Dataset Information

Air pollution exposure and COVID-19: A look at mortality in Mexico City using individual-level data.

ABSTRACT: We use individual-level data to estimate the effects of long- and short-term exposure to air pollution (PM_2.5) on the probability of dying from COVID-19. To the best of our knowledge, our study is the first to look at this relationship using individual-level data. We find that for Mexico City there is evidence of a positive relationship between pollution and mortality that significantly grows with age and that appears to be mostly driven by long- rather than short-term exposure. By using a rich set of individual- and municipal-level covariates we are able to isolate the effect of exposure to pollution from other crucial factors, thus alleviating endogeneity concerns related to selection. Our results provide yet another reason for the need to implement environmental strategies that will reduce the exposure to air pollution: it is a key element to improve the general population's health. In addition, and considering that at this moment we do not know when the pandemic will stop or if SARS-CoV-2 will become a recurrent threat, the relationship that we uncovered suggests that financial resources should be allocated to improve medical services in those areas where PM_2.5 concentrations tend to be high.

SUBMITTER: Lopez-Feldman A

PROVIDER: S-EPMC7688431 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Air pollution exposure and COVID-19: A look at mortality in Mexico City using individual-level data.

López-Feldman Alejandro A Heres David D Marquez-Padilla Fernanda F

The Science of the total environment 20201126

We use individual-level data to estimate the effects of long- and short-term exposure to air pollution (PM<sub>2.5</sub>) on the probability of dying from COVID-19. To the best of our knowledge, our study is the first to look at this relationship using individual-level data. We find that for Mexico City there is evidence of a positive relationship between pollution and mortality that significantly grows with age and that appears to be mostly driven by long- rather than short-term exposure. By us ...[more]

PMID: 33302074

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Project description:UNLABELLED:Geostatistical interpolation methods to estimate individual exposure to outdoor air pollutants can be used in pregnancy cohorts where personal exposure data are not collected. Our objectives were to a) develop four assessment methods (citywide average (CWA); nearest monitor (NM); inverse distance weighting (IDW); and ordinary Kriging (OK)), and b) compare daily metrics and cross-validations of interpolation models. We obtained 2008 hourly data from Mexico City's outdoor air monitoring network for PM10, PM2.5, O3, CO, NO2, and SO2 and constructed daily exposure metrics for 1,000 simulated individual locations across five populated geographic zones. Descriptive statistics from all methods were calculated for dry and wet seasons, and by zone. We also evaluated IDW and OK methods' ability to predict measured concentrations at monitors using cross validation and a coefficient of variation (COV). All methods were performed using SAS 9.3, except ordinary Kriging which was modeled using R's gstat package. Overall, mean concentrations and standard deviations were similar among the different methods for each pollutant. Correlations between methods were generally high (r=0.77 to 0.99). However, ranges of estimated concentrations determined by NM, IDW, and OK were wider than the ranges for CWA. Root mean square errors for OK were consistently equal to or lower than for the IDW method. OK standard errors varied considerably between pollutants and the computed COVs ranged from 0.46 (least error) for SO2 and PM10 to 3.91 (most error) for PM2.5. OK predicted concentrations measured at the monitors better than IDW and NM. Given the similarity in results for the exposure methods, OK is preferred because this method alone provides predicted standard errors which can be incorporated in statistical models. The daily estimated exposures calculated using these different exposure methods provide flexibility to evaluate multiple windows of exposure during pregnancy, not just trimester or pregnancy-long exposures. IMPLICATIONS:Many studies evaluating associations between outdoor air pollution and adverse pregnancy outcomes rely on outdoor air pollution monitoring data linked to information gathered from large birth registries, and often lack residence location information needed to estimate individual exposure. This study simulated 1,000 residential locations to evaluate four air pollution exposure assessment methods, and describes possible exposure misclassification from using spatial averaging versus geostatistical interpolation models. An implication of this work is that policies to reduce air pollution and exposure among pregnant women based on epidemiologic literature should take into account possible error in estimates of effect when spatial averages alone are evaluated.

