse. Objectives: We aimed to assess the association of long-term exposure to ambient air pollution with the risk of developing new and recurrent acute lower respiratory infections (ALRIs), characterized by persistently severe symptoms necessitating hospital contact, and identify the potential susceptible populations by socioeconomic status, smoking, physical activity status, overweight, and comorbidity with chronic lung disease. Methods: We followed 23,912 female nurses from the Danish Nurse Cohort (age >44 yr) from baseline (1993 or 1999) until 2018 for incident and recurrent ALRIs defined by hospital contact (inpatient, outpatient, and emergency room) data from the National Patient Register. Residential annual mean concentrations of fine particulate matter, nitrogen dioxide (NO2), and black carbon were modeled using the Danish Eulerian Hemispheric Model/Urban Background Model/Air Geographic Information System. We used marginal Cox models with time-varying exposures to assess the association of 3-year running mean air pollution level with incident and recurrent ALRIs and examined effect modification by age, socioeconomic status, smoking, physical activity, body mass index, and comorbidity with asthma or chronic obstructive pulmonary disease (COPD). Results: During a 21.3-year mean follow-up, 4,746 ALRIs were observed, of which 2,553 were incident. We observed strong positive associations of all three pollutants with incident ALRIs, with hazard ratios and 95% confidence intervals of 1.19 (1.08-1.31) per 2.5 μg/m3 for fine particulate matter, 1.17 (1.11-1.24) per 8.0 μg/m3 for NO2, and 1.09 (1.05-1.12) per 0.3 μg/m3 for black carbon, and slightly stronger associations with recurrent ALRIs. Associations were strongest in patients with COPD and nurses with low physical activity. Conclusions: Long-term exposure to air pollution at low levels was associated with risks of new and recurrent ALRIs, with patients with COPD and physically inactive subjects most vulnerable.
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Affiliation(s)
| | | | - Rina So
- Section of Environmental Health and
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Laust H Mortensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Denmark Statistic, Copenhagen, Denmark
| | | | | | | | | | | | | | - Jørgen Brandt
- Department of Environmental Science and
- iClimate, Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark; and
| | - Matthias Ketzel
- Department of Environmental Science and
- Global Centre for Clean Air Research, University of Surrey, Guildford, United Kingdom
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De Ridder D, Ladoy A, Choi Y, Jacot D, Vuilleumier S, Guessous I, Joost S, Greub G. Environmental and geographical factors influencing the spread of SARS-CoV-2 over 2 years: a fine-scale spatiotemporal analysis. Front Public Health 2024; 12:1298177. [PMID: 38957202 PMCID: PMC11217542 DOI: 10.3389/fpubh.2024.1298177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction Since its emergence in late 2019, the SARS-CoV-2 virus has led to a global health crisis, affecting millions and reshaping societies and economies worldwide. Investigating the determinants of SARS-CoV-2 diffusion and their spatiotemporal dynamics at high spatial resolution is critical for public health and policymaking. Methods This study analyses 194,682 georeferenced SARS-CoV-2 RT-PCR tests from March 2020 and April 2022 in the canton of Vaud, Switzerland. We characterized five distinct pandemic periods using metrics of spatial and temporal clustering like inverse Shannon entropy, the Hoover index, Lloyd's index of mean crowding, and the modified space-time DBSCAN algorithm. We assessed the demographic, socioeconomic, and environmental factors contributing to cluster persistence during each period using eXtreme Gradient Boosting (XGBoost) and SHapley Additive exPlanations (SHAP), to consider non-linear and spatial effects. Results Our findings reveal important variations in the spatial and temporal clustering of cases. Notably, areas with flatter epidemics had higher total attack rate. Air pollution emerged as a factor showing a consistent positive association with higher cluster persistence, substantiated by both immission models and, to a lesser extent, tropospheric NO2 estimations. Factors including population density, testing rates, and geographical coordinates, also showed important positive associations with higher cluster persistence. The socioeconomic index showed no significant contribution to cluster persistence, suggesting its limited role in the observed dynamics, which warrants further research. Discussion Overall, the determinants of cluster persistence remained across the study periods. These findings highlight the need for effective air quality management strategies to mitigate air pollution's adverse impacts on public health, particularly in the context of respiratory viral diseases like COVID-19.
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Affiliation(s)
- David De Ridder
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Geospatial Molecular Epidemiology Group (GEOME), Laboratory for Biological Geochemistry (LGB), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Anaïs Ladoy
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Geospatial Molecular Epidemiology Group (GEOME), Laboratory for Biological Geochemistry (LGB), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Yangji Choi
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Damien Jacot
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Séverine Vuilleumier
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Idris Guessous
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Joost
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Geospatial Molecular Epidemiology Group (GEOME), Laboratory for Biological Geochemistry (LGB), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
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Farré X, Blay N, Espinosa A, Castaño-Vinyals G, Carreras A, Garcia-Aymerich J, Cardis E, Kogevinas M, Goldberg X, de Cid R. Decoding depression by exploring the exposome-genome edge amidst COVID-19 lockdown. Sci Rep 2024; 14:13562. [PMID: 38866890 PMCID: PMC11169603 DOI: 10.1038/s41598-024-64200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
Risk of depression increased in the general population after the COVID-19 pandemic outbreak. By examining the interplay between genetics and individual environmental exposures during the COVID-19 lockdown, we have been able to gain an insight as to why some individuals are more vulnerable to depression, while others are more resilient. This study, conducted on a Spanish cohort of 9218 individuals (COVICAT), includes a comprehensive non-genetic risk analysis, the exposome, complemented by a genomics analysis in a subset of 2442 participants. Depression levels were evaluated using the Hospital Anxiety and Depression Scale. Together with Polygenic Risk Scores (PRS), we introduced a novel score; Poly-Environmental Risk Scores (PERS) for non-genetic risks to estimate the effect of each cumulative score and gene-environment interaction. We found significant positive associations for PERSSoc (Social and Household), PERSLife (Lifestyle and Behaviour), and PERSEnv (Wider Environment and Health) scores across all levels of depression severity, and for PRSB (Broad depression) only for moderate depression (OR 1.2, 95% CI 1.03-1.40). On average OR increased 1.2-fold for PERSEnv and 1.6-fold for PERLife and PERSoc from mild to severe depression level. The complete adjusted model explained 16.9% of the variance. We further observed an interaction between PERSEnv and PRSB showing a potential mitigating effect. In summary, stressors within the social and behavioral domains emerged as the primary drivers of depression risk in this population, unveiling a mitigating interaction effect that should be interpreted with caution.
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Affiliation(s)
- Xavier Farré
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Research Group on the Impact of Chronic Diseases and Their Trajectories (GRIMTra), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Natalia Blay
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Research Group on the Impact of Chronic Diseases and Their Trajectories (GRIMTra), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Ana Espinosa
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Anna Carreras
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisabeth Cardis
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Ximena Goldberg
- ISGlobal, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
- CIBER Salud Mental (CIBERSAM), Madrid, Spain.
| | - Rafael de Cid
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.
- Research Group on the Impact of Chronic Diseases and Their Trajectories (GRIMTra), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.
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Josa-Culleré A, Basagaña X, Koch S, Arbillaga-Etxarri A, Balcells E, Bosch de Basea M, Celorrio N, Foraster M, Rodriguez-Roisin R, Marin A, Peralta GP, Rodríguez-Chiaradia DA, Simonet P, Torán-Monserrat P, Vall-Casas P, Garcia-Aymerich J. Short-term effects of air pollution and weather on physical activity in patients with chronic obstructive pulmonary disease (COPD). ENVIRONMENTAL RESEARCH 2024; 247:118195. [PMID: 38237751 DOI: 10.1016/j.envres.2024.118195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/27/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Patients with chronic obstructive pulmonary disease (COPD) accumulate low levels of physical activity. How environmental factors affect their physical activity in the short-term is uncertain. AIM to assess the short-term effects of air pollution and weather on physical activity levels in COPD patients. METHODS This multi-center panel study assessed 408 COPD patients from Catalonia (Spain). Daily physical activity (i.e., steps, time in moderate-to-vigorous physical activity (MVPA), locomotion intensity, and sedentary time) was recorded in two 7-day periods, one year apart, using the Dynaport MoveMonitor. Air pollution (nitrogen dioxide (NO2), particulate matter below 10 μm (PM10) and a marker of black carbon (absorbance of PM2.5: PM2.5ABS), and weather (average and maximum temperature, and rainfall) were estimated the same day (lag zero) and up to 5 days prior to each assessment (lags 1-5). Mixed-effect distributed lag linear regression models were adjusted for age, sex, weekday, public holidays, greenness, season, and social class, with patient and city as random effects. RESULTS Patients (85% male) were on average (mean ± SD) 68 ± 9 years old with a post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57 ± 18% predicted. Higher NO2, PM10 and PM2.5ABS levels at lag four were associated with fewer steps, less time in MVPA, reduced locomotion intensity, and longer sedentary time (e.g., coefficient (95% CI) of -60 (-105, -15) steps per 10 μg/m3 increase in NO2). Higher average and maximum temperatures at lag zero were related to more steps and time in MVPA, and less sedentary time (e.g., +85 (15, 154) steps per degree Celsius). Higher rainfall at lag zero was related to fewer steps and more sedentary time. CONCLUSION Air pollution affects the amount and intensity of physical activity performed on the following days in COPD patients, whereas weather affects the amount of physical activity performed on the same day.
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Affiliation(s)
- Alícia Josa-Culleré
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Sarah Koch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ane Arbillaga-Etxarri
- Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, Donostia-San Sebastián, Spain
| | - Eva Balcells
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; Respiratory Medicine Department, Hospital del Mar, Barcelona, Spain; CIBER Respiratory Disease (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Magda Bosch de Basea
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Nuria Celorrio
- Clinical pneumologist, Department of Respiratory Medicine Hospital de Viladecans, Barcelona, Spain
| | - Maria Foraster
- PHAGEX Research Group, Blanquerna School of Health Science, Universitat Ramon Llull (URL), Barcelona, Spain
| | - Robert Rodriguez-Roisin
- CIBER Respiratory Disease (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Alicia Marin
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Germans Trias i Pujol Research Institute - IGTP, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriela P Peralta
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Diego A Rodríguez-Chiaradia
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Respiratory Disease (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain; Department of Pulmonary Medicine, Hospital del Mar, Spain
| | - Pere Simonet
- EAP Viladecans-2. Gerencia Metropolitana Sud, ICS, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; Multidisciplinary Research Group in Health and Society (GREMSAS) (2021 SGR 01484), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Spain; Department of Medicine, Faculty of Medicine, Universitat de Girona, 17001 Girona, Spain
| | | | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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Hajmohammadi H, Talaei M, Fecht D, Wang W, Vivaldi G, Faustini SE, Richter AG, Shaheen SO, Martineau AR, Sheikh A, Mudway IS, Griffiths CJ. Long-term air pollution exposure and risk of SARS-CoV-2 infection: A UK-wide cohort study. Respir Med 2024; 224:107567. [PMID: 38423343 DOI: 10.1016/j.rmed.2024.107567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The association between air quality and risk of SARS-CoV-2 infection is poorly understood. We investigated this association using serological individual-level data adjusting for a wide range of confounders, in a large population-based cohort (COVIDENCE UK). METHODS We assessed the associations between long-term (2015-19) nitrogen dioxide (NO2) and fine particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5), exposures with SARS-CoV-2 infection, level of antibody response among those infected, and COVID-19 disease severity. We used serological data from 10,489 participants in the COVIDENCE UK cohort, and estimated annual average air pollution exposure at each participant's home postcode. RESULTS After controlling for potential confounders, we found a positive association between 5-year NO2 and PM2.5 exposures and the risk of seropositivity: 10 unit increase in NO2 (μg/m3) was associated with an increasing risk of seropositivity by 1.092 (95% CI 1.02 to 1.17; p-for-trend 0.012). For PM2.5, 10 unit increase (μg/m3) was associated with an increasing risk of seropositivity by 1.65 (95% CI 1.015-2.68; p-for-trend 0·049). In addition, we found that NO2 was positively associated with higher antibody titres (p-for-trend 0·013) among seropositive participants, with no evidence of an association for PM2.5. CONCLUSION Our findings suggest that the long-term burden of air pollution increased the risks of SARS-CoV-2 infection and has important implications for future pandemic preparedness. This evidence strengthens the case for reducing long-term air pollution exposures to reduce the vulnerability of individuals to respiratory viruses.
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Affiliation(s)
- Hajar Hajmohammadi
- Asthma UK Centre for Applied Research, Centre for Primary Care, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Mohammad Talaei
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Heath, Imperial College London, London, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK
| | - Weiyi Wang
- MRC Centre for Environment and Health, School of Public Heath, Imperial College London, London, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK
| | - Giulia Vivaldi
- Centre for Immunobiology, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, UK
| | - Sian E Faustini
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Alex G Richter
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Seif O Shaheen
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adrian R Martineau
- Centre for Immunobiology, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ian S Mudway
- MRC Centre for Environment and Health, School of Public Heath, Imperial College London, London, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK; NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - Christopher J Griffiths
- Asthma UK Centre for Applied Research, Centre for Primary Care, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Ren X, Mi Z, Georgopoulos PG. Socioexposomics of COVID-19 across New Jersey: a comparison of geostatistical and machine learning approaches. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:197-207. [PMID: 36725924 PMCID: PMC9889956 DOI: 10.1038/s41370-023-00518-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Disparities in adverse COVID-19 health outcomes have been associated with multiple social and environmental stressors. However, research is needed to evaluate the consistency and efficiency of methods for studying these associations at local scales. OBJECTIVE To assess socioexposomic associations with COVID-19 outcomes across New Jersey and evaluate consistency of findings from multiple modeling approaches. METHODS We retrieved data for COVID-19 cases and deaths for the 565 municipalities of New Jersey up to the end of the first phase of the pandemic, and calculated mortality rates with and without long-term-care (LTC) facility deaths. We considered 84 spatially heterogeneous environmental, demographic and socioeconomic factors from publicly available databases, including air pollution, proximity to industrial sites/facilities, transportation-related noise, occupation and commuting, neighborhood and housing characteristics, age structure, racial/ethnic composition, poverty, etc. Six geostatistical models (Poisson/Negative-Binomial regression, Poison/Negative-Binomial mixed effect model, Poisson/Negative-Binomial Bersag-York-Mollie spatial model) and two Machine Learning (ML) methods (Random Forest, Extreme Gradient Boosting) were implemented to assess association patterns. The Shapley effects plot was established for explainable ML and change of support validation was introduced to compare performances of different approaches. RESULTS We found robust positive associations of COVID-19 mortality with historic exposures to NO2, population density, percentage of minority and below high school education, and other social and environmental factors. Exclusion of LTC deaths does not significantly affect correlations for most factors but findings can be substantially influenced by model structures and assumptions. The best performing geostatistical models involved flexible structures representing data variations. ML methods captured association patterns consistent with the best performing geostatistical models, and furthermore detected consistent nonlinear associations not captured by geostatistical models. SIGNIFICANCE The findings of this work improve the understanding of how social and environmental disparities impacted COVID-19 outcomes across New Jersey.
