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Short-term and long-term health impacts of air pollution reductions from COVID-19 lockdowns in China and Europe: a modelling study.

ABSTRACT: BACKGROUND:Exposure to poor air quality leads to increased premature mortality from cardiovascular and respiratory diseases. Among the far-reaching implications of the ongoing COVID-19 pandemic, a substantial improvement in air quality was observed worldwide after the lockdowns imposed by many countries. We aimed to assess the implications of different lockdown measures on air pollution levels in Europe and China, as well as the short-term and long-term health impact. METHODS:For this modelling study, observations of fine particulate matter (PM2·5) concentrations from more than 2500 stations in Europe and China during 2016-20 were integrated with chemical transport model simulations to reconstruct PM2·5 fields at high spatiotemporal resolution. The health benefits, expressed as short-term and long-term avoided mortality from PM2·5 exposure associated with the interventions imposed to control the COVID-19 pandemic, were quantified on the basis of the latest epidemiological studies. To explore the long-term variability in air quality and associated premature mortality, we built different scenarios of economic recovery (immediate or gradual resumption of activities, a second outbreak in autumn, and permanent lockdown for the whole of 2020). FINDINGS:The lockdown interventions led to a reduction in population-weighted PM2·5 of 14·5 ?g m-3 across China (-29·7%) and 2·2 ?g m-3 across Europe (-17·1%), with unprecedented reductions of 40 ?g m-3 in bimonthly mean PM2·5 in the areas most affected by COVID-19 in China. In the short term, an estimated 24?200 (95% CI 22?380-26?010) premature deaths were averted throughout China between Feb 1 and March 31, and an estimated 2190 (1960-2420) deaths were averted in Europe between Feb 21 and May 17. We also estimated a positive number of long-term avoided premature fatalities due to reduced PM2·5 concentrations, ranging from 76?400 (95% CI 62?600-86?900) to 287?000 (233?700-328?300) for China, and from 13?600 (11?900-15?300) to 29?500 (25?800-33?300) for Europe, depending on the future scenarios of economic recovery adopted. INTERPRETATION:These results indicate that lockdown interventions led to substantial reductions in PM2·5 concentrations in China and Europe. We estimated that tens of thousands of premature deaths from air pollution were avoided, although with significant differences observed in Europe and China. Our findings suggest that considerable improvements in air quality are achievable in both China and Europe when stringent emission control policies are adopted. FUNDING:None.

SUBMITTER: Giani P

PROVIDER: S-EPMC7508534 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Short-term and long-term health impacts of air pollution reductions from COVID-19 lockdowns in China and Europe: a modelling study.

Giani Paolo P Castruccio Stefano S Anav Alessandro A Howard Don D Hu Wenjing W Crippa Paola P

The Lancet. Planetary health 20200922 10

<h4>Background</h4>Exposure to poor air quality leads to increased premature mortality from cardiovascular and respiratory diseases. Among the far-reaching implications of the ongoing COVID-19 pandemic, a substantial improvement in air quality was observed worldwide after the lockdowns imposed by many countries. We aimed to assess the implications of different lockdown measures on air pollution levels in Europe and China, as well as the short-term and long-term health impact.<h4>Methods</h4>For ...[more]

PMID: 32976757

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Project description:BackgroundAir pollution is a major risk factor for planetary health and has long been suspected of predisposing humans to respiratory diseases induced by pathogens like influenza viruses. However, epidemiological evidence remains elusive due to lack of longitudinal data from large cohorts.ObjectiveOur aim is to quantify the short-term association of influenza incidence with exposure to ambient air pollutants in Chinese cities.MethodsBased on air pollutant data and influenza surveillance data from 82 cities in China over a period of 5 years, we applied a two-stage time series analysis to assess the association of daily incidence of reported influenza cases with six common air pollutants [particulate matter with aerodynamic diameter ≤2.5μm (PM2.5), particulate matter with aerodynamic diameter ≤10μm (PM10), NO2, SO2, CO, and O3], while adjusting for potential confounders including temperature, relative humidity, seasonality, and holiday effects. We built a distributed lag Poisson model for one or multiple pollutants in each individual city in the first stage and conducted a meta-analysis to pool city-specific estimates in the second stage.ResultsA total of 3,735,934 influenza cases were reported in 82 cities from 2015 to 2019, accounting for 72.71% of the overall case number reported in the mainland of China. The time series models for each pollutant alone showed that the daily incidence of reported influenza cases was positively associated with almost all air pollutants except for ozone. The most prominent short-term associations were found for SO2 and NO2 with cumulative risk ratios of 1.094 [95% confidence interval (CI): 1.054, 1.136] and 1.093 (95% CI: 1.067, 1.119), respectively, for each 10 μg/m3 increase in the concentration at each of the lags of 1-7 d. Only NO2 showed a significant association with the daily incidence of influenza cases in the multipollutant model that adjusts all six air pollutants together. The impact of air pollutants on influenza was generally found to be greater in children, in subtropical cities, and during cold months.DiscussionIncreased exposure to ambient air pollutants, particularly NO2, is associated with a higher risk of influenza-associated illness. Policies on reducing air pollution levels may help alleviate the disease burden due to influenza infection. https://doi.org/10.1289/EHP12146.

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Short-term and long-term health impacts of air pollution reductions from COVID-19 lockdowns in China and Europe: a modelling study.

Publications

Short-term and long-term health impacts of air pollution reductions from COVID-19 lockdowns in China and Europe: a modelling study.

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