Long-term air pollution and COVID-19 mortality rates in California: Findings from the Spring/Summer and Winter surges of COVID-19☆
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SUBMITTER: Garcia E
PROVIDER: S-EPMC8529382 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundAir pollution exposure may make people more vulnerable to COVID-19 infection. However, previous studies in this area mostly focused on infection before May 2020 and long-term exposure.ObjectiveTo assess both long-term and short-term exposure to air pollution and COVID-19 incidence across four case surges from 03/1/2020 to 02/28/2021.MethodsThe cohort included 4.6 million members from a large integrated health care system in southern California with comprehensive electronic medical records (EMR). COVID-19 cases were identified from EMR. Incidence of COVID-19 was computed at the census tract-level among members. Prior 1-month and 1-year averaged air pollutant levels (PM2.5, NO2, and O3) at the census tract-level were estimated based on hourly and daily air quality data. Data analyses were conducted by each wave: 3/1/2020-5/31/2020, 6/1/202-9/30/2020, 10/1/2020-12/31/2020, and 1/1/2021-2/28/2021 and pooled across waves using meta-analysis. Generalized linear mixed effects models with Poisson distribution and spatial autocorrelation were used with adjustment for meteorological factors and census tract-level social and health characteristics. Results were expressed as relative risk (RR) per 1 standard deviation.ResultsThe cohort included 446,440 COVID-19 cases covering 4609 census tracts. The pooled RRs (95% CI) of COVID-19 incidence associated with 1-year exposures to PM2.5, NO2, and O3 were 1.11 (1.04, 1.18) per 2.3 μg/m3,1.09 (1.02, 1.17) per 3.2 ppb, and 1.06 (1.00, 1.12) per 5.5 ppb respectively. The corresponding RRs (95% CI) associated with prior 1-month exposures were 1.11 (1.03, 1.20) per 5.2 μg/m3 for PM2.5, 1.09 (1.01, 1.17) per 6.0 ppb for NO2 and 0.96 (0.85, 1.08) per 12.0 ppb for O3.ConclusionLong-term PM2.5 and NO2 exposures were associated with increased risk of COVID-19 incidence across all case surges before February 2021. Short-term PM2.5 and NO2 exposures were also associated. Our findings suggest that air pollution may play a role in increasing the risk of COVID-19 infection.
| S-EPMC8767981 | biostudies-literature
Project description:Low rates of vaccination, emergence of novel variants of SARS-CoV-2, and increasing transmission relating to seasonal changes leave many U.S. communities at risk for surges of COVID-19 during the winter and spring of 2022 that might strain hospital capacity, as in previous waves. The trajectories of COVID-19 hospitalizations during this period are expected to differ across communities depending on their age distributions, vaccination coverage, cumulative incidence, and adoption of risk mitigating behaviors. Yet, existing predictive models of COVID-19 hospitalizations are almost exclusively focused on national- and state-level predictions. This leaves local policymakers in urgent need of tools that can provide early warnings about the possibility that COVID-19 hospitalizations may rise to levels that exceed local capacity. In this work, we develop simple decision rules to predict whether COVID-19 hospitalization will exceed the local hospitalization capacity within a 4- or 8-week period if no additional mitigating strategies are implemented during this time. These decision rules use real-time data related to hospital occupancy and new hospitalizations associated with COVID-19, and when available, genomic surveillance of SARS-CoV-2. We showed that these decision rules present reasonable accuracy, sensitivity, and specificity (all ≥80%) in predicting local surges in hospitalizations under numerous simulated scenarios, which capture substantial uncertainties over the future trajectories of COVID-19 during the winter and spring of 2022. Our proposed decision rules are simple, visual, and straightforward to use in practice by local decision makers without the need to perform numerical computations.Significance statementIn many U.S. communities, the risk of exceeding local healthcare capacity during the winter and spring of 2022 remains substantial since COVID-19 hospitalizations may rise due to seasonal changes, low vaccination coverage, and the emergence of new variants of SARS-CoV-2, such as the omicron variant. Here, we provide simple and easy-to-communicate decision rules to predict whether local hospital occupancy is expected to exceed capacity within a 4- or 8-week period if no additional mitigating measures are implemented. These decision rules can serve as an alert system for local policymakers to respond proactively to mitigate future surges in the COVID-19 hospitalization and minimize risk of overwhelming local healthcare capacity.