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Affiliation(s)
- Xiang Ren
- Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, Piscataway, NJ, 08854, USA
- Department of Chemical and Biochemical Engineering, Rutgers University, Piscataway, NJ, 08854, USA
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Zhongyuan Mi
- Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, Piscataway, NJ, 08854, USA
- Department of Environmental Sciences, Rutgers University, New Brunswick, NJ, 08901, USA
| | - Panos G Georgopoulos
- Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, Piscataway, NJ, 08854, USA.
- Department of Chemical and Biochemical Engineering, Rutgers University, Piscataway, NJ, 08854, USA.
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ, 08854, USA.
- Department of Environmental Sciences, Rutgers University, New Brunswick, NJ, 08901, USA.
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Ranzani O, Alari A, Olmos S, Milà C, Rico A, Basagaña X, Dadvand P, Duarte-Salles T, Forastiere F, Nieuwenhuijsen M, Vivanco-Hidalgo RM, Tonne C. Who is more vulnerable to effects of long-term exposure to air pollution on COVID-19 hospitalisation? ENVIRONMENT INTERNATIONAL 2024; 185:108530. [PMID: 38422877 DOI: 10.1016/j.envint.2024.108530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/23/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Factors that shape individuals' vulnerability to the effects of air pollution on COVID-19 severity remain poorly understood. We evaluated whether the association between long-term exposure to ambient NO2, PM2.5, and PM10 and COVID-19 hospitalisation differs by age, sex, individual income, area-level socioeconomic status, arterial hypertension, diabetes mellitus, and chronic obstructive pulmonary disease. METHODS We analysed a population-based cohort of 4,639,184 adults in Catalonia, Spain, during 2020. We fitted Cox proportional hazard models adjusted for several potential confounding factors and evaluated the interaction effect between vulnerability indicators and the 2019 annual average of NO2, PM2.5, and PM10. We evaluated interaction on both additive and multiplicative scales. RESULTS Overall, the association was additive between air pollution and the vulnerable groups. Air pollution and vulnerability indicators had a synergistic (greater than additive) effect for males and individuals with low income or living in the most deprived neighbourhoods. The Relative Excess Risk due to Interaction (RERI) was 0.21, 95 % CI, 0.15 to 0.27 for NO2 and 0.16, 95 % CI, 0.11 to 0.22 for PM2.5 for males; 0.13, 95 % CI, 0.09 to 0.18 for NO2 and 0.10, 95 % CI, 0.05 to 0.14 for PM2.5 for lower individual income and 0.17, 95 % CI, 0.12 to 0.22 for NO2 and 0.09, 95 % CI, 0.05 to 0.14 for PM2.5 for lower area-level socioeconomic status. Results for PM10 were similar to PM2.5. Results on multiplicative scale were inconsistent. CONCLUSIONS Long-term exposure to air pollution had a larger synergistic effect on COVID-19 hospitalisation for males and those with lower individual- and area-level socioeconomic status.
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Affiliation(s)
- Otavio Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anna Alari
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sergio Olmos
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carles Milà
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alex Rico
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Francesco Forastiere
- National Research Council, IFT, Palermo, Italy; Environmental Research Group, Imperial College London, London, UK
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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8
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Nakhjirgan P, Kashani H, Kermani M. Exposure to outdoor particulate matter and risk of respiratory diseases: a systematic review and meta-analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 46:20. [PMID: 38153542 DOI: 10.1007/s10653-023-01807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
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.
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Affiliation(s)
- Pegah Nakhjirgan
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
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9
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Pumarega J, Gasull M, Koponen J, Campi L, Rantakokko P, Henríquez-Hernández LA, Aguilar R, Donat-Vargas C, Zumbado M, Villar-García J, Rius C, Santiago-Díaz P, Vidal M, Jimenez A, Iglesias M, Dobaño C, Moncunill G, Porta M. Prepandemic personal concentrations of per- and polyfluoroalkyl substances (PFAS) and other pollutants: Specific and combined effects on the incidence of COVID-19 disease and SARS-CoV-2 infection. ENVIRONMENTAL RESEARCH 2023; 237:116965. [PMID: 37652221 DOI: 10.1016/j.envres.2023.116965] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To investigate the specific and combined effects of personal concentrations of some per- and polyfluoroalkyl substances (PFAS), other persistent organic pollutants (POPs), and chemical elements -measured in individuals' blood several years before the pandemic- on the development of SARS-CoV-2 infection and COVID-19 disease in the general population. METHODS We conducted a prospective cohort study in 240 individuals from the general population of Barcelona. PFAS, other POPs, and chemical elements were measured in plasma, serum, and whole blood samples, respectively, collected in 2016-2017. PFAS were analyzed by liquid chromatography-triple quadrupole mass spectrometry. SARS-CoV-2 infection was detected by rRT-PCR in nasopharyngeal swabs and/or antibody serology in blood samples collected in 2020-2021. RESULTS No individual PFAS nor their mixtures were significantly associated with SARS-CoV-2 seropositivity or COVID-19 disease. Previously identified mixtures of POPs and elements (Porta et al., 2023) remained significantly associated with seropositivity and COVID-19 when adjusted for PFAS (all OR > 4 or p < 0.05). Nine chemicals comprised mixtures associated with COVID-19: thallium, ruthenium, lead, benzo[b]fluoranthene, DDD, other DDT-related compounds, manganese, tantalum, and aluminium. And nine chemicals comprised the mixtures more consistently associated with SARS-CoV-2 seropositivity: thallium, ruthenium, lead, benzo[b]fluoranthene, DDD, gold, and (protectively) selenium, indium, and iron. CONCLUSIONS The PFAS studied were not associated with SARS-CoV-2 seropositivity or COVID-19. The results confirm the associations between personal blood concentrations of some POPs and chemical elements and the risk of COVID-19 and SARS-CoV-2 infection in what remains the only prospective and population-based cohort study on the topic. Mixtures of POPs and chemical elements may contribute to explain the heterogeneity in the risks of SARS-CoV-2 infection and COVID-19 in the general population.
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Affiliation(s)
- José Pumarega
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Magda Gasull
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Jani Koponen
- Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Laura Campi
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Panu Rantakokko
- Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Luis A Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Carolina Donat-Vargas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; ISGlobal, Campus Mar, Barcelona, Spain; Cardiovascular and Nutritonal Epidemiology Unit, Institut of Enviornmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | | | - Cristina Rius
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Alfons Jimenez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Mar Iglesias
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Miquel Porta
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain.
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10
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Jerrett M, Nau CL, Young DR, Butler RK, Batteate CM, Padilla A, Tartof SY, Su J, Burnett RT, Kleeman MJ. Air pollution and the sequelae of COVID-19 patients: A multistate analysis. ENVIRONMENTAL RESEARCH 2023; 236:116814. [PMID: 37558120 DOI: 10.1016/j.envres.2023.116814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
IMPORTANCE Recent evidence links air pollution to the severity COVID-19 symptoms and to death from the disease. To date, however, few studies have assessed whether air pollution affects the sequelae to more severe states or recovery from COVID-19 in a cohort with individual data. OBJECTIVE To assess how air pollution affects the transition to more severe COVID-19 states or to recovery from COVID-19 infection in a cohort with detailed patient information. DESIGN AND OUTCOMES We used a cohort design that followed patients admitted to hospital in the Kaiser Permanente Southern California (KPSC) Health System, which has 4.7 million members with characteristics similar to the general population. Enrollment began on 06/01/2020 and ran until 01/30/2021 for all patients admitted to hospital while ill with COVID-19. All possible states of sequelae were considered, including deterioration to intensive care, to death, discharge to recovery, or discharge to death. Transition risks were estimated with a multistate model. We assessed exposure using chemical transport model that predicted ambient concentrations of nitrogen dioxide, ozone, and fine particulate matter (PM2.5) at a 1 km scale. RESULTS Each increase in PM2.5 concentration equivalent to the interquartile range was associated with increased risk of deterioration to intensive care (HR of 1.16; 95% CI: 1.12-1.20) and deterioration to death (HR of 1.11; 95% CI: 1.04-1.17). Results for ozone were consistent with PM2.5 effects, but ozone also affected the transition from recovery to death: HR of 1.24 (95% CI: 1.01-1.51). NO2 had weaker effects but displayed some elevated risks. CONCLUSIONS PM2.5 and ozone were significantly associated with transitions to more severe states while in hospital and to death after discharge from hospital. Reducing air pollution could therefore lead to improved prognosis for COVID-19 patients and a sustainable means of reducing the health impacts of coronaviruses now and in the future.
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Affiliation(s)
- Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles 650 Charles Young Dr. S, 56-070 CHS Box 951772, Los Angeles, CA, 90095, USA.
| | - Claudia L Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Rebecca K Butler
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Christina M Batteate
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles 650 Charles Young Dr. S, 56-070 CHS Box 951772, Los Angeles, CA, 90095, USA
| | - Ariadna Padilla
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Sara Y Tartof
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720, USA
| | - Richard T Burnett
- Population Studies Division, Environmental Health Directorate, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering, University of California, Davis, 1 Sheilds Avenue, Davis, CA, 95616, USA
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11
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Fedrizzi L, Carugno M, Consonni D, Lombardi A, Bandera A, Bono P, Ceriotti F, Gori A, Pesatori AC. Air pollution exposure, SARS-CoV-2 infection, and immune response in a cohort of healthcare workers of a large university hospital in Milan, Italy. ENVIRONMENTAL RESEARCH 2023; 236:116755. [PMID: 37517490 DOI: 10.1016/j.envres.2023.116755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Several studies have examined the possible relationship between air pollutants and the risk of COVID-19 but most returned controversial findings. We tried to assess the association between (short- and long-term) exposure to particulate and gaseous pollutants, SARS-CoV-2 infections, and immune response in a population of healthcare workers (HCWs) with well-characterized individual data. We collected occupational and clinical characteristics of all HCWs who performed a nasopharyngeal swab (NPS) for detecting SARS-CoV-2 at the Policlinico Hospital in Milan (Lombardy, Italy) between February 24, 2020 (day after first documented case of COVID-19 in our hospital) and December 26, 2020 (day before start of the vaccination campaign). Each subject was assigned daily average levels of particulate matter ≤10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) retrieved from the air quality monitoring station closest to his/her residential address. Air pollution data were treated as time-dependent variables, generating person-days at risk. Multivariate Poisson regression models were fit to evaluate the rate of positive NPS and to assess the association between air pollution and antibody titer among NPS-positive HCWs. Among 3712 included HCWs, 635 (17.1%) had at least one positive NPS. A 10 μg/m3 increase in NO2 average concentration in the four days preceding NPS was associated with a higher risk of testing positive [Incidence Rate Ratio (IRR) = 1.08, 95% confidence interval (CI): 1.01; 1.16)]. When considering a 1 μg/m3 increase in 2019 annual NO2 average, we observed a higher risk of infection (IRR: 1.02, 95%CI: 1.00; 1.03) and an increased antibody titer (+2.4%, 95%CI: 1.1; 3.6%). Findings on PM10 and O3 were less consistent and, differently from NO2, were not confirmed in multipollutant models. Our study increases the body of evidence suggesting an active role of air pollution exposure on SARS-CoV-2 infection and confirms the importance of implementing pollution reduction policies to improve public health.
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Affiliation(s)
- Luca Fedrizzi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Carugno
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Lombardi
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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12
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Gonçalves KDS, Cirino GG, da Costa MO, do Couto LDO, Tortelote GG, Hacon SDS. The potential impact of PM2.5 on the covid-19 crisis in the Brazilian Amazon region. Rev Saude Publica 2023; 57:67. [PMID: 37878853 PMCID: PMC10519675 DOI: 10.11606/s1518-8787.2023057005134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/23/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE This study aims to assess covid-19 morbidity, mortality, and severity from 2020 to 2021 in five Brazilian Amazon states with the highest records of wildfires. METHODS A distributed lag non-linear model was applied to estimate the potential exposure risk association with particulate matter smaller than 2.5-µm in diameter (PM2.5). Daily mean temperature, relative humidity, percentual of community mobility, number of hospital beds, days of the week, and holidays were considered in the final models for controlling the confounding factors. RESULTS The states of Para, Mato Grosso, and Amazonas have reported the highest values of overall cases, deaths, and severe cases of covid-19. The worrying growth in the percentual rates in 2020/2021 for the incidence, severity, and mortality were highlighted in Rondônia and Mato Grosso. The growth in 2020/2021 in the estimations of PM2.5 concentrations was higher in Mato Grosso, with an increase of 24.4%, followed by Rondônia (14.9%). CONCLUSION This study establishes an association between wildfire-generated PM2.5 and increasing covid-19 incidence, mortality, and severity within the studied area. The findings showed that the risk of covid-19 morbidity and mortality is nearly two times higher among individuals exposed to high concentrations of PM2.5. The attributable fraction to PM2.5 in the studied area represents an important role in the risk associated with covid-19 in the Brazilian Amazon region.
