Air pollution impact on the Covid-19 mortality in Iran considering the comorbidity (obesity, diabetes, and hypertension) correlations

How air pollution influences the difference between overweight and obesity: a comprehensive analysis of direct and indirect correlations

Background

Obesity, characterized by excessive or abnormal fat accumulation, is a major public health concern. Air pollution is a significant potential obesogenic factor, but the clear direct and indirect correlations between air pollution and obesity remain unclear. This study aims to provide a comprehensive understanding of the relationship between air pollution and obesity by identifying both direct and indirect causal correlations.

Methods

We used nationally representative data from the China Family Panel Survey. Air pollution concentrations were quantified as the mass (μg) of air pollutants per cubic meter (m3) based on nationally representative statistical data. To minimize statistical bias inherent in traditional methods, the direct relationship between air pollution and obesity was estimated using a regression discontinuity model, while the potential underlying mechanisms were explored through structural equation modeling.

Results

Air pollution was generally positively associated with overweight/obesity ( O R O W A Q I = 1.109, [95%CI = 1.027:1.305], O R O B A Q I = 1.032, [95%CI = 1.006:1.217], O R SO A Q I = 1.069, [95%CI = 1.014:1.208], PM2.5 and PM10 positively affected overweight/obesity ( O R O W PM 2.5 = 1.173, [95%CI = 1.094:1.252], O R O B PM 2.5 = 1.022, [95%CI = 1.016:1.028], O R SO PM 2.5 = 1.035 [95%CI = 1.015:1.055], O R O W PM 10 = 1.053, [95%CI = 1.030:1.076], O R O B PM 10 = 1.008 [95%CI = 1.006:1.010], O R SO PM 10 = 1.013 [95%CI = 1.007:1.019]), and SO2 and CO posed negative impacts on overweight/obesity ( O R O W SO 2 = 0.972, [95%CI = 0.965:0.979], O R O B SO 2 = 0.997, [95%CI = 0.996:0.998], O R SO SO 2 = 0.994, [95%CI = 0.991:0.997], O R O W C O = 0.986, [95%CI = 0.980:0.992], O R O B C O = 0.998, [95%CI = 0.997:0.999], O R SO C O = 0.999, [95%CI = 0.998:0.999]). The impact of air pollution on overweight/obesity was more significant among men, older individuals, and rural populations compared to women, younger individuals, and urban populations. Furthermore, the relationship between air pollution and overweight/obesity was mediated by social behavior determinants, including physical activity (β = 0.18, [95%CI = 0.04:0.29]), sedentary behavior (β = 0.12, [95%CI = 0.04:0.16]), sleep (β = 0.06, [95%CI = 0.02:0.13], smoking (β = 0.07, [95%CI = 0.02:0.15]), alcohol consumption (β = 0.08, [95%CI = 0.04:0.11]), and mental health (β = 0.06, [95%CI = 0.01:0.09]).

Conclusion

Air pollution was generally associated with an increased risk of overweight and obesity, with PM2.5 and PM10 having a positive influence, while SO2 and CO had a negative impact. The effect of air pollution was more pronounced among men, older individuals, and rural populations compared to women, younger individuals, and urban populations. Additionally, social behavior factors, such as physical activity, sedentary behavior, sleep, smoking, alcohol consumption, and mental health, predominantly mediated the relationship between air pollution and obesity.

The Lag -Effects of Air Pollutants and Meteorological Factors on COVID-19 Infection Transmission and Severity: Using Machine Learning Techniques

BACKGROUND

Exposure to air pollution is a major health problem worldwide. This study aimed to investigate the effect of the level of air pollutants and meteorological parameters with their related lag time on the transmission and severity of coronavirus disease 19 (COVID-19) using machine learning (ML) techniques in Shiraz, Iran. Study Design: An ecological study.

METHODS

In this ecological research, three main ML techniques, including decision trees, random forest, and extreme gradient boosting (XGBoost), have been applied to correlate meteorological parameters and air pollutants with infection transmission, hospitalization, and death due to COVID-19 from 1 October 2020 to 1 March 2022. These parameters and pollutants included particulate matter (PM2), sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), nitric oxide (NO), ozone (O3 ), carbon monoxide (CO), temperature (T), relative humidity (RH), dew point (DP), air pressure (AP), and wind speed (WS).

RESULTS

Based on the three ML techniques, NO2 (lag 5 day), CO (lag 4), and T (lag 25) were the most important environmental features affecting the spread of COVID-19 infection. In addition, the most important features contributing to hospitalization due to COVID-19 included RH (lag 28), T (lag 11), and O3 (lag 10). After adjusting for the number of infections, the most important features affecting the number of deaths caused by COVID-19 were NO2 (lag 20), O3 (lag 22), and NO (lag 23).