| S-EPMC8687467 | biostudies-literature
Project description:Various recent studies have shown that societal efforts to mitigate (e.g. "lockdown") the outbreak of the 2019 coronavirus disease (COVID-19) caused non-negligible impacts on the environment, especially air quality. To examine if interventional policies due to COVID-19 have had a similar impact in the US state of California, this paper investigates the spatiotemporal patterns and changes in air pollution before, during and after the lockdown of the state, comparing the air quality measurements in 2020 with historical averages from 2015 to 2019. Through time series analysis, a sudden drop and uptick of air pollution are found around the dates when shutdown and reopening were ordered, respectively. The spatial patterns of nitrogen dioxide (NO2) tropospheric vertical column density (TVCD) show a decreasing trend over the locations of major powerplants and an increasing trend over residential areas near interactions of national highways. Ground-based observations around California show a 38%, 49%, and 31% drop in the concentration of NO2, carbon monoxide (CO) and particulate matter 2.5 (PM2.5) during the lockdown (March 19-May 7) compared to before (January 26-March 18) in 2020. These are 16%, 25% and 19% sharper than the means of the previous five years in the same periods, respectively. Our study offers evidence of the environmental impact introduced by COVID-19, and insight into related economic influences.
| S-EPMC7416771 | biostudies-literature
Project description:Background and aimsConifers are key components of many temperate and boreal forests and are important for forestry, but species differences in stem growth responses to climate are still poorly understood and may hinder effective management of these forests in a warmer and drier future.MethodsWe studied 19 Northern Hemisphere conifer species planted in a 50-year-old common garden experiment in the Netherlands to (1) assess the effect of temporal dynamics in climate on stem growth, (2) test for a possible positive relationship between the growth potential and climatic growth sensitivity across species, and (3) evaluate the extent to which stem growth is controlled by phylogeny.Key resultsEighty-nine per cent of the species showed a significant reduction in stem growth to summer drought, 37 % responded negatively to spring frost and 32 % responded positively to higher winter temperatures. Species differed largely in their growth sensitivity to climatic variation and showed, for example, a four-fold difference in growth reduction to summer drought. Remarkably, we did not find a positive relationship between productivity and climatic sensitivity, but instead observed that some species combined a low growth sensitivity to summer drought with high growth potential. Both growth sensitivity to climate and growth potential were partly phylogenetically controlled.ConclusionsA warmer and drier future climate is likely to reduce the productivity of most conifer species. We did not find a relationship between growth potential and growth sensitivity to climate; instead, some species combined high growth potential with low sensitivity to summer drought. This may help forest managers to select productive species that are able to cope with a warmer and drier future.
| S-EPMC8422889 | biostudies-literature
Project description:Better understanding the risk factors that exacerbate Covid-19 symptoms and lead to worse health outcomes is vitally important in the public health fight against the virus. One such risk factor that is currently under investigation is air pollution concentrations, with some studies finding statistically significant effects while other studies have found no consistent associations. The aim of this paper is to add to this global evidence base on the potential association between air pollution concentrations and Covid-19 hospitalisations and deaths, by presenting the first study on this topic at the small-area scale in Scotland, United Kingdom. Our study is one of the most comprehensive to date in terms of its temporal coverage, as it includes all hospitalisations and deaths in Scotland between 1st March 2020 and 31st July 2021. We quantify the effects of air pollution on Covid-19 outcomes using a small-area spatial ecological study design, with inference using Bayesian hierarchical models that allow for the residual spatial correlation present in the data. A key advantage of our study is its extensive sensitivity analyses, which examines the robustness of the results to our modelling assumptions. We find clear evidence that PM2.5 concentrations are associated with hospital admissions, with a 1 μgm-3 increase in concentrations being associated with between a 7.4% and a 9.3% increase in hospitalisations. In addition, we find some evidence that PM2.5 concentrations are associated with deaths, with a 1 μgm-3 increase in concentrations being associated with between a 2.9% and a 10.3% increase in deaths.