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Affiliation(s)
- Karen dos Santos Gonçalves
- Barcelona Institute for Global HealthBiomedical Data Science TeamBarcelonaSpainBarcelona Institute for Global Health. Biomedical Data Science Team. Barcelona, Spain
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sergio AroucaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil
| | - Glauber G. Cirino
- Universidade Federal do ParáInstituto de GeociênciasBelémPABrasil Universidade Federal do Pará. Instituto de Geociências. Belém, PA, Brasil
| | | | - Lucas de Oliveira do Couto
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sergio AroucaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil
| | - Giovane G. Tortelote
- Tulane UniversityDepartment of PediatricsNew OrleansUnited States Tulane University. Department of Pediatrics. New Orleans, United States
| | - Sandra de Souza Hacon
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sergio AroucaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil
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13
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Woodward SM, Mork D, Wu X, Hou Z, Braun D, Dominici F. Combining aggregate and individual-level data to estimate individual-level associations between air pollution and COVID-19 mortality in the United States. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002178. [PMID: 37531330 PMCID: PMC10395946 DOI: 10.1371/journal.pgph.0002178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023]
Abstract
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.
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Affiliation(s)
- Sophie M. Woodward
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Daniel Mork
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Xiao Wu
- Department of Biostatistics, Columbia University, New York, New York, United States of America
| | - Zhewen Hou
- Department of Statistics, Columbia University, New York, New York, United States of America
| | - Danielle Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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14
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Vos S, De Waele E, Goeminne P, Bijnens EM, Bongaerts E, Martens DS, Malina R, Ameloot M, Dams K, De Weerdt A, Dewyspelaere G, Jacobs R, Mistiaen G, Jorens P, Nawrot TS. Pre-admission ambient air pollution and blood soot particles predict hospitalisation outcomes in COVID-19 patients. Eur Respir J 2023; 62:2300309. [PMID: 37343978 PMCID: PMC10288811 DOI: 10.1183/13993003.00309-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/19/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Air pollution exposure is one of the major risk factors for aggravation of respiratory diseases. We investigated whether exposure to air pollution and accumulated black carbon (BC) particles in blood were associated with coronavirus disease 2019 (COVID-19) disease severity, including the risk for intensive care unit (ICU) admission and duration of hospitalisation. METHODS From May 2020 until March 2021, 328 hospitalised COVID-19 patients (29% at intensive care) were recruited from two hospitals in Belgium. Daily exposure levels (from 2016 to 2019) for particulate matter with aerodynamic diameter <2.5 µm and <10 µm (PM2.5 and PM10, respectively), nitrogen dioxide (NO2) and BC were modelled using a high-resolution spatiotemporal model. Blood BC particles (internal exposure to nano-sized particles) were quantified using pulsed laser illumination. Primary clinical parameters and outcomes included duration of hospitalisation and risk of ICU admission. RESULTS Independent of potential confounders, an interquartile range (IQR) increase in exposure in the week before admission was associated with increased duration of hospitalisation (PM2.5 +4.13 (95% CI 0.74-7.53) days, PM10 +4.04 (95% CI 1.24-6.83) days and NO2 +4.54 (95% CI 1.53-7.54) days); similar effects were observed for long-term NO2 and BC exposure on hospitalisation duration. These effect sizes for an IQR increase in air pollution on hospitalisation duration were equivalent to the effect of a 10-year increase in age on hospitalisation duration. Furthermore, for an IQR higher blood BC load, the OR for ICU admission was 1.33 (95% CI 1.07-1.65). CONCLUSIONS In hospitalised COVID-19 patients, higher pre-admission ambient air pollution and blood BC levels predicted adverse outcomes. Our findings imply that air pollution exposure influences COVID-19 severity and therefore the burden on medical care systems during the COVID-19 pandemic.
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Affiliation(s)
- Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- S. Vos and E. De Waele contributed equally
| | - Elien De Waele
- Hospital VITAZ Sint-Niklaas, Sint-Niklaas, Belgium
- S. Vos and E. De Waele contributed equally
| | | | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Department of Environmental Sciences, Faculty of Science, Open University, Heerlen, The Netherlands
| | - Eva Bongaerts
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Dries S Martens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Robert Malina
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Marcel Ameloot
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - Karolien Dams
- Antwerp University Hospital, University of Antwerp (LEMP), Edegem, Belgium
| | - Annick De Weerdt
- Antwerp University Hospital, University of Antwerp (LEMP), Edegem, Belgium
| | | | - Rita Jacobs
- Antwerp University Hospital, University of Antwerp (LEMP), Edegem, Belgium
| | | | - Philippe Jorens
- Antwerp University Hospital, University of Antwerp (LEMP), Edegem, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Department of Public Health and Primary Care, Occupational and Environmental Medicine, KU Leuven, Leuven, Belgium
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15
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Calatayud V, Diéguez JJ, Agathokleous E, Sicard P. Machine learning model to predict vehicle electrification impacts on urban air quality and related human health effects. ENVIRONMENTAL RESEARCH 2023; 228:115835. [PMID: 37019297 DOI: 10.1016/j.envres.2023.115835] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/16/2023]
Abstract
Air pollution is a prevailing environmental problem in cities worldwide. The future vehicle electrification (VE), which in Europe will be importantly fostered by the ban of thermal engines from 2035, is expected to have an important effect on urban air quality. Machine learning models represent an optimal tool for predicting changes in air pollutants concentrations in the context of future VE. For the city of Valencia (Spain), a XGBoost (eXtreme Gradient Boosting package) model was used in combination with SHAP (SHapley Additive exPlanations) analysis, both to investigate the importance of different factors explaining air pollution concentrations and predicting the effect of different levels of VE. The model was trained with 5 years of data including the COVID-19 lockdown period in 2020, in which mobility was strongly reduced resulting in unprecedent changes in air pollution concentrations. The interannual meteorological variability of 10 years was also considered in the analyses. For a 70% VE, the model predicted: 1) improvements in nitrogen dioxide pollution (-34% to -55% change in annual mean concentrations, for the different air quality stations), 2) a very limited effect on particulate matter concentrations (-1 to -4% change in annual means of PM2.5 and PM10), 3) heterogeneous responses in ground-level ozone concentrations (-2% to +12% change in the annual means of the daily maximum 8-h average concentrations). Even at a high VE increase of 70%, the 2021 World Health Organization Air Quality Guidelines will be exceeded for all pollutants in some stations. VE has a potentially important impact in terms of reducing NO2-associated premature mortality, but complementary strategies for reducing traffic and controlling all different air pollution sources should also be implemented to protect human health.
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Affiliation(s)
- V Calatayud
- Fundación CEAM, Parque Tecnológico, C/Charles R. Darwin, 14, Paterna, Spain.
| | - J J Diéguez
- Fundación CEAM, Parque Tecnológico, C/Charles R. Darwin, 14, Paterna, Spain
| | - E Agathokleous
- Institute of Ecology, Key Laboratory of Agrometeorology of Jiangsu Province, School of Applied Meteorology, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - P Sicard
- ARGANS, 260 Route Du Pin Montard, Biot, France
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16
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Zhang J, Lim YH, So R, Jørgensen JT, Mortensen LH, Napolitano GM, Cole-Hunter T, Loft S, Bhatt S, Hoek G, Brunekreef B, Westendorp R, Ketzel M, Brandt J, Lange T, Kølsen-Fisher T, Andersen ZJ. Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalisation or death: Danish nationwide cohort study. Eur Respir J 2023; 62:2300280. [PMID: 37343976 PMCID: PMC10288813 DOI: 10.1183/13993003.00280-2023] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/08/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible. METHODS We followed 3 721 810 Danish residents aged ≥30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter ≤2.5 μm (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual- and area-level socioeconomic status, and population density. RESULTS 138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM2.5 (per 0.53 μg·m-3) and NO2 (per 3.59 μg·m-3) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O3. CONCLUSION Long-term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.
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Affiliation(s)
- Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust H Mortensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Copenhagen, Denmark
| | - George M Napolitano
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Rudi Westendorp
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, UK
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iCLIMATE, Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Thea Kølsen-Fisher
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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17
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Dong Z, Ma J, Qiu J, Ren Q, Shan Q, Duan X, Li G, Zuo YY, Qi Y, Liu Y, Liu G, Lynch I, Fang M, Liu S. Airborne fine particles drive H1N1 viruses deep into the lower respiratory tract and distant organs. SCIENCE ADVANCES 2023; 9:eadf2165. [PMID: 37294770 PMCID: PMC10256160 DOI: 10.1126/sciadv.adf2165] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 05/05/2023] [Indexed: 06/11/2023]
Abstract
Mounting data suggest that environmental pollution due to airborne fine particles (AFPs) increases the occurrence and severity of respiratory virus infection in humans. However, it is unclear whether and how interactions with AFPs alter viral infection and distribution. We report synergetic effects between various AFPs and the H1N1 virus, regulated by physicochemical properties of the AFPs. Unlike infection caused by virus alone, AFPs facilitated the internalization of virus through a receptor-independent pathway. Moreover, AFPs promoted the budding and dispersal of progeny virions, likely mediated by lipid rafts in the host plasma membrane. Infected animal models demonstrated that AFPs favored penetration of the H1N1 virus into the distal lung, and its translocation into extrapulmonary organs including the liver, spleen, and kidney, thus causing severe local and systemic disorders. Our findings revealed a key role of AFPs in driving viral infection throughout the respiratory tract and beyond. These insights entail stronger air quality management and air pollution reduction policies.
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Affiliation(s)
- Zheng Dong
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Juan Ma
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jiahuang Qiu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Quanzhong Ren
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China
| | - Qing’e Shan
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
| | - Xuefeng Duan
- CAS Key Laboratory of Pathogenic Microbiology & Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Guangle Li
- Department of Mechanical Engineering, University of Hawaii at Mānoa, Honolulu, HI 96822, USA
| | - Yi Y. Zuo
- Department of Mechanical Engineering, University of Hawaii at Mānoa, Honolulu, HI 96822, USA
| | - Yu Qi
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yajun Liu
- Beijing Jishuitan Hospital, Peking University Health Science Center, Beijing 100035, China
| | - Guoliang Liu
- Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
| | - Iseult Lynch
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Min Fang
- CAS Key Laboratory of Pathogenic Microbiology & Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Sijin Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
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18
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Ranzani O, Alari A, Olmos S, Milà C, Rico A, Ballester J, Basagaña X, Chaccour C, Dadvand P, Duarte-Salles T, Foraster M, Nieuwenhuijsen M, Sunyer J, Valentín A, Kogevinas M, Lazcano U, Avellaneda-Gómez C, Vivanco R, Tonne C. Long-term exposure to air pollution and severe COVID-19 in Catalonia: a population-based cohort study. Nat Commun 2023; 14:2916. [PMID: 37225741 DOI: 10.1038/s41467-023-38469-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/02/2023] [Indexed: 05/26/2023] Open
Abstract
The association between long-term exposure to ambient air pollutants and severe COVID-19 is uncertain. We followed 4,660,502 adults from the general population in 2020 in Catalonia, Spain. Cox proportional models were fit to evaluate the association between annual averages of PM2.5, NO2, BC, and O3 at each participant's residential address and severe COVID-19. Higher exposure to PM2.5, NO2, and BC was associated with an increased risk of COVID-19 hospitalization, ICU admission, death, and hospital length of stay. An increase of 3.2 µg/m3 of PM2.5 was associated with a 19% (95% CI, 16-21) increase in hospitalizations. An increase of 16.1 µg/m3 of NO2 was associated with a 42% (95% CI, 30-55) increase in ICU admissions. An increase of 0.7 µg/m3 of BC was associated with a 6% (95% CI, 0-13) increase in deaths. O3 was positively associated with severe outcomes when adjusted by NO2. Our study contributes robust evidence that long-term exposure to air pollutants is associated with severe COVID-19.
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Affiliation(s)
- Otavio Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anna Alari
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sergio Olmos
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carles Milà
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alex Rico
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Ballester
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carlos Chaccour
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universidad de Navarra, Pamplona, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Payam Dadvand
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Maria Foraster
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- PHAGEX Research Group, Blanquerna School of Health Science, Universitat Ramon Llull (URL), Barcelona, Spain
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Sunyer
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antònia Valentín
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Manolis Kogevinas
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Uxue Lazcano
- Instituto Biodonostia, Grupo Atención Primaria, San Sebastian, Spain
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
| | | | - Rosa Vivanco
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
| | - Cathryn Tonne
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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19
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Bernhard GH, Madronich S, Lucas RM, Byrne SN, Schikowski T, Neale RE. Linkages between COVID-19, solar UV radiation, and the Montreal Protocol. Photochem Photobiol Sci 2023; 22:991-1009. [PMID: 36995652 PMCID: PMC10062285 DOI: 10.1007/s43630-023-00373-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 03/31/2023]
Abstract
There are several connections between coronavirus disease 2019 (COVID-19), solar UV radiation, and the Montreal Protocol. Exposure to ambient solar UV radiation inactivates SARS-CoV-2, the virus responsible for COVID-19. An action spectrum describing the wavelength dependence of the inactivation of SARS-CoV-2 by UV and visible radiation has recently been published. In contrast to action spectra that have been assumed in the past for estimating the effect of UV radiation on SARS-CoV-2, the new action spectrum has a large sensitivity in the UV-A (315-400 nm) range. If this "UV-A tail" is correct, solar UV radiation could be much more efficient in inactivating the virus responsible for COVID-19 than previously thought. Furthermore, the sensitivity of inactivation rates to the total column ozone would be reduced because ozone absorbs only a small amount of UV-A radiation. Using solar simulators, the times for inactivating SARS-CoV-2 have been determined by several groups; however, many measurements are affected by poorly defined experimental setups. The most reliable data suggest that 90% of viral particles embedded in saliva are inactivated within ~ 7 min by solar radiation for a solar zenith angle (SZA) of 16.5° and within ~ 13 min for a SZA of 63.4°. Slightly longer inactivation times were found for aerosolised virus particles. These times can become considerably longer during cloudy conditions or if virus particles are shielded from solar radiation. Many publications have provided evidence of an inverse relationship between ambient solar UV radiation and the incidence or severity of COVID-19, but the reasons for these negative correlations have not been unambiguously identified and could also be explained by confounders, such as ambient temperature, humidity, visible radiation, daylength, temporal changes in risk and disease management, and the proximity of people to other people. Meta-analyses of observational studies indicate inverse associations between serum 25-hydroxy vitamin D (25(OH)D) concentration and the risk of SARS-CoV-2 positivity or severity of COVID-19, although the quality of these studies is largely low. Mendelian randomisation studies have not found statistically significant evidence of a causal effect of 25(OH)D concentration on COVID-19 susceptibility or severity, but a potential link between vitamin D status and disease severity cannot be excluded as some randomised trials suggest that vitamin D supplementation is beneficial for people admitted to a hospital. Several studies indicate significant positive associations between air pollution and COVID-19 incidence and fatality rates. Conversely, well-established cohort studies indicate no association between long-term exposure to air pollution and infection with SARS-CoV-2. By limiting increases in UV radiation, the Montreal Protocol has also suppressed the inactivation rates of pathogens exposed to UV radiation. However, there is insufficient evidence to conclude that the expected larger inactivation rates without the Montreal Protocol would have had tangible consequences on the progress of the COVID-19 pandemic.