Project description:BackgroundSeveral studies have been focusing on the potential role of atmospheric pollutants in the diffusion and impact on health of Covid-19. This study's objective was to estimate the association between ≤10 μm diameter particulate matter (PM10) exposure and the likelihood of experiencing pneumonia due to Covid-19 using individual-level data in Italy.MethodsInformation on Covid-19 patients was retrieved from the Italian IQVIA® Longitudinal Patient Database (LPD), a computerized network of general practitioners (GPs) including anonymous data on patients' consultations and treatments. All patients with a Covid-19 diagnosis during March 18th, 2020 - June 30th, 2020 were included in the study. The date of first Covid-19 registration was the starting point of the 3-month follow-up (Index Date). Patients were classified based on Covid-19-related pneumonia registrations on the Index date and/or during follow-up presence/absence. Each patient was assigned individual exposure by calculating average PM10 during the 30-day period preceding the Index Date, and according to GP's office province. A multiple generalized linear mixed model, mixed-effects logistic regression, was used to assess the association between PM10 exposure tertiles and the likelihood of experiencing pneumonia.ResultsAmong 6483 Covid-19 patients included, 1079 (16.6%) had a diagnosis of pneumonia. Pneumonia patients were older, more frequently men, more health-impaired, and had a higher individual-level exposure to PM10 during the month preceding Covid-19 diagnosis. The mixed-effects model showed that patients whose PM10 exposure level fell in the second tertile had a 30% higher likelihood of having pneumonia than that of first tertile patients, and the risk for those who were in the third tertile was almost doubled.ConclusionThe consistent findings toward a positive association between PM10 levels and the likelihood of experiencing pneumonia due to Covid-19 make the implementation of new strategies to reduce air pollution more and more urgent.

Project description:BackgroundStudies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed.ObjectivesWe aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19.MethodsThe Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend).ResultsOf the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35 μg/m3); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7 μg/m3 or 70 parts per billion). An interquartile range (IQR) increase (5.2 μg/m3) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2 μg/m3) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions.DiscussionShort-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. https://doi.org/10.1289/EHP10836.

Project description:Background The association between fine particulate matter and cardiovascular disease has been convincingly demonstrated. The role of traffic-related air pollutants is less clear. To better understand the role of traffic-related air pollutants in cardiovascular disease development, we examined associations between NO2, carotid atherosclerotic plaque, and cardiometabolic disorders associated with cardiovascular disease. Methods and Results Cross-sectional analyses were conducted among 2227 patients (62.9±13.8 years; 49.5% women) from the Stroke Prevention and Atherosclerosis Research Centre (SPARC) in London, Ontario, Canada. Total carotid plaque area measured by ultrasound, cardiometabolic disorders, and residential locations were provided by SPARC medical records. Long-term outdoor residential NO2 concentrations were generated by a land use regression model. Associations between NO2, total carotid plaque area, and cardiometabolic disorders were examined using multiple regression models adjusted for age, sex, smoking, and socioeconomic status. Mean NO2 was 5.4±1.6 ppb in London, Ontario. NO2 was associated with a significant increase in plaque (3.4 mm2 total carotid plaque area per 1 ppb NO2), exhibiting a linear dose-response. NO2 was also positively associated with triglycerides, total cholesterol, and the ratio of low- to high-density lipoprotein cholesterol (P<0.05). Diabetes mellitus mediated the relationship between NO2 and total carotid plaque area (P<0.05). Conclusions Our results demonstrate that even low levels of traffic-related air pollutants are linked to atherosclerotic plaque burden, an association that may be partially attributable to pollution-induced diabetes mellitus. Our findings suggest that reducing ambient concentrations in cities with NO2 below current standards would result in additional health benefits. Given the billions of people exposed to traffic emissions, our study supports the global public health significance of reducing air pollution.