CONCLUSION

Our findings suggested that epidemics caused by COVID-19 and (possibly) similarly viral transmitted infections, including flu, air pollutants, and meteorological parameters, can be used to predict their burden on the community and health system. In addition, meteorological and air quality data should be included in preventive measures.

Global association between air pollution and COVID-19 mortality: A systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic presents unprecedented challenge for global public health systems and exacerbates existing health disparities. Epidemiological evidence suggested a potential linkage between particulate and gaseous pollutants and COVID-19 mortality. We aimed to summarize the overall risk of COVID-19 mortality associated with ambient air pollutants over the short- and long-term.

METHODS

For the systematic review and meta-analysis, we searched five databases for studies evaluating the risk of COVID-19 mortality from exposure to air pollution. Inclusion of articles was assessed independently on the basis of research topic and availability of effect estimates. The risk estimates (relative risk) for each pollutant were pooled with a random-effect model. Potential heterogeneity was explored by subgroup analysis. Funnel plots and trim-and-fill methods were employed to assess and adjust for publication bias.

FINDINGS

The systematic review retrieved 2059 records, and finally included 43 original studies. PM2.5 (RR: 1.71, 95 % CI: 1.40-2.08, per 10 μg/m3 increase), NO2 (RR: 1.33, 1.07-1.65, per 10 ppb increase) and O3 (RR: 1.61, 1.00-2.57, per 10 ppb increase) were positively associated with COVID-19 mortality for long-term exposures. Accordingly, a higher risk of COVID-19 mortality was associated with PM2.5 (1.05, 1.02-1.08), PM10 (1.05, 1.01-1.08), and NO2 (1.40, 1.04-1.90) for short-term exposures. There was some heterogeneity across subgroups of income level and geographical areas.

CONCLUSION

Both long-term and short-term exposures to ambient air pollution may increase the risk of COVID-19 mortality. Future studies utilizing individual-level information on demographics, exposures, outcome ascertainment and confounders are warranted to improve the accuracy of estimates.

Environmental Factors Influencing the Dynamics and Evolution of COVID-19: A Systematic Review on the Study of Short-Term Ozone Exposure

The potential influence of environmental factors, particularly air pollutants such as ozone (O3), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00-1.13) compared to the general population (OR: 1.00, 95% CI: 0.98-1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: -0.187) and mortality (coefficient: -0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O3 exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics.

Combining aggregate and individual-level data to estimate individual-level associations between air pollution and COVID-19 mortality in the United States

Imposing stricter regulations for PM2.5 has the potential to mitigate damaging health and climate change effects. Recent evidence establishing a link between exposure to air pollution and COVID-19 outcomes is one of many arguments for the need to reduce the National Ambient Air Quality Standards (NAAQS) for PM2.5. However, many studies reporting a relationship between COVID-19 outcomes and PM2.5 have been criticized because they are based on ecological regression analyses, where area-level counts of COVID-19 outcomes are regressed on area-level exposure to air pollution and other covariates. It is well known that regression models solely based on area-level data are subject to ecological bias, i.e., they may provide a biased estimate of the association at the individual-level, due to within-area variability of the data. In this paper, we augment county-level COVID-19 mortality data with a nationally representative sample of individual-level covariate information from the American Community Survey along with high-resolution estimates of PM2.5 concentrations obtained from a validated model and aggregated to the census tract for the contiguous United States. We apply a Bayesian hierarchical modeling approach to combine county-, census tract-, and individual-level data to ultimately draw inference about individual-level associations between long-term exposure to PM2.5 and mortality for COVID-19. By analyzing data prior to the Emergency Use Authorization for the COVID-19 vaccines we found that an increase of 1 μg/m3 in long-term PM2.5 exposure, averaged over the 17-year period 2000-2016, is associated with a 3.3% (95% credible interval, 2.8 to 3.8%) increase in an individual's odds of COVID-19 mortality. Code to reproduce our study is publicly available at https://github.com/NSAPH/PM_COVID_ecoinference. The results confirm previous evidence of an association between long-term exposure to PM2.5 and COVID-19 mortality and strengthen the case for tighter regulations on harmful air pollution and greenhouse gas emissions.