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Affiliation(s)
- G H Bernhard
- Biospherical Instruments Inc., San Diego, CA, USA.
| | - S Madronich
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, USA
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - S N Byrne
- Faculty of Medicine and Health, The University of Sydney, School of Medical Sciences, Sydney, Australia
| | - T Schikowski
- Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - R E Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
- School of Public Health, University of Queensland, Brisbane, Australia.
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20
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Bernhard GH, Bais AF, Aucamp PJ, Klekociuk AR, Liley JB, McKenzie RL. Stratospheric ozone, UV radiation, and climate interactions. Photochem Photobiol Sci 2023; 22:937-989. [PMID: 37083996 PMCID: PMC10120513 DOI: 10.1007/s43630-023-00371-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 04/14/2023]
Abstract
This assessment provides a comprehensive update of the effects of changes in stratospheric ozone and other factors (aerosols, surface reflectivity, solar activity, and climate) on the intensity of ultraviolet (UV) radiation at the Earth's surface. The assessment is performed in the context of the Montreal Protocol on Substances that Deplete the Ozone Layer and its Amendments and Adjustments. Changes in UV radiation at low- and mid-latitudes (0-60°) during the last 25 years have generally been small (e.g., typically less than 4% per decade, increasing at some sites and decreasing at others) and were mostly driven by changes in cloud cover and atmospheric aerosol content, caused partly by climate change and partly by measures to control tropospheric pollution. Without the Montreal Protocol, erythemal (sunburning) UV irradiance at northern and southern latitudes of less than 50° would have increased by 10-20% between 1996 and 2020. For southern latitudes exceeding 50°, the UV Index (UVI) would have surged by between 25% (year-round at the southern tip of South America) and more than 100% (South Pole in spring). Variability of erythemal irradiance in Antarctica was very large during the last four years. In spring 2019, erythemal UV radiation was at the minimum of the historical (1991-2018) range at the South Pole, while near record-high values were observed in spring 2020, which were up to 80% above the historical mean. In the Arctic, some of the highest erythemal irradiances on record were measured in March and April 2020. For example in March 2020, the monthly average UVI over a site in the Canadian Arctic was up to 70% higher than the historical (2005-2019) average, often exceeding this mean by three standard deviations. Under the presumption that all countries will adhere to the Montreal Protocol in the future and that atmospheric aerosol concentrations remain constant, erythemal irradiance at mid-latitudes (30-60°) is projected to decrease between 2015 and 2090 by 2-5% in the north and by 4-6% in the south due to recovering ozone. Changes projected for the tropics are ≤ 3%. However, in industrial regions that are currently affected by air pollution, UV radiation will increase as measures to reduce air pollutants will gradually restore UV radiation intensities to those of a cleaner atmosphere. Since most substances controlled by the Montreal Protocol are also greenhouse gases, the phase-out of these substances may have avoided warming by 0.5-1.0 °C over mid-latitude regions of the continents, and by more than 1.0 °C in the Arctic; however, the uncertainty of these calculations is large. We also assess the effects of changes in stratospheric ozone on climate, focusing on the poleward shift of climate zones, and discuss the role of the small Antarctic ozone hole in 2019 on the devastating "Black Summer" fires in Australia. Additional topics include the assessment of advances in measuring and modeling of UV radiation; methods for determining personal UV exposure; the effect of solar radiation management (stratospheric aerosol injections) on UV radiation relevant for plants; and possible revisions to the vitamin D action spectrum, which describes the wavelength dependence of the synthesis of previtamin D3 in human skin upon exposure to UV radiation.
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Affiliation(s)
- G H Bernhard
- Biospherical Instruments Inc, San Diego, CA, USA.
| | - A F Bais
- Laboratory of Atmospheric Physics, Department of Physics, Aristotle University, Thessaloniki, Greece.
| | - P J Aucamp
- Ptersa Environmental Consultants, Pretoria, South Africa
| | - A R Klekociuk
- Antarctic Climate Program, Australian Antarctic Division, Kingston, Australia
| | - J B Liley
- National Institute of Water & Atmospheric Research, Lauder, New Zealand
| | - R L McKenzie
- National Institute of Water & Atmospheric Research, Lauder, New Zealand
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21
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Stafoggia M, Ranzi A, Ancona C, Bauleo L, Bella A, Cattani G, Nobile F, Pezzotti P, Iavarone I. Long-Term Exposure to Ambient Air Pollution and Mortality among Four Million COVID-19 Cases in Italy: The EpiCovAir Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:57004. [PMID: 37167483 PMCID: PMC10174641 DOI: 10.1289/ehp11882] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
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.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - Carla Ancona
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Lisa Bauleo
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | | | - Giorgio Cattani
- Italian Institute for Environmental Protection and Research (ISPRA), Rome, Italy
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
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22
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Ruvira G, Ruvira-Durante J, Cosín-Sales J, Marín-García PJ, Llobat L. Environmental gaseous pollutants are related to increase of acute coronary syndrome in Valencia region. Med Clin (Barc) 2023:S0025-7753(23)00160-4. [PMID: 37088610 DOI: 10.1016/j.medcli.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION AND AIMS Environmental pollution are one of the most relevant risk factors to atherosclerosis. To know awareness about the importance of urban air pollution as a trigger for hospital admission due to acute coronary syndrome (ACS), this study analyzed levels of different gaseous air pollutants in the air and its correlation with number of ACS. METHODS Epidemiological data of patients admitted for ACS in five towns during the years 2006-2008 were recovered. Clinical data regarding admissions for ACS were obtained from the hospital admission services. Measures of seven air contaminants were recovered from the environmental stations. Mixed model including sex, age, location, and the average levels of air pollutants contaminants as fixed effects and its interaction were performed. RESULTS The incidence rate of ACS is higher in man than woman, and higher in older people than young. The maximum ACS were in the last trimester of the year, was the most elevated levels of gaseous pollutants have been found. Levels of NO2, NO, and CO are positively correlated between them, and negatively correlated with O3 levels. All air pollutants analyzed increase the number of ACS hospital admission in the five locations evaluated. CONCLUSIONS Levels of gaseous pollutants are related between them, being the levels of NO2, NO, and CO, positively correlated, and negatively correlated with levels of O3. Number of ACS hospital admission increases with levels of five air gaseous pollutants studied.
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Affiliation(s)
- Guillem Ruvira
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | | | - Juan Cosín-Sales
- Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain
| | - Pablo Jesús Marín-García
- Departamento de Producción y Sanidad Animal, Salud Pública y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Lola Llobat
- Departamento de Producción y Sanidad Animal, Salud Pública y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.
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23
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Porta M, Pumarega J, Gasull M, Aguilar R, Henríquez-Hernández LA, Basagaña X, Zumbado M, Villar-García J, Rius C, Mehta S, Vidal M, Jimenez A, Campi L, Lop J, Pérez Luzardo OL, Dobaño C, Moncunill G. Individual blood concentrations of persistent organic pollutants and chemical elements, and COVID-19: A prospective cohort study in Barcelona. ENVIRONMENTAL RESEARCH 2023; 223:115419. [PMID: 36740154 PMCID: PMC9898057 DOI: 10.1016/j.envres.2023.115419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND There is wide, largely unexplained heterogeneity in immunological and clinical responses to SARS-CoV-2 infection. Numerous environmental chemicals, such as persistent organic pollutants (POPs) and chemical elements (including some metals, essential trace elements, rare earth elements, and minority elements), are immunomodulatory and cause a range of adverse clinical events. There are no prospective studies on the effects of such substances on the incidence of SARS-CoV-2 infection and COVID-19. OBJECTIVE To investigate the influence of blood concentrations of POPs and elements measured several years before the pandemic on the development of SARS-CoV-2 infection and COVID-19 in individuals from the general population. METHODS We conducted a prospective cohort study in 154 individuals from the general population of Barcelona. POPs and elements were measured in blood samples collected in 2016-2017. SARS-CoV-2 infection was detected by rRT-PCR in nasopharyngeal swabs and/or by antibody serology using eighteen isotype-antigen combinations measured in blood samples collected in 2020-2021. We analyzed the associations between concentrations of the contaminants and SARS-CoV-2 infection and development of COVID-19, taking into account personal habits and living conditions during the pandemic. RESULTS Several historically prevalent POPs, as well as arsenic, cadmium, mercury, and zinc, were not associated with COVID-19, nor with SARS-CoV-2 infection. However, DDE (adjusted OR = 5.0 [95% CI: 1.2-21]), lead (3.9 [1.0-15]), thallium (3.4 [1.0-11]), and ruthenium (5.0 [1.8-14]) were associated with COVID-19, as were tantalum, benzo(b)fluoranthene, DDD, and manganese. Thallium (3.8 [1.6-8.9]), and ruthenium (2.9 [1.3-6.7]) were associated with SARS-CoV-2 infection, and so were lead, gold, and (protectively) iron and selenium. We identified mixtures of up to five substances from several chemical groups, with all substances independently associated to the outcomes. CONCLUSIONS Our results provide the first prospective and population-based evidence of an association between individual concentrations of some contaminants and COVID-19 and SARS-CoV-2 infection. POPs and elements may contribute to explain the heterogeneity in the development of SARS-CoV-2 infection and COVID-19 in the general population. If the associations are confirmed as causal, means are available to mitigate the corresponding risks.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - José Pumarega
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Magda Gasull
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Luis A Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences, Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Xavier Basagaña
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; ISGlobal - PSMar - PRBB, Barcelona, Spain
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences, Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | | | - Cristina Rius
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Sneha Mehta
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; Columbia Mailman School of Public Health, New York, USA
| | - Marta Vidal
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Alfons Jimenez
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Laura Campi
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Lop
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain
| | - Octavio L Pérez Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences, Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Carlota Dobaño
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
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24
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Sheppard N, Carroll M, Gao C, Lane T. Particulate matter air pollution and COVID-19 infection, severity, and mortality: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163272. [PMID: 37030371 PMCID: PMC10079587 DOI: 10.1016/j.scitotenv.2023.163272] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/14/2023]
Abstract
Ecological evidence links ambient particulate matter ≤2.5 mm (PM2.5) and the rate of COVID-19 infections, severity, and deaths. However, such studies are unable to account for individual-level differences in major confounders like socioeconomic status and often rely on imprecise measures of PM2.5. We conducted a systematic review of case-control and cohort studies, which rely on individual-level data, searching Medline, Embase, and the WHO COVID-19 database up to 30 June 2022. Study quality was evaluated using the Newcastle-Ottawa Scale. Results were pooled with a random effects meta-analysis, with Egger's regression, funnel plots, and leave-one-out/trim-and-fill sensitivity analyses to account for publication bias. N = 18 studies met inclusion criteria. A 10 μg/m3 increase in PM2.5 was associated with 66 % (95 % CI: 1.31-2.11) greater odds of COVID-19 infection (N = 7) and 127 % (95 % CI: 1.41-3.66) odds of severe illness (hospitalisation, ICU admission, or requiring respiratory support) (N = 6). Pooled mortality results (N = 5) indicated increased deaths due to PM2.5 but were non-significant (OR 1.40; 0.94 to 2.10). Most studies were rated "good" quality (14/18 studies), though there were numerous methodological issues; few used individual-level data to adjust for socioeconomic status (4/18 studies), instead using area-based indicators (11/18 studies) or no such adjustments (3/18 studies). Most severity (9/10 studies) and mortality studies (5/6 studies) were based on people already diagnosed COVID-19, potentially introducing collider bias. There was evidence of publication bias in studies of infection (p = 0.012) but not severity (p = 0.132) or mortality (p = 0.100). While methodological limits and evidence of bias require cautious interpretation of the findings, we found compelling evidence that PM2.5 increases the risk of COVID-19 infection and severe disease, and weaker evidence of an increase in mortality risk.