| S-EPMC9176207 | biostudies-literature
Project description:BackgroundAir pollution exposure has been associated with increased risk of COVID-19 incidence and mortality by ecological analyses. Few studies have investigated the specific effect of traffic-related air pollution on COVID-19 severity.ObjectiveTo investigate the associations of near-roadway air pollution (NRAP) exposure with COVID-19 severity and mortality using individual-level exposure and outcome data.MethodsThe retrospective cohort includes 75,010 individuals (mean age 42.5 years, 54% female, 66% Hispanic) diagnosed with COVID-19 at Kaiser Permanente Southern California between 3/1/2020-8/31/2020. NRAP exposures from both freeways and non-freeways during 1-year prior to the COVID-19 diagnosis date were estimated based on residential address history using the CALINE4 line source dispersion model. Primary outcomes include COVID-19 severity defined as COVID-19-related hospitalizations, intensive respiratory support (IRS), intensive care unit (ICU) admissions within 30 days, and mortality within 60 days after COVID-19 diagnosis. Covariates including socio-characteristics and comorbidities were adjusted for in the analysis.ResultOne standard deviation (SD) increase in 1-year-averaged non-freeway NRAP (0.5 ppb NOx) was associated with increased odds of COVID-19-related IRS and ICU admission [OR (95% CI): 1.07 (1.01, 1.13) and 1.11 (1.04, 1.19) respectively] and increased risk of mortality (HR = 1.10, 95% CI = 1.03, 1.18). The associations of non-freeway NRAP with COVID-19 outcomes were largely independent of the effect of regional fine particulate matter and nitrogen dioxide exposures. These associations were generally consistent across age, sex, and race/ethnicity subgroups. The associations of freeway and total NRAP with COVID-19 severity and mortality were not statistically significant.ConclusionsData from this multiethnic cohort suggested that NRAP, particularly non-freeway exposure in Southern California, may be associated with increased risk of COVID-19 severity and mortality among COVID-19 infected patients. Future studies are needed to assess the impact of emerging COVID-19 variants and chemical components from freeway and non-freeway NRAP.
| S-EPMC8416551 | biostudies-literature
Project description:BackgroundRecent evidence links ambient air pollution to COVID-19 incidence, severity, and death, but few studies have analyzed individual-level mortality data with high quality exposure models.MethodsWe sought to assess whether higher air pollution exposures led to greater risk of death during or after hospitalization in confirmed COVID-19 cases among patients who were members of the Kaiser Permanente Southern California (KPSC) healthcare system (N=21,415 between 06-01-2020 and 01-31-2022 of whom 99.85 % were unvaccinated during the study period). We used 1 km resolution chemical transport models to estimate ambient concentrations of several common air pollutants, including ozone, nitrogen dioxide, and fine particle matter (PM2.5). We also derived estimates of pollutant exposures from ultra-fine particulate matter (PM0.1), PM chemical species, and PM sources. We employed Cox proportional hazards models to assess associations between air pollution exposures and death from COVID-19 among hospitalized patients.FindingsWe found significant associations between COVID-19 death and several air pollution exposures, including: PM2.5 mass, PM0.1 mass, PM2.5 nitrates, PM2.5 elemental carbon, PM2.5 on-road diesel, and PM2.5 on-road gasoline. Based on the interquartile (IQR) exposure increment, effect sizes ranged from hazard ratios (HR) = 1.12 for PM2.5 mass and PM2.5 nitrate to HR ∼ 1.06-1.07 for other species or source markers. Humidity and temperature in the month of diagnosis were also significant negative predictors of COVID-19 death and negative modifiers of the air pollution effects.InterpretationAir pollution exposures and meteorology were associated the risk of COVID-19 death in a cohort of patients from Southern California. These findings have implications for prevention of death from COVID-19 and for future pandemics.