Critical air pollutant assessments and health effects attributed to PM2.5 during and after COVID-19 lockdowns in Iran: application of AirQ+ models

Objectives

The aim of this study was to evaluate changes in air quality index (AQI) values before, during, and after lockdown, as well as to evaluate the number of hospitalizations due to respiratory and cardiovascular diseases attributed to atmospheric PM_2.5 pollution in Semnan, Iran in the period from 2019 to 2021 during the COVID-19 pandemic.

Methods

Daily air quality records were obtained from the global air quality index project and the US Environmental Protection Administration (EPA). In this research, the AirQ+ model was used to quantify health consequences attributed to particulate matter with an aerodynamic diameter of <2.5 μm (PM_2.5).

Results

The results of this study showed positive correlations between air pollution levels and reductions in pollutant levels during and after the lockdown. PM_2.5 was the critical pollutant for most days of the year, as its AQI was the highest among the four investigated pollutants on most days. Mortality rates from chronic obstructive pulmonary disease (COPD) attributed to PM_2.5 in 2019-2021 were 25.18% in 2019, 22.55% in 2020, and 22.12% in 2021. Mortality rates and hospital admissions due to cardiovascular and respiratory diseases decreased during the lockdown. The results showed a significant decrease in the percentage of days with unhealthy air quality in short-term lockdowns in Semnan, Iran with moderate air pollution. Natural mortality (due to all-natural causes) and other mortalities related to COPD, ischemic heart disease (IHD), lung cancer (LC), and stroke attributed to PM_2.5 in 2019-2021 decreased.

Conclusion

Our results support the general finding that anthropogenic activities cause significant health threats, which were paradoxically revealed during a global health crisis/challenge.

The Nexus Between COVID-19 Factors and Air Pollution

Background and Objective

There have been significant effects of the current coronavirus-19 (COVID-19) infection outbreak on many facets of everyday life, particularly the environment. Despite the fact that a number of studies have already been published on the topic, an analysis of those studies' findings on COVID-19's effects on environmental pollution is still lacking. The goal of the research is to look into greenhouse gas emissions and air pollution in Bangladesh when COVID-19 is under rigorous lockdown. The specific drivers of the asymmetric relationship between air pollution and COVID-19 are being investigated.

Methods

The nonlinear relationship between carbon dioxide ( C O 2 ) emissions, fine particulate matter ( P M 2 . 5 ) , and COVID-19, as well as its precise components, are also being investigated. To examine the asymmetric link between COVID-19 factors on C O 2 emissions and P M 2 . 5 , we employed the nonlinear autoregressive distributed lag (NARDL) model. Daily positive cases and daily confirmed death by COVID-19 are considered the factors of COVID-19, with lockdown as a dummy variable.

Results

The bound test confirmed the existence of long-run and short-run relationships between variables. Bangladesh's strict lockdown, enforced in reaction to a surge of COVID-19 cases, reduced air pollution and dangerous gas emissions, mainly C O 2 , according to the dynamic multipliers graph.

Severe Acute Respiratory Syndrome and Particulate Matter Exposure: A Systematic Review

BACKGROUND

Particulate matter (PM) exposure is responsible for seven million deaths annually and has been implicated in the pathogenesis of respiratory infections such as severe acute respiratory syndrome (SARS). Understanding modifiable risk factors of high mortality, resource burdensome C19 and exposure risks such as PM is key to mitigating their devastating effects. This systematic review focuses on the literature available, identifying the spatial and temporal variation in the role of quantified PM exposure in SARS disease outcome and planning our future experimental studies.

METHODS

The systematic review utilized keywords adhered to the PRISMA guidelines. We included original human research studies in English.

RESULTS

Initial search yielded N = 906, application of eligibility criteria yielded N = 46. Upon analysis of risk of bias N = 41 demonstrated high risk. Studies found a positive association between elevated PM2.5, PM10 and SARS-related outcomes. A geographic and temporal variation in both PM and C19's role was observed.

CONCLUSION

C19 is a high mortality and resource intensive disease which devastated the globe. PM exposure is also a global health crisis. Our systematic review focuses on the intersection of this impactful disease-exposure dyad and understanding the role of PM is important in the development of interventions to prevent future spread of viral infections.

The lock-down effects of COVID-19 on the air pollution indices in Iran and its neighbors

Introduction

The COVID-19 restrictions have a lot of various peripheral negative and positive effects, like economic shocks and decreasing air pollution, respectively. Many studies showed NO2 reduction in most parts of the world.