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Affiliation(s)
- Nicola Sheppard
- Monash School of Medicine, Monash University, Clayton, Victoria, Australia
| | - Matthew Carroll
- Monash Rural Health Churchill, Monash University, Churchill, VIC, Australia
| | - Caroline Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Tyler Lane
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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25
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Kogevinas M, Karachaliou M, Espinosa A, Aguilar R, Castaño-Vinyals G, Garcia-Aymerich J, Carreras A, Cortés B, Pleguezuelos V, Papantoniou K, Rubio R, Jiménez A, Vidal M, Serra P, Parras D, Santamaría P, Izquierdo L, Cirach M, Nieuwenhuijsen M, Dadvand P, Straif K, Moncunill G, de Cid R, Dobaño C, Tonne C. Long-Term Exposure to Air Pollution and COVID-19 Vaccine Antibody Response in a General Population Cohort (COVICAT Study, Catalonia). ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47001. [PMID: 37017430 PMCID: PMC10075082 DOI: 10.1289/ehp11989] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/05/2023] [Accepted: 02/22/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Ambient air pollution has been associated with COVID-19 disease severity and antibody response induced by infection. OBJECTIVES We examined the association between long-term exposure to air pollution and vaccine-induced antibody response. METHODS This study was nested in an ongoing population-based cohort, COVICAT, the GCAT-Genomes for Life cohort, in Catalonia, Spain, with multiple follow-ups. We drew blood samples in 2021 from 1,090 participants of 2,404 who provided samples in 2020, and we included 927 participants in this analysis. We measured immunoglobulin M (IgM), IgG, and IgA antibodies against five viral-target antigens, including receptor-binding domain (RBD), spike-protein (S), and segment spike-protein (S2) triggered by vaccines available in Spain. We estimated prepandemic (2018-2019) exposure to fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)], nitrogen dioxide (NO2), black carbon (BC), and ozone (O3) using Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) models. We adjusted estimates for individual- and area-level covariates, time since vaccination, and vaccine doses and type and stratified by infection status. We used generalized additive models to explore the relationship between air pollution and antibodies according to days since vaccination. RESULTS Among vaccinated persons not infected by SARS-CoV-2 (n=632), higher prepandemic air pollution levels were associated with a lower vaccine antibody response for IgM (1 month post vaccination) and IgG. Percentage change in geometric mean IgG levels per interquartile range of PM2.5 (1.7 μg/m3) were -8.1 (95% CI: -15.9, 0.4) for RBD, -9.9 (-16.2, -3.1) for S, and -8.4 (-13.5, -3.0) for S2. We observed a similar pattern for NO2 and BC and an inverse pattern for O3. Differences in IgG levels by air pollution levels persisted with time since vaccination. We did not observe an association of air pollution with vaccine antibody response among participants with prior infection (n=295). DISCUSSION Exposure to air pollution was associated with lower COVID-19 vaccine antibody response. The implications of this association on the risk of breakthrough infections require further investigation. https://doi.org/10.1289/EHP11989.
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Affiliation(s)
- Manolis Kogevinas
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Ana Espinosa
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Ruth Aguilar
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Gemma Castaño-Vinyals
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Carreras
- Genomes for Life-GCAT lab Group, Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Beatriz Cortés
- Genomes for Life-GCAT lab Group, Germans Trias i Pujol Research Institute, Badalona, Spain
| | | | - Kyriaki Papantoniou
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Rocío Rubio
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Alfons Jiménez
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - Marta Vidal
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Pau Serra
- Institut d’Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
| | - Daniel Parras
- Institut d’Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
| | - Pere Santamaría
- Institut d’Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Luis Izquierdo
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Enfermedades Infecciosas, Barcelona, Spain
| | - Marta Cirach
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Payam Dadvand
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Kurt Straif
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Gemma Moncunill
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Enfermedades Infecciosas, Barcelona, Spain
| | - Rafael de Cid
- Genomes for Life-GCAT lab Group, Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Carlota Dobaño
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Enfermedades Infecciosas, Barcelona, Spain
| | - Cathryn Tonne
- Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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26
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Yu Q, Cao W, Hamer D, Urbanek N, Straif-Bourgeois S, Cormier SA, Ferguson T, Richmond-Bryant J. Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020-August 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4611. [PMID: 36901619 PMCID: PMC10001987 DOI: 10.3390/ijerph20054611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.
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Affiliation(s)
- Qingzhao Yu
- Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Wentao Cao
- Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Diana Hamer
- Division of Academic Affairs, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA
| | - Norman Urbanek
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
| | - Susanne Straif-Bourgeois
- Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Stephania A. Cormier
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Tekeda Ferguson
- Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Jennifer Richmond-Bryant
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
- Center for Geospatial Analytics, North Carolina State University, Raleigh, NC 27695, USA
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27
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Baretta D, Koch S, Cobo I, Castaño-Vinyals G, de Cid R, Carreras A, Buekers J, Garcia-Aymerich J, Inauen J, Chevance G. Resilience characterized and quantified from physical activity data: A tutorial in R. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 65:102361. [PMID: 37665834 DOI: 10.1016/j.psychsport.2022.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/25/2022] [Accepted: 12/05/2022] [Indexed: 09/06/2023]
Abstract
Consistent physical activity is key for health and well-being, but it is vulnerable to stressors. The process of recovering from such stressors and bouncing back to the previous state of physical activity can be referred to as resilience. Quantifying resilience is fundamental to assess and manage the impact of stressors on consistent physical activity. In this tutorial, we present a method to quantify the resilience process from physical activity data. We leverage the prior operationalization of resilience, as used in various psychological domains, as area under the curve and expand it to suit the characteristics of physical activity time series. As use case to illustrate the methodology, we quantified resilience in step count time series (length = 366 observations) for eight participants following the first COVID-19 lockdown as a stressor. Steps were assessed daily using wrist-worn devices. The methodology is implemented in R and all coding details are included. For each person's time series, we fitted multiple growth models and identified the best one using the Root Mean Squared Error (RMSE). Then, we used the predicted values from the selected model to identify the point in time when the participant recovered from the stressor and quantified the resulting area under the curve as a measure of resilience for step count. Further resilience features were extracted to capture the different aspects of the process. By developing a methodological guide with a step-by-step implementation, we aimed at fostering increased awareness about the concept of resilience for physical activity and facilitate the implementation of related research.
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Affiliation(s)
- Dario Baretta
- Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.
| | - Sarah Koch
- Barcelona Institute for Global Health (ISGlobal), C/ Doctor Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Inés Cobo
- Barcelona Institute for Global Health (ISGlobal), C/ Doctor Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Gemma Castaño-Vinyals
- Barcelona Institute for Global Health (ISGlobal), C/ Doctor Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Rafael de Cid
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Camí de Les Escoles s/n, 08916, Badalona, Barcelona, Spain
| | - Anna Carreras
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Camí de Les Escoles s/n, 08916, Badalona, Barcelona, Spain
| | - Joren Buekers
- Barcelona Institute for Global Health (ISGlobal), C/ Doctor Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health (ISGlobal), C/ Doctor Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Jennifer Inauen
- Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Guillaume Chevance
- Barcelona Institute for Global Health (ISGlobal), C/ Doctor Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
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Ambient air pollution exposure linked to long COVID among young adults: a nested survey in a population-based cohort in Sweden. Lancet Reg Health Eur 2023; 28:100608. [PMID: 37131862 PMCID: PMC9989696 DOI: 10.1016/j.lanepe.2023.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 03/09/2023] Open
Abstract
Background Post COVID-19 conditions, also known as long COVID, are of public health concern, but little is known about their underlying risk factors. We aimed to investigate associations of air pollution exposure with long COVID among Swedish young adults. Methods We used data from the BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology [in Swedish]) cohort. From October 2021 to February 2022 participants answered a web-questionnaire focusing on persistent symptoms following acute SARS-CoV-2 infection. Long COVID was defined as symptoms after confirmed infection with SARS-CoV-2 lasting for two months or longer. Ambient air pollution levels (particulate matter ≤2.5 μm [PM2.5], ≤10 μm [PM10], black carbon [BC] and nitrogen oxides [NOx]) at individual-level addresses were estimated using dispersion modelling. Findings A total of 753 participants with SARS-CoV-2 infection were included of whom 116 (15.4%) reported having long COVID. The most common symptoms were altered smell/taste (n = 80, 10.6%), dyspnea (n = 36, 4.8%) and fatigue (n = 34, 4.5%). Median annual PM2.5 exposure in 2019 (pre-pandemic) was 6.39 (interquartile range [IQR] 6.06-6.71) μg/m3. Adjusted Odds Ratios (95% confidence intervals) of PM2.5 per IQR increase were 1.28 (1.02-1.60) for long COVID, 1.65 (1.09-2.50) for dyspnea symptoms and 1.29 (0.97-1.70) for altered smell/taste. Positive associations were found for the other air pollutants and remained consistent across sensitivity analyses. Associations tended to be stronger among participants with asthma, and those having had COVID during 2020 (versus 2021). Interpretation Ambient long-term PM2.5 exposure may affect the risk of long COVID in young adults, supporting efforts for continuously improving air quality. Funding The study received funding from the Swedish Research Council (grant no. 2020-01886, 2022-06340), the Swedish Research Council for Health, Working life and Welfare (FORTE grant no. 2017-01146), the Swedish Heart-Lung Foundation, Karolinska Institute (no. 2022-01807) and Region Stockholm (ALF project for cohort and database maintenance).
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Podury S, Kwon S, Javed U, Farooqi MS, Li Y, Liu M, Grunig G, Nolan A. Severe Acute Respiratory Syndrome and Particulate Matter Exposure: A Systematic Review. Life (Basel) 2023; 13:538. [PMID: 36836898 PMCID: PMC9962044 DOI: 10.3390/life13020538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Particulate matter (PM) exposure is responsible for seven million deaths annually and has been implicated in the pathogenesis of respiratory infections such as severe acute respiratory syndrome (SARS). Understanding modifiable risk factors of high mortality, resource burdensome C19 and exposure risks such as PM is key to mitigating their devastating effects. This systematic review focuses on the literature available, identifying the spatial and temporal variation in the role of quantified PM exposure in SARS disease outcome and planning our future experimental studies. METHODS The systematic review utilized keywords adhered to the PRISMA guidelines. We included original human research studies in English. RESULTS Initial search yielded N = 906, application of eligibility criteria yielded N = 46. Upon analysis of risk of bias N = 41 demonstrated high risk. Studies found a positive association between elevated PM2.5, PM10 and SARS-related outcomes. A geographic and temporal variation in both PM and C19's role was observed. CONCLUSION C19 is a high mortality and resource intensive disease which devastated the globe. PM exposure is also a global health crisis. Our systematic review focuses on the intersection of this impactful disease-exposure dyad and understanding the role of PM is important in the development of interventions to prevent future spread of viral infections.
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Affiliation(s)
- Sanjiti Podury
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (S.P.); (S.K.); (U.J.); (M.S.F.)
| | - Sophia Kwon
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (S.P.); (S.K.); (U.J.); (M.S.F.)
| | - Urooj Javed
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (S.P.); (S.K.); (U.J.); (M.S.F.)
| | - Muhammad S. Farooqi
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (S.P.); (S.K.); (U.J.); (M.S.F.)
| | - Yiwei Li
- Department of Population Health, Division of Biostatistics, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (Y.L.); (M.L.)
| | - Mengling Liu
- Department of Population Health, Division of Biostatistics, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (Y.L.); (M.L.)
- Department of Medicine, Division of Environmental Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA;
| | - Gabriele Grunig
- Department of Medicine, Division of Environmental Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA;
| | - Anna Nolan
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA; (S.P.); (S.K.); (U.J.); (M.S.F.)
- Department of Medicine, Division of Environmental Medicine, New York University Grossman School of Medicine (NYUGSoM), New York, NY 10016, USA;
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Zsichla L, Müller V. Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors. Viruses 2023; 15:175. [PMID: 36680215 PMCID: PMC9863423 DOI: 10.3390/v15010175] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The clinical course and outcome of COVID-19 are highly variable, ranging from asymptomatic infections to severe disease and death. Understanding the risk factors of severe COVID-19 is relevant both in the clinical setting and at the epidemiological level. Here, we provide an overview of host, viral and environmental factors that have been shown or (in some cases) hypothesized to be associated with severe clinical outcomes. The factors considered in detail include the age and frailty, genetic polymorphisms, biological sex (and pregnancy), co- and superinfections, non-communicable comorbidities, immunological history, microbiota, and lifestyle of the patient; viral genetic variation and infecting dose; socioeconomic factors; and air pollution. For each category, we compile (sometimes conflicting) evidence for the association of the factor with COVID-19 outcomes (including the strength of the effect) and outline possible action mechanisms. We also discuss the complex interactions between the various risk factors.
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Affiliation(s)
- Levente Zsichla
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
| | - Viktor Müller
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
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Coker ES, Molitor J, Liverani S, Martin J, Maranzano P, Pontarollo N, Vergalli S. Bayesian profile regression to study the ecologic associations of correlated environmental exposures with excess mortality risk during the first year of the Covid-19 epidemic in lombardy, Italy. ENVIRONMENTAL RESEARCH 2023; 216:114484. [PMID: 36220446 PMCID: PMC9547389 DOI: 10.1016/j.envres.2022.114484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Many countries, including Italy, have experienced significant social and spatial inequalities in mortality during the Covid-19 pandemic. This study applies a multiple exposures framework to investigate how joint place-based factors influence spatial inequalities of excess mortality during the first year of the Covid -19 pandemic in the Lombardy region of Italy. For the Lombardy region, we integrated municipality-level data on all-cause mortality between 2015 and 2020 with 13 spatial covariates, including 5-year average concentrations of six air pollutants, the average temperature in 2020, and multiple socio-demographic factors, and health facilities per capita. Using the clustering algorithm Bayesian profile regression, we fit spatial covariates jointly to identify clusters of municipalities with similar exposure profiles and estimated associations between clusters and excess mortality in 2020. Cluster analysis resulted in 13 clusters. Controlling for spatial autocorrelation of excess mortality and health-protective agency, two clusters had significantly elevated excess mortality than the rest of Lombardy. Municipalities in these highest-risk clusters are in Bergamo, Brescia, and Cremona provinces. The highest risk cluster (C11) had the highest long-term particulate matter air pollution levels (PM2.5 and PM10) and significantly elevated NO2 and CO air pollutants, temperature, proportion ≤18 years, and male-to-female ratio. This cluster is significantly lower for income and ≥65 years. The other high-risk cluster, Cluster 10 (C10), is elevated significantly for ozone but significantly lower for other air pollutants. Covariates with elevated levels for C10 include proportion 65 years or older and a male-to-female ratio. Cluster 10 is significantly lower for income, temperature, per capita health facilities, ≤18 years, and population density. Our results suggest that joint built, natural, and socio-demographic factors influenced spatial inequalities of excess mortality in Lombardy in 2020. Studies must apply a multiple exposures framework to guide policy decisions addressing the complex and multi-dimensional nature of spatial inequalities of Covid-19-related mortality.
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Affiliation(s)
- Eric S Coker
- Department of Environmental and Global Health, University of Florida, 1225 Center Dr, Gainesville, FL, 32610, United States.
