Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy

ObjectivesTo investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city.MethodsCitizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 av...

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Veröffentlicht in:Occupational and environmental medicine (London, England) Jg. 79; H. 3; S. 192 - 199
Hauptverfasser: Veronesi, Giovanni, De Matteis, Sara, Calori, Giuseppe, Pepe, Nicola, Ferrario, Marco M
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group Ltd 01.03.2022
BMJ Publishing Group LTD
BMJ Publishing Group
Schriftenreihe:Original research
Schlagworte:
Adult
Aged
Air Pollutants - chemistry
Air pollution
Air Pollution - adverse effects
Air quality
Chemical transport
Coronaviruses
COVID-19
COVID-19 - epidemiology
Diabetes mellitus
Environment
Environmental Exposure - analysis
Epidemics
epidemiology
Exposure
Fatalities
Female
Humans
Hypertension
Incidence
Indoor air pollution
Italy - epidemiology
Male
Middle Aged
Nitrogen dioxide
Outdoor air quality
Ozone
Particulate matter
Pollutants
Pollution control
Population density
Prospective Studies
Public transportation
Regression analysis
Regression models
Residence Characteristics
Residential density
Respiratory tract diseases
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Time Factors
Urban Population
Italy
Europe
China
COVID-19
epidemiology
air pollution
ISSN:1351-0711, 1470-7926, 1470-7926
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Zusammenfassung:ObjectivesTo investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city.MethodsCitizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1 µg/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models.ResultsThe 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5 µg/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95% CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models.ConclusionsLong-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.
Bibliographie:Original research
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1351-0711
1470-7926
1470-7926
DOI:10.1136/oemed-2021-107833