Long-term exposure to air pollution and severe COVID-19 in Catalonia: a population-based cohort study

Ranzani, Otávio T.; Alari, Anna; Olmos, Sergio; Milà, Carles; Rico, Alex; Ballester, Joan; Basagaña, Xavier; Chaccour, Carlos; Dadvand, Payam; Duarte‐Salles, Talita; Foraster, María; Nieuwenhuijsen, Mark; Sunyer, Jordi; Valentín, Antònia; Kogevinas, Manolis; Lazcano, Uxue; Avellaneda-Gómez, Carla; Vivanco, R.; Tonne, Cathryn

doi:10.1038/s41467-023-38469-7

Cited by 23 publications

(4 citation statements)

References 36 publications

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“…We addressed this concern in previous work and found that the overall uncertainty in attributable burden calculations, expressed by the 95% confidence intervals (of order 35%), is much more strongly determined by the relative risk calculations than by the resolution of the analysis. 42 Finally, air pollution was shown to contribute to deaths from covid-19, 43 44 estimated at a proportion of about 15% globally, 45 but this additional health burden does not apply to the estimates for 2019.…”

Section: Discussionmentioning

confidence: 99%

Air pollution deaths attributable to fossil fuels: observational and modelling study

Lelieveld,

Haines,

Burnett

et al. 2023

BMJ

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Objectives To estimate all cause and cause specific deaths that are attributable to fossil fuel related air pollution and to assess potential health benefits from policies that replace fossil fuels with clean, renewable energy sources. Design Observational and modelling study. Methods An updated atmospheric composition model, a newly developed relative risk model, and satellite based data were used to determine exposure to ambient air pollution, estimate all cause and disease specific mortality, and attribute them to emission categories. Data sources Data from the global burden of disease 2019 study, observational fine particulate matter and population data from National Aeronautics and Space Administration (NASA) satellites, and atmospheric chemistry, aerosol, and relative risk modelling for 2019. Results Globally, all cause excess deaths due to fine particulate and ozone air pollution are estimated at 8.34 million (95% confidence interval 5.63 to 11.19) deaths per year. Most (52%) of the mortality burden is related to cardiometabolic conditions, particularly ischaemic heart disease (30%). Stroke and chronic obstructive pulmonary disease both account for 16% of mortality burden. About 20% of all cause mortality is undefined, with arterial hypertension and neurodegenerative diseases possibly implicated. An estimated 5.13 million (3.63 to 6.32) excess deaths per year globally are attributable to ambient air pollution from fossil fuel use and therefore could potentially be avoided by phasing out fossil fuels. This figure corresponds to 82% of the maximum number of air pollution deaths that could be averted by controlling all anthropogenic emissions. Smaller reductions, rather than a complete phase-out, indicate that the responses are not strongly non-linear. Reductions in emission related to fossil fuels at all levels of air pollution can decrease the number of attributable deaths substantially. Estimates of avoidable excess deaths are markedly higher in this study than most previous studies for these reasons: the new relative risk model has implications for high income (largely fossil fuel intensive) countries and for low and middle income countries where the use of fossil fuels is increasing; this study accounts for all cause mortality in addition to disease specific mortality; and the large reduction in air pollution from a fossil fuel phase-out can greatly reduce exposure. Conclusions Phasing out fossil fuels is deemed to be an effective intervention to improve health and save lives as part the United Nations' goal of climate neutrality by 2050. Ambient air pollution would no longer be a leading, environmental health risk factor if the use of fossil fuels were superseded by equitable access to clean sources of renewable energy.

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Section: Discussionmentioning

confidence: 99%

Air pollution deaths attributable to fossil fuels: observational and modelling study

Lelieveld,

Haines,

Burnett

et al. 2023

BMJ

Self Cite

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“…There is an ongoing debate about the association between air pollution, SARS-CoV-2 infection, and COVID-19 severity. While the study of this relationship is complex (59), several potential biological mechanisms underpinning these associations have been identified, ranging from air pollution's influence on the transport and viability of viral particles to its impact on the body's innate defense mechanisms and long-term immune function (60)(61)(62).…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Environmental and geographical factors influencing the spread of SARS-CoV-2 over 2 years: a fine-scale spatiotemporal analysis

De Ridder,

Ladoy,

Choi

et al. 2024

Front. Public Health

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IntroductionSince 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.MethodsThis 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.ResultsOur 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.DiscussionOverall, 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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“…Therefore, the present multicenter research aimed to evaluate the association between exposure to air pollution (PM 10, PM 2.5 , and B(a)P levels) estimated during the viral incubation period and further clinical course of COVID‐19 in patients hospitalized in Poland during two pandemic waves dominated by different variants of SARS‐CoV‐2. In this regard, assessed exposure had to be considered short‐term, contrary to other studies in which air quality data taken into account corresponded to annual or longer intervals 33–36 . Specifically, we examined the relationship between increased levels of air pollutants and early COVID‐19 symptoms, the concentration of inflammatory and coagulopathy markers at admission, oxygen saturation, the need for oxygen supplementation and mechanical ventilation, and fatal outcome.…”

Section: Introductionmentioning

confidence: 99%

Short‐term exposure to ambient air pollution and COVID‐19 severity during SARS‐CoV‐2 Delta and Omicron waves: A multicenter study

Poniedziałek

Rzymski

Zarębska-Michaluk

et al. 2023

Journal of Medical Virology

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Air pollution may affect the clinical course of respiratory diseases, including This study aimed to evaluate the relationship between exposure of adult patients to mean 24 h levels of particulate matter sized <10 μm (PM 10 ) and <2.5 μm (PM 2.5 ) and benzo(a)pyrene (B(a)P) during a week before their hospitalization due to SARS-CoV-2 infection and symptomatology, hyperinflammation, coagulopathy, the clinical course of disease, and outcome. The analyses were conducted during two pandemic waves: (i) dominated by highly pathogenic Delta variant (n = 1440) and (ii) clinically less-severe Omicron (n = 785), while the analyzed associations were adjusted for patient's age, BMI, gender, and comorbidities. The exposure to mean 24 h B(a)P exceeding the limits was associated with increased odds of fever and fatigue as early COVID-19 symptoms, hyperinflammation due to serum C-reactive protein >200 mg/L and interleukin-6 >100 pg/mL, coagulopathy due to D-dimer >2 mg/L and fatal outcome. Elevated PM 10 and PM 2.5 levels were associated with higher odds of respiratory symptoms, procalcitonin >0.25 ng/mL and interleukin >100 pg/mL, lower oxygen saturation, need for oxygen support, and death. The significant relationships between exposure to air pollutants and the course and outcomes of COVID-19 were observed during both

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Long-term exposure to air pollution and severe COVID-19 in Catalonia: a population-based cohort study

Cited by 23 publications

References 36 publications

Air pollution deaths attributable to fossil fuels: observational and modelling study

Air pollution deaths attributable to fossil fuels: observational and modelling study

Environmental and geographical factors influencing the spread of SARS-CoV-2 over 2 years: a fine-scale spatiotemporal analysis

Short‐term exposure to ambient air pollution and COVID‐19 severity during SARS‐CoV‐2 Delta and Omicron waves: A multicenter study

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