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Milam Hall 157, 2520 SW Campus Way, Corvallis, OR, 97331, United States.
| | - Silvia Liverani
- School of Mathematical Sciences, Queen Mary University of London, Mile End Road London E1 4NS, United Kingdom.
| | - James Martin
- Department of Environmental and Global Health, University of Florida, 1225 Center Dr, Gainesville, FL, 32610, United States
| | - Paolo Maranzano
- Department of Economics, Management and Statistics of the University of Milano-Bicocca (UniMiB), Piazza Dell'Ateneo Nuovo, 1 - 20126, Milano, Italy.
| | - Nicola Pontarollo
- Department of Economics and Management, Università Degli Studi di Brescia, Brescia, Via S. Faustino 74/B, 25122, Brescia, Italy.
| | - Sergio Vergalli
- Department of Agricultural Economics, Università Cattolica Del Sacro Cuore, Piacenza, Via Emilia Parmense, 29122, Piacenza PC, Italy.
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Granados G, Sáez-López M, Aljama C, Sampol J, Cruz MJ, Ferrer J. Asbestos Exposure and Severity of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16305. [PMID: 36498378 PMCID: PMC9739528 DOI: 10.3390/ijerph192316305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The aim of this study was to analyse the relationship between occupational exposure to asbestos and the severity of SARS-CoV-2 infection. METHODS We evaluated patients who survived admission in our centre for COVID-19 pneumonia. Demographic, analytical, and clinical variables were collected during admission. After discharge, a previously validated occupational exposure to asbestos questionnaire was administered. Spirometry, CO diffusion test, the 6-min walk test, and high-resolution chest CT were performed. Patients who required respiratory support (oxygen, CPAP, or NIV) were considered severe. RESULTS In total, 293 patients (mean age 54 + 13 years) were included. Occupational exposure to asbestos was detected in 67 (24%). Patients with occupational exposure to asbestos had a higher frequency of COVID-19 pneumonia requiring respiratory support (n = 52, 77.6%) than their unexposed peers (n = 139, 61.5%) (p = 0.015). Asbestos exposure was associated with COVID-19 severity in the univariate but not in the multivariate analysis. No differences were found regarding follow-up variables including spirometry and the DLCO diffusion, the 6-min walk test, and CT alterations. CONCLUSIONS In hospitalised patients with COVID-19 pneumonia, those with occupational exposure to asbestos more frequently needed respiratory support. However, an independent association between asbestos exposure and COVID-19 severity could not be confirmed.
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Affiliation(s)
- Galo Granados
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Respiratory Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - María Sáez-López
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
| | - Cristina Aljama
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
| | - Júlia Sampol
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
- Department of Respiratory Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - María-Jesús Cruz
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Respiratory Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Jaume Ferrer
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Respiratory Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Se-COVID-19 Team
- Department of Respiratory Medicine, Vall d’Hebron University Hospital, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain
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D'Isidoro M, D'Elia I, Vitali L, Briganti G, Cappelletti A, Piersanti A, Finardi S, Calori G, Pepe N, Di Giosa A, Bolignano A, Zanini G. Lessons learnt for air pollution mitigation policies from the COVID-19 pandemic: The Italian perspective. ATMOSPHERIC POLLUTION RESEARCH 2022; 13:101620. [PMID: 36474671 PMCID: PMC9716127 DOI: 10.1016/j.apr.2022.101620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/01/2023]
Abstract
Policies to improve air quality need to be based on effective plans for reducing anthropogenic emissions. In 2020, the outbreak of COVID-19 pandemic resulted in significant reductions of anthropogenic pollutant emissions, offering an unexpected opportunity to observe their consequences on ambient concentrations. Taking the national lockdown occurred in Italy between March and May 2020 as a case study, this work tries to infer if and what lessons may be learnt concerning the impact of emission reduction policies on air quality. Variations of NO2, O3, PM10 and PM2.5 concentrations were calculated from numerical model simulations obtained with business as usual and lockdown specific emissions. Both simulations were performed at national level with a horizontal resolution of 4 km, and at local level on the capital city Rome at 1 km resolution. Simulated concentrations showed a good agreement with in-situ observations, confirming the modelling systems capability to reproduce the effects of emission reductions on ambient concentration variations, which differ according to the individual air pollutant. We found a general reduction of pollutant concentrations except for ozone, that experienced an increase in Rome and in the other urban areas, and a decrease elsewhere. The obtained results suggest that acting on precursor emissions, even with sharp reductions like those experienced during the lockdown, may lead to significant, albeit complex, reduction patterns for secondary pollutant concentrations. Therefore, to be more effective, reduction measures should be carefully selected, involving more sectors than those related to mobility, such as residential and agriculture, and integrated on different scales.
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Affiliation(s)
- Massimo D'Isidoro
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
| | - Ilaria D'Elia
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
| | - Lina Vitali
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
| | - Gino Briganti
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
| | - Andrea Cappelletti
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
| | - Antonio Piersanti
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
| | | | | | | | | | - Andrea Bolignano
- ARPA-Lazio Environmental Protection Agency of the Lazio Region, Rome, Italy
| | - Gabriele Zanini
- ENEA - Italian Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
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Delgado-Ortiz L, Carsin AE, Merino J, Cobo I, Koch S, Goldberg X, Chevance G, Bosch de Basea M, Castaño-Vinyals G, Espinosa A, Carreras A, Cortes Martínez B, Straif K, de Cid R, Kogevinas M, Garcia-Aymerich J. Changes in Population Health-Related Behaviors During a COVID-19 Surge: A Natural Experiment. Ann Behav Med 2022; 57:216-226. [PMID: 36394497 PMCID: PMC10074031 DOI: 10.1093/abm/kaac054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
The study of impact of lockdowns on individual health-related behaviors has produced divergent results.
Purpose
To identify patterns of change in multiple health-related behaviors analyzed as a whole, and their individual determinants.
Methods
Between March and August 2020, we collected data on smoking, alcohol, physical activity, weight, and sleep in a population-based cohort from Catalonia who had available pre-pandemic data. We performed multiple correspondence and cluster analyses to identify patterns of change in health-related behaviors and built multivariable multinomial logistic regressions to identify determinants of behavioral change.
Results
In 10,032 participants (59% female, mean (SD) age 55 (8) years), 8,606 individuals (86%) modified their behavior during the lockdown. We identified five patterns of behavioral change that were heterogeneous and directed both towards worsening and improvement in diverse combinations. Patterns ranged from “global worsening” (2,063 participants, 21%) characterized by increases in smoking, alcohol consumption, and weight, and decreases in physical activity levels and sleep time, to “improvement” (2,548 participants, 25%) characterized by increases in physical activity levels, decreases in weight and alcohol consumption, and both increases and decreases in sleep time. Being female, of older age, teleworking, having a higher education level, assuming caregiving responsibilities, and being more exposed to pandemic news were associated with changing behavior (all p < .05), but did not discriminate between favorable or unfavorable changes.
Conclusions
Most of the population experienced changes in health-related behavior during lockdowns. Determinants of behavior modification were not explicitly associated with the direction of changes but allowed the identification of older, teleworking, and highly educated women who assumed caregiving responsibilities at home as susceptible population groups more vulnerable to lockdowns.
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Affiliation(s)
- Laura Delgado-Ortiz
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Anne-Elie Carsin
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
| | - Jordi Merino
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital , Boston, MA , USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard , Cambridge, MA , USA
- Department of Medicine, Harvard Medical School , Boston, MA , USA
| | - Inés Cobo
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Sarah Koch
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Ximena Goldberg
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Guillaume Chevance
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
| | - Magda Bosch de Basea
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Gemma Castaño-Vinyals
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
| | - Ana Espinosa
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
| | - Anna Carreras
- Germans Trias i Pujol Research Institute (IGTP), Genomes for Life-GCAT , Badalona , Spain
| | | | - Kurt Straif
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Global Public Health and the Common Good Program, Boston College , MA , USA
| | - Rafael de Cid
- Germans Trias i Pujol Research Institute (IGTP), Genomes for Life-GCAT , Badalona , Spain
| | - Manolis Kogevinas
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
| | - Judith Garcia-Aymerich
- Non-Communicable Diseases and Environment Program, Barcelona Institute for Global Health (ISGlobal) , Barcelona , Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
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Álvaro-Meca A, Sepúlveda-Crespo D, Resino R, Ryan P, Martínez I, Resino S. Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study. Environ Health 2022; 21:107. [PMID: 36348411 PMCID: PMC9640778 DOI: 10.1186/s12940-022-00928-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults. METHODS We conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain's State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values). RESULTS Almost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O3 and higher values of relative humidity and NO2. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO2 [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O3 [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM10 at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI. CONCLUSION Unfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO2, O3, PM10, and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Rosa Resino
- Departamento de Geografía, Facultad de Geografía e Historia, Universidad Complutense de Madrid, Madrid, Spain
| | - Pablo Ryan
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigaciones Sanitarias Gregorio Marañón (IiSGM), Madrid, Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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English PB, Von Behren J, Balmes JR, Boscardin J, Carpenter C, Goldberg DE, Horiuchi S, Richardson M, Solomon G, Valle J, Reynolds P. Association between long-term exposure to particulate air pollution with SARS-CoV-2 infections and COVID-19 deaths in California, U.S.A. ENVIRONMENTAL ADVANCES 2022; 9:100270. [PMID: 35912397 PMCID: PMC9316717 DOI: 10.1016/j.envadv.2022.100270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 05/08/2023]
Abstract
Previous studies have reported associations between air pollution and COVID-19 morbidity and mortality, but most have limited their exposure assessment to a large area, have not used individual-level variables, nor studied infections. We examined 3.1 million SARS-CoV-2 infections and 49,691 COVID-19 deaths that occurred in California from February 2020 to February 2021 to evaluate risks associated with long-term neighborhood concentrations of particulate matter less than 2.5 μm in diameter (PM2.5). We obtained individual address data on SARS-CoV-2 infections and COVID-19 deaths and assigned 2000-2018 1km-1km gridded PM2.5 surfaces to census block groups. We included individual covariate data on age and sex, and census block data on race/ethnicity, air basin, Area Deprivation Index, and relevant comorbidities. Our analyses were based on generalized linear mixed models utilizing a Poisson distribution. Those living in the highest quintile of long-term PM2.5 exposure had risks of SARS-CoV-2 infections 20% higher and risks of COVID-19 mortality 51% higher, compared to those living in the lowest quintile of long-term PM2.5 exposure. Those living in the areas of highest long-term PM2.5 exposure were more likely to be Hispanic and more vulnerable, based on the Area Deprivation Index. The increased risks for SARS-CoV-2 Infections and COVID-19 mortality associated with highest long-term PM2.5 concentrations at the neighborhood-level in California were consistent with a growing body of literature from studies worldwide, and further highlight the importance of reducing levels of air pollution to protect public health.
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Affiliation(s)
- Paul B English
- Tracking California Public Health Institute, 555 12th St., Suite 290, Oakland, CA 94607, United States
| | - Julie Von Behren
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - John R Balmes
- Department of Medicine, University of California, San Francisco, CA, United States
| | - John Boscardin
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Catherine Carpenter
- Tracking California Public Health Institute, 555 12th St., Suite 290, Oakland, CA 94607, United States
| | - Debbie E Goldberg
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Sophia Horiuchi
- Tracking California Public Health Institute, 555 12th St., Suite 290, Oakland, CA 94607, United States
| | - Maxwell Richardson
- Tracking California Public Health Institute, 555 12th St., Suite 290, Oakland, CA 94607, United States
| | - Gina Solomon
- Tracking California Public Health Institute, 555 12th St., Suite 290, Oakland, CA 94607, United States
- Department of Medicine, University of California, San Francisco, CA, United States
| | - Jhaqueline Valle
- Tracking California Public Health Institute, 555 12th St., Suite 290, Oakland, CA 94607, United States
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
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Sheridan C, Klompmaker J, Cummins S, James P, Fecht D, Roscoe C. Associations of air pollution with COVID-19 positivity, hospitalisations, and mortality: Observational evidence from UK Biobank. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 308:119686. [PMID: 35779662 PMCID: PMC9243647 DOI: 10.1016/j.envpol.2022.119686] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 05/26/2023]
Abstract
Individual-level studies with adjustment for important COVID-19 risk factors suggest positive associations of long-term air pollution exposure (particulate matter and nitrogen dioxide) with COVID-19 infection, hospitalisations and mortality. The evidence, however, remains limited and mechanisms unclear. We aimed to investigate these associations within UK Biobank, and to examine the role of underlying chronic disease as a potential mechanism. UK Biobank COVID-19 positive laboratory test results were ascertained via Public Health England and general practitioner record linkage, COVID-19 hospitalisations via Hospital Episode Statistics, and COVID-19 mortality via Office for National Statistics mortality records from March-December 2020. We used annual average outdoor air pollution modelled at 2010 residential addresses of UK Biobank participants who resided in England (n = 424,721). We obtained important COVID-19 risk factors from baseline UK Biobank questionnaire responses (2006-2010) and general practitioner record linkage. We used logistic regression models to assess associations of air pollution with COVID-19 outcomes, adjusted for relevant confounders, and conducted sensitivity analyses. We found positive associations of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) with COVID-19 positive test result after adjustment for confounders and COVID-19 risk factors, with odds ratios of 1.05 (95% confidence intervals (CI) = 1.02, 1.08), and 1.05 (95% CI = 1.01, 1.08), respectively. PM 2.5 and NO 2 were positively associated with COVID-19 hospitalisations and deaths in minimally adjusted models, but not in fully adjusted models. No associations for PM10 were found. In analyses with additional adjustment for pre-existing chronic disease, effect estimates were not substantially attenuated, indicating that underlying chronic disease may not fully explain associations. We found some evidence that long-term exposure to PM2.5 and NO2 was associated with a COVID-19 positive test result in UK Biobank, though not with COVID-19 hospitalisations or deaths.
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Affiliation(s)
- Charlotte Sheridan
- London School of Hygiene & Tropical Medicine, Keppel St., London, WC1E 7HT, United Kingdom.
| | - Jochem Klompmaker
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States.
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St., London, United Kingdom.
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, United States.
| | - Daniela Fecht
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Medicine, St Mary's Campus, Imperial College London, London, W2 1PG, United Kingdom.