Methods

Iran and its land and maritime neighbors have about 7.4% of the world population and 6.3% and 5.8% of World COVID-19 cases and deaths, respectively. The air pollution indices of them such as CH4 (Methane), CO_1 (CO), H2O (Water), HCHO (Tropospheric Atmospheric Formaldehyde), NO2 (Nitrogen oxides), O3 (ozone), SO2 (Sulfur Dioxide), UVAI_AAI [UV Aerosol Index (UVAI)/Absorbing Aerosol Index (AAI)] are studied from the First quarter of 2019 to the fourth quarter of 2021 with Copernicus Sentinel 5 Precursor (S5P) satellite data set from Google Earth Engine. The outliers are detected based on the depth functions. We use a two-sample t test, Wilcoxon test, and interval-wise testing for functional data to control the familywise error rate.

Result

The adjusted p value comparison between Q2 of 2019 and Q2 of 2020 in NO2 for almost all countries is statistically significant except Iraq, UAE, Bahrain, Qatar, and Kuwait. But, the CO and HCHO are not statistically significant in any country. Although CH4, O3, and UVAI_AAI are statistically significant for some countries. In the Q2 comparison for NO2 between 2020 and 2021, only Iran, Armenia, Turkey, UAE, and Saudi Arabia are statistically significant. However, Ch4 is statistically significant for all countries except Azerbaijan.

Conclusions

The comparison with and without adjusted p values declares the decreases in some air pollution in these countries.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40808-022-01528-x.

Tracing out the effect of transportation infrastructure on NO2 concentration levels with Kernel Density Estimation by investigating successive COVID-19-induced lockdowns

This study aims to investigate the effect of transportation infrastructure on the decrease of NO₂ air pollution during three COVID-19-induced lockdowns in a vast region of France. For this purpose, using Sentinel-5P satellite data, the relative change in tropospheric NO₂ air pollution during the three lockdowns was calculated. The estimation of regional infrastructure intensity was performed using Kernel Density Estimation, being the predictor variable. By performing hotspot-coldspot analysis on the relative change in NO₂ air pollution, significant spatial clusters of decreased air pollution during the three lockdowns were identified. Based on the clusters, a novel spatial index, the Clustering Index (CI) was developed using its Coldspot Clustering Index (CCI) variant as a predicted variable in the regression model between infrastructure intensity and NO₂ air pollution decline. The analysis revealed that during the three lockdowns there was a strong and statistically significant relationship between the transportation infrastructure and the decline index, CCI (r = 0.899, R² = 0.808). The results showed that the largest decrease in NO₂ air pollution was recorded during the first lockdown, and in this case, there was the strongest inverse correlation with transportation infrastructure (r = -0.904, R² = 0.818). Economic and population predictors also explained with good fit the decrease in NO₂ air pollution during the first lockdown: GDP (R² = 0.511), employees (R² = 0.513), population density (R² = 0.837). It is concluded that not only economic-population variables determined the reduction of near-surface air pollution but also the transportation infrastructure. Further studies are recommended to investigate other pollutant gases as predicted variables.

Ecological studies of COVID-19 and air pollution: How useful are they?

Background:

Results from ecological studies have suggested that air pollution increases the risk of developing and dying from COVID-19. Drawing causal inferences from the measures of association reported in ecological studies is fraught with challenges given biases arising from an outcome whose ascertainment is incomplete, varies by region, time, and across sociodemographic characteristics, and cannot account for clustering or within-area heterogeneity. Through a series of analyses, we illustrate the dangers of using ecological studies to assess whether ambient air pollution increases the risk of dying from, or transmitting, COVID-19.

Methods:

We performed an ecological analysis in the continental United States using county-level ambient concentrations of fine particulate matter (PM_2.5) between 2000 and 2016 and cumulative COVID-19 mortality counts through June 2020, December 2020, and April 2021. To show that spurious associations can be obtained in ecological data, we modeled the association between PM_2.5 and the prevalence of human immunodeficiency virus (HIV). We fitted negative binomial models, with a logarithmic offset for county-specific population, to these data. Natural cubic splines were used to describe the shape of the exposure-response curves.

Results:

Our analyses revealed that the shape of the exposure-response curve between PM_2.5 and COVID-19 changed substantially over time. Analyses of COVID-19 mortality through June 30, 2021, suggested a positive linear relationship. In contrast, an inverse pattern was observed using county-level concentrations of PM_2.5 and the prevalence of HIV.

Conclusions:

Our analyses indicated that ecological analyses are prone to showing spurious relationships between ambient air pollution and mortality from COVID-19 as well as the prevalence of HIV. We discuss the many potential biases inherent in any ecological-based analysis of air pollution and COVID-19.