| S-EPMC9715495 | biostudies-literature
Project description:Background:The novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 240,000 lives worldwide, causing tremendous public health, social, and economic damages. While the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis. Methods:We conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010-2016) county-level exposures to NO2, PM2.5 and O3 and county-level COVID-19 case-fatality and mortality rates in the US. We used both single and multipollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level healthcare capacity, phase-of-epidemic, population mobility, sociodemographic, socioeconomic status, behavior risk factors, and meteorological factors. Results:1,027,799 COVID-19 cases and 58,489 deaths were reported in 3,122 US counties from January 22, 2020 to April 29, 2020, with an overall observed case-fatality rate of 5.8%. Spatial variations were observed for both COVID-19 death outcomes and long-term ambient air pollutant levels. County-level average NO2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models (p-values<0.05). Per inter-quartile range (IQR) increase in NO2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 7.1% (95% CI 1.2% to 13.4%) and 11.2% (95% CI 3.4% to 19.5%), respectively. We did not observe significant associations between long-term exposures to PM2.5 or O3 and COVID-19 death outcomes (p-values>0.05), although per IQR increase in PM2.5 (3.4 ug/m3) was marginally associated with 10.8% (95% CI: -1.1% to 24.1%) increase in COVID-19 mortality rate. Discussions and Conclusions:Long-term exposure to NO2, which largely arises from urban combustion sources such as traffic, may enhance susceptibility to severe COVID-19 outcomes, independent of long-term PM2.5 and O3 exposure. The results support targeted public health actions to protect residents from COVID-19 in heavily polluted regions with historically high NO2 levels. Moreover, continuation of current efforts to lower traffic emissions and ambient air pollution levels may be an important component of reducing population-level risk of COVID-19 deaths.
| S-EPMC7273261 | biostudies-literature
Project description:BackgroundThe novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 600,000 lives worldwide, causing tremendous public health, social, and economic damages. Although the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis.MethodsWe conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010-2016) county-level exposures to NO2, PM2.5, and O3 and county-level COVID-19 case-fatality and mortality rates in the United States. We used both single- and multi-pollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level health care capacity, phase of epidemic, population mobility, population density, sociodemographics, socioeconomic status, race and ethnicity, behavioral risk factors, and meteorology.ResultsFrom January 22, 2020, to July 17, 2020, 3,659,828 COVID-19 cases and 138,552 deaths were reported in 3,076 US counties, with an overall observed case-fatality rate of 3.8%. County-level average NO2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models. When adjusted for co-pollutants, per interquartile-range (IQR) increase in NO2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 11.3% (95% CI 4.9%-18.2%) and 16.2% (95% CI 8.7%-24.0%), respectively. We did not observe significant associations between COVID-19 case-fatality rate and long-term exposure to PM2.5 or O3, although per IQR increase in PM2.5 (2.6 μg/m3) was marginally associated, with a 14.9% (95% CI 0.0%-31.9%) increase in COVID-19 mortality rate when adjusted for co-pollutants.DiscussionLong-term exposure to NO2, which largely arises from urban combustion sources such as traffic, may enhance susceptibility to severe COVID-19 outcomes, independent of long-term PM2.5 and O3 exposure. The results support targeted public health actions to protect residents from COVID-19 in heavily polluted regions with historically high NO2 levels. Continuation of current efforts to lower traffic emissions and ambient air pollution may be an important component of reducing population-level risk of COVID-19 case fatality and mortality.
| S-EPMC7505160 | biostudies-literature
Project description:The novel coronavirus disease (COVID-19) is primarily respiratory in nature, and as such, there is interest in examining whether air pollution might contribute to disease susceptibility or outcome. We merged data on COVID-19 cumulative prevalence and fatality rates as of May 31, 2020 with 2014-2019 pollution data from the US Environmental Protection Agency Environmental Justice Screen (EJSCREEN), with control for state testing rates, population density, and population covariate data from the County Health Rankings. Pollution data included three types of air emission concentrations (particulate matter<2.5 μm (PM2.5), ozone and diesel particulate matter (DPM)), and four pollution source variables (proximity to traffic, National Priority List sites, Risk Management Plan (RMP) sites, and hazardous waste treatment, storage and disposal facilities (TSDFs)). Results of mixed model linear multiple regression analyses indicated that, controlling for covariates, COVID-19 prevalence and fatality rates were significantly associated with greater DPM. Proximity to TSDFs was associated to greater fatality rates, and proximity to RMPs was associated with greater prevalence rates. Results are consistent with previous research indicating that air pollution increases susceptibility to respiratory viral pathogens. Results should be interpreted cautiously given the ecological design, the time lag between exposure and outcome, and the uncertainties in measuring COVID-19 prevalence. Areas with worse prior air quality, especially higher concentrations of diesel exhaust, may be at greater COVID-19 risk, although further studies are needed to confirm these relationships.
| S-EPMC7320861 | biostudies-literature