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States; MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Medicine, St Mary's Campus, Imperial College London, London, W2 1PG, United Kingdom; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, United States.
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Chen Z, Sidell MA, Huang BZ, Chow T, Eckel SP, Martinez MP, Gheissari R, Lurmann F, Thomas DC, Gilliland FD, Xiang AH. Ambient Air Pollutant Exposures and COVID-19 Severity and Mortality in a Cohort of Patients with COVID-19 in Southern California. Am J Respir Crit Care Med 2022; 206:440-448. [PMID: 35537137 DOI: 10.1164/rccm.202108-1909oc] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Rationale: Ecological studies have shown air pollution associations with coronavirus disease (COVID-19) outcomes. However, few cohort studies have been conducted. Objectives: To conduct a cohort study investigating the association between air pollution and COVID-19 severity using individual-level data from the electronic medical record. Methods: This cohort included all individuals who received diagnoses of COVID-19 from Kaiser Permanente Southern California between March 1 and August 31, 2020. One-year and 1-month averaged ambient air pollutant (particulate matter ⩽2.5 μm in aerodynamic diameter [PM2.5], NO2, and O3) exposures before COVID-19 diagnosis were estimated on the basis of residential address history. Outcomes included COVID-19-related hospitalizations, intensive respiratory support (IRS), and ICU admissions within 30 days and mortality within 60 days after COVID-19 diagnosis. Covariates included socioeconomic characteristics and comorbidities. Measurements and Main Results: Among 74,915 individuals (mean age, 42.5 years; 54% women; 66% Hispanic), rates of hospitalization, IRS, ICU admission, and mortality were 6.3%, 2.4%, 1.5%, and 1.5%, respectively. Using multipollutant models adjusted for covariates, 1-year PM2.5 and 1-month NO2 average exposures were associated with COVID-19 severity. The odds ratios associated with a 1-SD increase in 1-year PM2.5 (SD, 1.5 μg/m3) were 1.24 (95% confidence interval [CI], 1.16-1.32) for COVID-19-related hospitalization, 1.33 (95% CI, 1.20-1.47) for IRS, and 1.32 (95% CI, 1.16-1.51) for ICU admission; the corresponding odds ratios associated with 1-month NO2 (SD, 3.3 ppb) were 1.12 (95% CI, 1.06-1.17) for hospitalization, 1.18 (95% CI, 1.10-1.27) for IRS, and 1.21 (95% CI, 1.11-1.33) for ICU admission. The hazard ratios for mortality were 1.14 (95% CI, 1.02-1.27) for 1-year PM2.5 and 1.07 (95% CI, 0.98-1.16) for 1-month NO2. No significant interactions with age, sex or ethnicity were observed. Conclusions: Ambient PM2.5 and NO2 exposures may affect COVID-19 severity and mortality.
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Affiliation(s)
- Zhanghua Chen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Margo A Sidell
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Brian Z Huang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Ting Chow
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Sandrah P Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mayra P Martinez
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Roya Gheissari
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Duncan C Thomas
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank D Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
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Casey JA, Kioumourtzoglou MA, Ogburn EL, Melamed A, Shaman J, Kandula S, Neophytou A, Darwin KC, Sheffield JS, Gyamfi-Bannerman C. Long-Term Fine Particulate Matter Concentrations and Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2: Differential Relationships by Socioeconomic Status Among Pregnant Individuals in New York City. Am J Epidemiol 2022; 191:1897-1905. [PMID: 35916364 PMCID: PMC9384549 DOI: 10.1093/aje/kwac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
We aimed to determine whether long-term ambient concentrations of fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5)) were associated with increased risk of testing positive for coronavirus disease 2019 (COVID-19) among pregnant individuals who were universally screened at delivery and whether socioeconomic status (SES) modified this relationship. We used obstetrical data collected from New-York Presbyterian Hospital/Columbia University Irving Medical Center in New York, New York, between March and December 2020, including data on Medicaid use (a proxy for low SES) and COVID-19 test results. We linked estimated 2018-2019 PM2.5 concentrations (300-m resolution) with census-tract-level population density, household size, income, and mobility (as measured by mobile-device use) on the basis of residential address. Analyses included 3,318 individuals; 5% tested positive for COVID-19 at delivery, 8% tested positive during pregnancy, and 48% used Medicaid. Average long-term PM2.5 concentrations were 7.4 (standard deviation, 0.8) μg/m3. In adjusted multilevel logistic regression models, we saw no association between PM2.5 and ever testing positive for COVID-19; however, odds were elevated among those using Medicaid (per 1-μg/m3 increase, odds ratio = 1.6, 95% confidence interval: 1.0, 2.5). Further, while only 22% of those testing positive showed symptoms, 69% of symptomatic individuals used Medicaid. SES, including unmeasured occupational exposures or increased susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to concurrent social and environmental exposures, may explain the increased odds of testing positive for COVID-19 being confined to vulnerable pregnant individuals using Medicaid.
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Affiliation(s)
- Joan A Casey
- Correspondence Address: Correspondence to Joan A. Casey, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 W 168th St, Rm 1206 New York, NY 10032-3727 ()
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Elizabeth L Ogburn
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, United States
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Andreas Neophytou
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Kristin C Darwin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeanne S Sheffield
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, United States,Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego School of Medicine and UC San Diego Health
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40
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Rzymski P, Poniedziałek B, Rosińska J, Rogalska M, Zarębska-Michaluk D, Rorat M, Moniuszko-Malinowska A, Lorenc B, Kozielewicz D, Piekarska A, Sikorska K, Dworzańska A, Bolewska B, Angielski G, Kowalska J, Podlasin R, Oczko-Grzesik B, Mazur W, Szymczak A, Flisiak R. The association of airborne particulate matter and benzo[a]pyrene with the clinical course of COVID-19 in patients hospitalized in Poland. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119469. [PMID: 35580710 PMCID: PMC9106990 DOI: 10.1016/j.envpol.2022.119469] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 05/06/2023]
Abstract
Air pollution can adversely affect the immune response and increase the severity of the viral disease. The present study aimed to explore the relationship between symptomatology, clinical course, and inflammation markers of adult patients with coronavirus disease 2019 (COVID-19) hospitalized in Poland (n = 4432) and air pollution levels, i.e., mean 24 h and max 24 h level of benzo(a)pyrene (B(a)P) and particulate matter <10 μm (PM10) and <2.5 μm (PM2.5) during a week before their hospitalization. Exposures to PM2.5 and B(a)P exceeding the limits were associated with higher odds of early respiratory symptoms of COVID-19 and hyperinflammatory state: interleukin-6 > 100 pg/mL, procalcitonin >0.25 ng/mL, and white blood cells count >11 × 103/mL. Except for the mean 24 h PM10 level, the exceedance of other air pollution parameters was associated with increased odds for oxygen saturation <90%. Exposure to elevated PM2.5 and B(a)P levels increased the odds of oxygen therapy and death. This study evidences that worse air quality is related to increased severity of COVID-19 and worse outcome in hospitalized patients. Mitigating air pollution shall be an integral part of measures undertaken to decrease the disease burden during a pandemic of viral respiratory illness.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806, Poznań, Poland; Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806, Poznań, Poland.
| | - Barbara Poniedziałek
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806, Poznań, Poland.
| | - Joanna Rosińska
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806, Poznań, Poland.
| | - Magdalena Rogalska
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089, Białystok, Poland.
| | | | - Marta Rorat
- Department of Forensic Medicine, Wrocław Medical University, 50-367, Wrocław, Poland; First Infectious Diseases Ward, Gromkowski Regional Specialist Hospital in Wrocław, 51-149, Wrocław, Poland.
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, 15-089, Białystok, Poland.
| | - Beata Lorenc
- Pomeranian Center of Infectious Diseases, Department of Infectious Diseases, 80-210, Gdańsk, Poland.
| | - Dorota Kozielewicz
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100, Toruń, Poland.
| | - Anna Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, 90-549, Łódź, Poland.
| | - Katarzyna Sikorska
- Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, 80-210, Gdańsk, Poland.
| | - Anna Dworzańska
- Department of Infectious Diseases and Hepatology, Medical University of Lublin, 20-059, Lublin, Poland.
| | - Beata Bolewska
- Department of Infectious Diseases, Poznan University of Medical Sciences, 61-701, Poznań, Poland.
| | | | - Justyna Kowalska
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 02-091, Warsaw, Poland.
| | - Regina Podlasin
- Regional Hospital of Infectious Diseases in Warsaw, Warsaw, Poland.
| | - Barbara Oczko-Grzesik
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-055, Katowice, Poland.
| | - Włodzimierz Mazur
- Clinical Department of Infectious Diseases in Chorzów, Medical University of Silesia, Katowice, Poland.
| | - Aleksandra Szymczak
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Wroclaw Medical University, Wrocław, Poland.
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089, Białystok, Poland.
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41
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Safari Z, Fouladi-Fard R, Vahedian M, Mahmoudian MH, Rahbar A, Fiore M. Health impact assessment and evaluation of economic costs attributed to PM 2.5 air pollution using BenMAP-CE. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1891-1902. [PMID: 35852660 PMCID: PMC9295116 DOI: 10.1007/s00484-022-02330-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 06/01/2023]
Abstract
Air pollution is considered the most prominent public health. Economically, air pollution imposes additional costs on governments. This study aimed to quantify health effects and associated economic values of reducing PM2.5 air pollution using BenMAP-CE in Qom in 2019. The air quality data were acquired from Qom Province Environmental Protection Agency, and the population data were collected from Qom Province Management and Planning Organization website. The number of deaths due to Stroke, Chronic Obstructive Pulmonary Disease, Lung Cancer, and Ischemic Heart Disease attributable to PM2.5 were estimated using BenMAP-CE based on two control scenarios, 2.4 and 10 μg/m3, known as scenarios I and II, respectively. The associated economic effect of premature deaths was assessed by value of a statistical life (VSL) approach. The annual average of PM2.5 concentration was found to be 16.32 μg/m3 (SD: 9.93). A total of 4694.5 and 2475.94 premature deaths in scenarios I and II were found to be attributable to PM2.5 in overall, respectively. The total associated cost was calculated to be 855.91 and 451.40 million USD in scenarios I and II, respectively. The total years of life lost due to PM2.5 exposure in 2019 was 158,657.06 and 78,351.51 in scenarios I and II, respectively. The results of both health and economic assessment indicate the importance of solving the air pollution problem in Qom, as well as other big cities in Iran. The elimination of limitations, such as insufficient local data, should be regarded in future studies.
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Affiliation(s)
- Zahra Safari
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, 3715614566 Iran
- Student Research Committee, Qom University of Medical Sciences, Qom, 3715614566 Iran
| | - Reza Fouladi-Fard
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, 3715614566 Iran
| | - Mostafa Vahedian
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, 3715614566 Iran
| | - Mohammad Hassan Mahmoudian
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, 3715614566 Iran
| | - Ahmad Rahbar
- Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, 3715614566 Iran
| | - Maria Fiore
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 87-95123 Catania, Italy
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Yu Q, Cao W, Hamer D, Urbanek N, Straif-Bourgeois S, Cormier S, Ferguson T, Richmond-Bryant J. Risk factors among Black and White COVID-19 patients from a Louisiana Hospital System, March, 2020 - August, 2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.07.27.22278118. [PMID: 35923320 PMCID: PMC9347280 DOI: 10.1101/2022.07.27.22278118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives To investigate relationships between race and COVID-19 hospitalizations, intensive care unit (ICU) admissions, and mortality over time and which characteristics, may mediate COVID-19 associations. Methods We analyzed hospital admissions, ICU admissions, and mortality among positive COVID-19 cases within the ten-hospital Franciscan Ministries of Our Lady Health System around the Mississippi River Industrial Corridor in Louisiana over four waves of the pandemic from March 1, 2020 - August 31, 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships. Results Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed these rates became greater in White patients. However, Black patients were still disproportionately represented in these measures. Age was a significant mediator for all outcomes across waves, while comorbidity and emissions of naphthalene and chloroprene acted as mediators for the full study period. Conclusions The role of race evolved throughout the pandemic in Louisiana, but Black patients bore a disproportionate impact. Naphthalene and chloroprene air pollution partially explained the long-term associations. Our findings imply that air pollution might contribute to the increased COVID-19 hospitalizations and mortality among Black residents in Louisiana but likely do not explain most of the effect of race.