Project description:Ambient air pollution was known to cause central nervous system diseases and depressive symptoms. In this study, we examined the associations between air pollution exposure and the prevalence of insomnia in Taipei City of Taiwan. We applied the health information system of electrical medical records of Taipei City Hospital to collect a total of 5108 study subjects (insomniacs N = 912 and non-insomniacs N = 4196) over 18 years old from the family medicine and internal medicine outpatients of six branches of Taipei City Hospital. These patients were grouped into insomniacs and non-insomniacs following the primary insomnia diagnosis (ICD9:780.52, 780.54, 307.41, 307.42, ICD10: G47.00, G47.01, G47.09, F51.01, F51.09) and the prescription times of anxiolytics and hypnotics. We estimated one-year average concentrations of PM2.5, ozone, and NOx before the first date of insomnia diagnosis and the last date of outpatient visit for insomniacs and non-insomniacs, respectively, by using the data of nearest air quality monitoring stations relative to study subjects' residential addresses. Logistic regression analysis was employed to examine the independent effects of air pollution concentrations on the risk of insomnia. One-year average PM2.5, ozone, and NOx levels for insomniacs was significantly higher than those of non-insomniacs. After adjusting for confounding factors, increase each 1(μg/m3) in one-year average PM2.5 showed a statistically significant association with insomnia (the odds ratio 1.610, 95% CI [1.562,1.660]). As to multi pollutants, one-year average PM2.5 (1.624, [1.570, 1.681] and ozone (1.198, [1.094, 1.311]) exposure showed a significant association with insomnia. Subgroup analysis revealed that the influence of PM2.5 and ozone on insomnia have significant risks in people with major chronic disease. This study demonstrated a positive association between PM2.5 and ozone exposure and the prevalence of hypnotic-treated insomnia. Especially, the people with major chronic diseases were with obvious effect of PM2.5 and ozone on risk of insomnia.

Project description:BackgroundInfluenza imposes a heavy burden on public health. Little is known, however, of the associations between detailed measures of exposure to ambient air pollution and influenza at an individual level.ObjectiveWe examined individual-level associations between six criteria air pollutants and influenza using case-crossover design.MethodsIn this individual-level time-stratified case-crossover study, we linked influenza cases collected by the Guangzhou Center for Disease Control and Prevention from 1 January 2013 to 31 December 2019 with individual residence-level exposure to particulate matter (PM2.5 and PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO). The exposures were estimated for the day of onset of influenza symptoms (lag 0), 1-7 d before the onset (lags 1-7), as well as an 8-d moving average (lag07), using a random forest model and linked to study participants' home addresses. Conditional logistic regression was developed to investigate the associations between short-term exposure to air pollution and influenza, adjusting for mean temperature, relative humidity, public holidays, population mobility, and community influenza susceptibility.ResultsN=108,479 eligible cases were identified in our study. Every 10-μg/m3 increase in exposure to PM2.5, PM10, NO2, and CO and every 5-μg/m3 increase in SO2 over 8-d moving average (lag07) was associated with higher risk of influenza with a relative risk (RR) of 1.028 (95% CI: 1.018, 1.038), 1.041 (95% CI: 1.032, 1.049), 1.169 (95% CI: 1.151, 1.188), 1.004 (95% CI: 1.003, 1.006), and 1.134 (95% CI: 1.107, 1.163), respectively. There was a negative association between O3 and influenza with a RR of 0.878 (95% CI: 0.866, 0.890).ConclusionsOur findings suggest that short-term exposure to air pollution, except for O3, is associated with greater risk for influenza. Further studies are necessary to decipher underlying mechanisms and design preventive interventions and policies. https://doi.org/10.1289/EHP12145.

Dataset Information

Air pollution exposure and COVID-19: A look at mortality in Mexico City using individual-level data.

Publications

Air pollution exposure and COVID-19: A look at mortality in Mexico City using individual-level data.

Similar Datasets

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