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Affiliation(s)
- Qingzhao Yu
- Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112
| | - Wentao Cao
- Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112
| | - Diana Hamer
- Division of Academic Affairs, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808
| | - Norman Urbanek
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695
| | | | - Stephania Cormier
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA 70803
- Pennington Biomedical Research Center, Baton Rouge, LA 70808
| | - Tekeda Ferguson
- Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112
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Nobile F, Michelozzi P, Ancona C, Cappai G, Cesaroni G, Davoli M, Di Martino M, Nicastri E, Girardi E, Beccacece A, Scognamiglio P, Sorge C, Vairo F, Stafoggia M. Air pollution, SARS-CoV-2 incidence and COVID-19 mortality in Rome - a longitudinal study. Eur Respir J 2022; 60:2200589. [PMID: 35896215 PMCID: PMC9301936 DOI: 10.1183/13993003.00589-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022]
Abstract
Chronic exposure to ambient air pollution has been related to increased mortality in the general population [1]. After the outbreak of the SARS-CoV-2 pandemic in 2019, there has been a fast proliferation of epidemiological studies linking ambient air pollution to coronavirus disease 2019 (COVID-19) incidence or adverse prognosis [2]. It has been hypothesised that ambient air pollution might increase human vulnerability to viruses by reducing immune defences, promoting a low-level chronic inflammatory state, or leading to chronic diseases [3]. Most studies have applied ecological designs, and failed to account for key individual-level or area-level determinants of COVID-19 spread or severity, such as demographic characteristics of the studied populations, socioeconomic or clinical susceptibility, and area-level proxies of disease spread such as mobility or population density [4]. Long-term exposure to air pollution (PM2.5 and NO2) was associated with COVID-19 mortality, but not with SARS-CoV-2 incidence, in a large observational population-based cohort of >1.5 million subjects in Rome, Italy https://bit.ly/3zZjjSC
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Affiliation(s)
- Federica Nobile
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Paola Michelozzi
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Carla Ancona
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Giovanna Cappai
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Giulia Cesaroni
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Mirko Di Martino
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Emanuele Nicastri
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Alessia Beccacece
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Paola Scognamiglio
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Chiara Sorge
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesco Vairo
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Massimo Stafoggia
- Department of Epidemiology of the Regional Health Service, ASL Roma 1, Rome, Italy
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44
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Rzymski P, Poniedziałek B, Rosińska J, Ciechanowski P, Peregrym M, Pokorska-Śpiewak M, Talarek E, Zaleska I, Frańczak-Chmura P, Pilarczyk M, Figlerowicz M, Kucharek I, Flisiak R. Air pollution might affect the clinical course of COVID-19 in pediatric patients. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 239:113651. [PMID: 35594828 PMCID: PMC9110326 DOI: 10.1016/j.ecoenv.2022.113651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 05/05/2023]
Abstract
Air pollution, to which children are more susceptible than adults, can promote airway inflammation, potentially exaggerating the effects of respiratory viral infection. This study examined the association between the clinical manifestation of COVID-19 in unvaccinated pediatric patients hospitalized in Poland (n = 766) and levels of particulate matter 2.5 (PM2.5) and benzo(a)pyrene (B(a)P) within a week before hospitalization. Children aged ≤ 12 years exposed to mean and max 24 h B(a)P levels > 1 ng/m3 revealed higher odds of cough, dyspnea, fever, and increased concentrations of inflammatory markers (C-reactive protein, interleukin-6, procalcitonin, white blood cell count). In older patients (13-17 years), elevated mean 24 h B(a)P levels increased odds of dyspnea, fever, and diarrhea, and higher concentrations of C-reactive protein and procalcitonin. Exposure to max 24 h PM2.5 levels > 20 µg/m3 was associated with higher odds of cough, increased concentrations of C-reactive protein (group ≤12 years), and increased procalcitonin concentration (groups ≤12 years and 13-17 years). In both age groups, length of stay was extended in patients exposed to elevated levels of max 24 h PM2.5, mean and max 24 h B(a)P. This study suggests that worse air quality, particularly reflected in increased B(a)P levels, might affect the clinical course of COVID-19 in pediatric patients and adds to the disease burden during a pandemic.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland; Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland.
| | - Barbara Poniedziałek
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
| | - Joanna Rosińska
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
| | - Przemysław Ciechanowski
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland.
| | - Michał Peregrym
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland.
| | - Maria Pokorska-Śpiewak
- Department of Children's Infectious Diseases, Medical University of Warsaw, Regional Hospital of Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
| | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw, Regional Hospital of Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
| | - Izabela Zaleska
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland.
| | - Paulina Frańczak-Chmura
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-089 Lublin, Poland.
| | - Małgorzata Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland.
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
| | - Izabela Kucharek
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland.
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089 Białystok, Poland.
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Aix ML, Petit P, Bicout DJ. Air pollution and health impacts during the COVID-19 lockdowns in Grenoble, France. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 303:119134. [PMID: 35283200 PMCID: PMC8908221 DOI: 10.1016/j.envpol.2022.119134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
It is undeniable that exposure to outdoor air pollution impacts the health of populations and therefore constitutes a public health problem. Any actions or events causing variations in air quality have repercussions on populations' health. Faced with the worldwide COVID-19 health crisis that began at the end of 2019, the governments of several countries were forced, in the beginning of 2020, to put in place very strict containment measures that could have led to changes in air quality. While many works in the literature have studied the issue of changes in the levels of air pollutants during the confinements in different countries, very few have focused on the impact of these changes on health risks. In this work, we compare the 2020 period, which includes two lockdowns (March 16 - May 10 and a partial shutdown Oct. 30 - Dec. 15) to a reference period 2015-2019 to determine how these government-mandated lockdowns affected concentrations of NO2, O3, PM2.5, and PM10, and how that affected human health factors, including low birth weight, lung cancer, mortality, asthma, non-accidental mortality, respiratory, and cardiovascular illnesses. To this end, we structured 2020 into four periods, alternating phases of freedom and lockdowns characterized by a stringency index. For each period, we calculated (1) the differences in pollutant levels between 2020 and a reference period (2015-2019) at both background and traffic stations; and (2) the resulting variations in the epidemiological based relative risks of health outcomes. As a result, we found that relative changes in pollutant levels during the 2020 restriction period were as follows: NO2 (-32%), PM2.5 (-22%), PM10 (-15%), and O3 (+10.6%). The pollutants associated with the highest health risk reductions in 2020 were PM2.5 and NO2, while PM10 and O3 changes had almost no effect on health outcomes. Reductions in short-term risks were related to reductions in PM2.5 (-3.2% in child emergency room visits for asthma during the second lockdown) and NO2 (-1.5% in hospitalizations for respiratory causes). Long-term risk reductions related to PM2.5 were low birth weight (-8%), mortality (-3.3%), and lung cancer (-2%), and to NO2 for mortality (-0.96%). Overall, our findings indicate that the confinement period in 2020 resulted in a substantial improvement in air quality in the Grenoble area.
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Affiliation(s)
- Marie-Laure Aix
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France
| | - Pascal Petit
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France
| | - Dominique J Bicout
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France.
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Di Ciaula A, Bonfrate L, Portincasa P, Appice C, Belfiore A, Binetti M, Cafagna G, Campanale G, Carrieri A, Cascella G, Cataldi S, Cezza A, Ciannarella M, Cicala L, D'Alitto F, Dell'Acqua A, Dell'Anna L, Diaferia M, Erroi G, Fiermonte F, Galerati I, Giove M, Grimaldi L, Mallardi C, Mastrandrea E, Mazelli GD, Mersini G, Messina G, Messina M, Montesano A, Noto A, Novielli ME, Noviello M, Palma MV, Palmieri VO, Passerini F, Perez F, Piro C, Prigigallo F, Pugliese S, Rossi O, Stasi C, Stranieri R, Vitariello G. Nitrogen dioxide pollution increases vulnerability to COVID-19 through altered immune function. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:44404-44412. [PMID: 35133597 PMCID: PMC9200946 DOI: 10.1007/s11356-022-19025-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/29/2022] [Indexed: 02/07/2023]
Abstract
Previous ecological studies suggest the existence of possible interplays between the exposure to air pollutants and SARS-CoV-2 infection. Confirmations at individual level, however, are lacking. To explore the relationships between previous exposure to particulate matter < 10 μm (PM10) and nitrogen dioxide (NO2), the clinical outcome following hospital admittance, and lymphocyte subsets in COVID-19 patients with pneumonia. In 147 geocoded patients, we assessed the individual exposure to PM10 and NO2 in the 2 weeks before hospital admittance. We divided subjects according to the clinical outcome (i.e., discharge at home vs in-hospital death), and explored the lymphocyte-related immune function as an index possibly affecting individual vulnerability to the infection. As compared with discharged subjects, patients who underwent in-hospital death presented neutrophilia, lymphopenia, lower number of T CD45, CD3, CD4, CD16/56 + CD3 + , and B CD19 + cells, and higher previous exposure to NO2, but not PM10. Age and previous NO2 exposure were independent predictors for mortality. NO2 concentrations were also negatively related with the number of CD45, CD3, and CD4 cells. Previous NO2 exposure is a co-factor independently affecting the mortality risk in infected individuals, through negative immune effects. Lymphopenia and altered lymphocyte subsets might precede viral infection due to nonmodifiable (i.e., age) and external (i.e., air pollution) factors. Thus, decreasing the burden of air pollutants should be a valuable primary prevention measure to reduce individual susceptibility to SARS-CoV-2 infection and mortality.
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Affiliation(s)
- Agostino Di Ciaula
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy.
- International Society of Doctors for Environment (ISDE), Arezzo, Italy.
| | - Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | | | - C Appice
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Belfiore
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Binetti
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Cafagna
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Campanale
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Carrieri
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Cascella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - S Cataldi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Cezza
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Ciannarella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - L Cicala
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F D'Alitto
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Dell'Acqua
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - L Dell'Anna
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Diaferia
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Erroi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Fiermonte
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - I Galerati
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Giove
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - L Grimaldi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - C Mallardi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - E Mastrandrea
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G D Mazelli
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Mersini
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Messina
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Messina
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Montesano
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Noto
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M E Novielli
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Noviello
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M V Palma
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - V O Palmieri
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Passerini
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Perez
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - C Piro
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Prigigallo
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - S Pugliese
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - O Rossi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - C Stasi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - R Stranieri
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Vitariello
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
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Chen C, Wang J, Kwong J, Kim J, van Donkelaar A, Martin RV, Hystad P, Su Y, Lavigne E, Kirby-McGregor M, Kaufman JS, Benmarhnia T, Chen H. Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study. CMAJ 2022; 194:E693-E700. [PMID: 35609912 PMCID: PMC9188786 DOI: 10.1503/cmaj.220068] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
Background: The tremendous global health burden related to COVID-19 means that identifying determinants of COVID-19 severity is important for prevention and intervention. We aimed to explore long-term exposure to ambient air pollution as a potential contributor to COVID-19 severity, given its known impact on the respiratory system. Methods: We used a cohort of all people with confirmed SARS-CoV-2 infection, aged 20 years and older and not residing in a long-term care facility in Ontario, Canada, during 2020. We evaluated the association between long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ground-level ozone (O3), and risk of COVID-19-related hospital admission, intensive care unit (ICU) admission and death. We ascertained individuals’ long-term exposures to each air pollutant based on their residence from 2015 to 2019. We used logistic regression and adjusted for confounders and selection bias using various individual and contextual covariates obtained through data linkage. Results: Among the 151 105 people with confirmed SARS-CoV-2 infection in Ontario in 2020, we observed 8630 hospital admissions, 1912 ICU admissions and 2137 deaths related to COVID-19. For each interquartile range increase in exposure to PM2.5 (1.70 μg/m3), we estimated odds ratios of 1.06 (95% confidence interval [CI] 1.01–1.12), 1.09 (95% CI 0.98–1.21) and 1.00 (95% CI 0.90–1.11) for hospital admission, ICU admission and death, respectively. Estimates were smaller for NO2. We also estimated odds ratios of 1.15 (95% CI 1.06–1.23), 1.30 (95% CI 1.12–1.50) and 1.18 (95% CI 1.02–1.36) per interquartile range increase of 5.14 ppb in O3 for hospital admission, ICU admission and death, respectively. Interpretation: Chronic exposure to air pollution may contribute to severe outcomes after SARS-CoV-2 infection, particularly exposure to O3.
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Affiliation(s)
- Chen Chen
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que.
| | - John Wang
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Jeff Kwong
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - JinHee Kim
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Aaron van Donkelaar
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Randall V Martin
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Perry Hystad
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Yushan Su
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Eric Lavigne
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Megan Kirby-McGregor
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Jay S Kaufman
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que
| | - Hong Chen
- Scripps Institution of Oceanography (C. Chen, Benmarhnia), University of California San Diego, La Jolla, Calif.; Public Health Ontario (Wang, Kwong, Kim, H. Chen); ICES Central (Kwong, H. Chen); Dalla Lana School of Public Health (Kwong, Kim, H. Chen), and Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.; Department of Energy, Environmental, and Chemical Engineering (van Donkelaar, Martin), Washington University in St. Louis, St. Louis, Mo.; College of Public Health and Human Studies (Hystad), Oregon State University, Corvallis, Ore.; Ontario Ministry of the Environment (Su), Conservation and Parks, Toronto, Ont.; Environmental Health Science and Research Bureau (Lavigne, H. Chen), Health Canada, Ottawa, Ont.; Department of Epidemiology and Biostatistics and Occupational Health (Kirby-McGregor, Kaufman), McGill University, Montréal, Que.
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Nassikas NJ, Kraus A, Lee AG. Dying to Breathe: Air Pollution Adds Insult to Injury in COVID-19. Am J Respir Crit Care Med 2022; 206:368-369. [PMID: 35580063 DOI: 10.1164/rccm.202205-0838ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nicholas J Nassikas
- Beth Israel Deaconess Medical Center, 1859, Division of Pulmonary, Critical Care, and Sleep Medicine, Boston, Massachusetts, United States
| | - Adam Kraus
- Mount Sinai School of Medicine, 5925, Departments of Medicine and Pediatrics, New York, New York, United States
| | - Alison G Lee
- Mount Sinai School of Medicine, 5925, Division of Pulmonary, Sleep and Critical Care Medicine, New York, New York, United States;
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Relationship between Meteorological and Air Quality Parameters and COVID-19 in Casablanca Region, Morocco. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094989. [PMID: 35564384 PMCID: PMC9100265 DOI: 10.3390/ijerph19094989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 01/09/2023]
Abstract
The aim of this study was to investigate the relationship between meteorological parameters, air quality and daily COVID-19 transmission in Morocco. We collected daily data of confirmed COVID-19 cases in the Casablanca region, as well as meteorological parameters (average temperature, wind, relative humidity, precipitation, duration of insolation) and air quality parameters (CO, NO2, 03, SO2, PM10) during the period of 2 March 2020, to 31 December 2020. The General Additive Model (GAM) was used to assess the impact of these parameters on daily cases of COVID-19. A total of 172,746 confirmed cases were reported in the study period. Positive associations were observed between COVID-19 and wind above 20 m/s and humidity above 80%. However, temperatures above 25° were negatively associated with daily cases of COVID-19. PM10 and O3 had a positive effect on the increase in the number of daily confirmed COVID-19 cases, while precipitation had a borderline effect below 25 mm and a negative effect above this value. The findings in this study suggest that significant associations exist between meteorological factors, air quality pollution (PM10) and the transmission of COVID-19. Our findings may help public health authorities better control the spread of COVID-19.
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50
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Kaufman JD. Environmental Health Perspectives at 50. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:41001. [PMID: 35442067 PMCID: PMC9020373 DOI: 10.1289/ehp11367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Joel D Kaufman
- Environmental Health Perspectives, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina, USA
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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