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Veronesi G, De Matteis S, Silibello C, Giusti EM, Ageno W, Ferrario MM. Interactive Effects of Long-term Exposure to Air Pollutants on SARS-CoV-2 Infection and Severity: A Northern Italian Population-based Cohort Study. Epidemiology 2025; 36:11-19. [PMID: 39316827 PMCID: PMC11594552 DOI: 10.1097/ede.0000000000001792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 09/18/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND We examined interactions, to our knowledge not yet explored, between long-term exposures to particulate matter (PM 10 ) with nitrogen dioxide (NO 2 ) and ozone (O 3 ) on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity and severity. METHODS We followed 709,864 adult residents of Varese Province from 1 February 2020 until the first positive test, COVID-19 hospitalization, or death, up to 31 December 2020. We estimated residential annual means of PM 10 , NO 2 , and O 3 in 2019 from chemical transport and random-forest models. We estimated the interactive effects of pollutants with urbanicity on SARS-CoV-2 infectivity, hospitalization, and mortality endpoints using Cox regression models adjusted for socio-demographic factors and comorbidities, and additional cases due to interactions using Poisson models. RESULTS In total 41,065 individuals were infected, 5203 were hospitalized and 1543 died from COVID-19 during follow-up. Mean PM 10 was 1.6 times higher and NO 2 2.6 times higher than WHO limits, with wide gradients between urban and nonurban areas. PM 10 and NO 2 were positively associated with SARS-CoV-2 infectivity and mortality, and PM 10 with hospitalizations in urban areas. Interaction analyses estimated that the effect of PM 10 (per 3.5 µg/m 3 ) on infectivity was strongest in urban areas [hazard ratio (HR) = 1.12; 95% CI =1.09, 1.16], corresponding to 854 additional cases per 100,000 person-years, and in areas at high NO 2 co-exposure (HR = 1.15; 1.08, 1.22). At higher levels of PM 10 co-exposure, the protective association of O 3 reversed (HR =1.32, 1.17, 1.49), yielding 278 additional cases per µg/m 3 increase in O 3 . We estimated similar interactive effects for severity endpoints. CONCLUSIONS We estimate that interactive effects between pollutants exacerbated the burden of the SARS-CoV-2 pandemic in urban areas.
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Affiliation(s)
- Giovanni Veronesi
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - Sara De Matteis
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Emanuele M. Giusti
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - Walter Ageno
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - Marco M. Ferrario
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
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Mougin L, Bougault V, Racinais S, Mountjoy ML, Stephenson B, Carter S, James LJ, Mears SA, Taylor L. Environmental challenges facing athletes, stakeholders and spectators at Paris 2024 Olympic and Paralympic Games: an evidence-based review of mitigation strategies and recommendations. Br J Sports Med 2024; 58:870-881. [PMID: 38955507 DOI: 10.1136/bjsports-2024-108281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
The upcoming Paris 2024 Olympic and Paralympic Games could face environmental challenges related to heat, air quality and water quality. These challenges will pose potential threats to athletes and impact thousands of stakeholders and millions of spectators. Recognising the multifaceted nature of these challenges, a range of strategies will be essential for mitigating adverse effects on participants, stakeholders and spectators alike. From personalised interventions for athletes and attendees to comprehensive measures implemented by organisers, a holistic approach is crucial to address these challenges and the possible interplay of heat, air and water quality factors during the event. This evidence-based review highlights various environmental challenges anticipated at Paris 2024, offering strategies applicable to athletes, stakeholders and spectators. Additionally, it provides recommendations for Local Organising Committees and the International Olympic Committee that may be applicable to future Games. In summary, the review offers solutions for consideration by the stakeholders responsible for and affected by the anticipated environmental challenges at Paris 2024.
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Affiliation(s)
- Loïs Mougin
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | | | - Sébastien Racinais
- Environmental Stress Unit, CREPS Montpellier Font-Romeu, Montpellier, France
- DMEM, UMR 866 INRAE / University of Montpellier, Montpellier, France
| | - Margo L Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ben Stephenson
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- UK Sports Institute, Loughborough, UK
| | - Sarah Carter
- Faculty of Health, Exercise and Sports Science, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Stephen A Mears
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- University of Technology Sydney, Sydney, New South Wales, Australia
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Zhang Y, Frimpong AJ, Tang J, Olayode IO, Kyei SK, Owusu-Ansah P, Agyeman PK, Fayzullayevich JV, Tan G. An explicit review and proposal of an integrated framework system to mitigate the baffling complexities induced by road dust-associated contaminants. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 349:123957. [PMID: 38631446 DOI: 10.1016/j.envpol.2024.123957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/03/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
Road dust-associated contaminants (RD-AC) are gradually becoming a much thornier problem, as their monotonous correlations render them carcinogenic, mutagenic, and teratogenic. While many studies have examined the harmful effects of road dust on both humans and the environment, few studies have considered the co-exposure risk and gradient outcomes given the spatial extent of RD-AC. In this spirit, this paper presents in-depth elucidation into the baffling complexities induced by both major and emerging contaminants of road dust through a panorama-to-profile up-to-date review of diverse studies unified by the goal of advancing innovative methods to mitigate these contaminants. The paper thoroughly explores the correlations between RD-AC and provides insights to understand their potential in dispersing saprotrophic microorganisms. It also explores emerging challenges and proposes a novel integrated framework system aimed at thermally inactivating viruses and other pathogenic micro-organisms commingled with RD-AC. The main findings are: (i) the co-exposure risk of both major and emerging contaminants add another layer of complexity, highlighting the need for more holistic framework strategies, given the geospatial morphology of these contaminants; (ii) road dust contaminants show great potential for extended prevalence and severity of viral particles pollution; (iii) increasing trend of environmentally persistent free radicals (EPFRs) in road dust, with studies conducted solely in China thus far; and (iv) substantial hurdle exists in acquiring data concerning acute procedural distress and long-term co-exposure risk to RD-ACs. Given the baffling complexities of RD-ACs, co-exposure risk and the need for innovative mitigation strategies, the study underscore the significance of establishing robust systems for deep road dust contaminants control and future research efforts while recognizing the interconnectivity within the contaminants associated with road dust.
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Affiliation(s)
- Yuxiao Zhang
- School of Automotive Engineering, Wuhan University of Technology, Wuhan, 430070, China; Suizhou-WUT Industrial Research Institute, Suizhou Economic Development Zone, Zengdu District, Suizhou City, Hubei Province, China
| | - Alex Justice Frimpong
- School of Automotive Engineering, Wuhan University of Technology, Wuhan, 430070, China; Suizhou-WUT Industrial Research Institute, Suizhou Economic Development Zone, Zengdu District, Suizhou City, Hubei Province, China; Department of Automotive and Agricultural Mechanization Engineering, Kumasi Technical University, Kumasi, Ghana
| | - Jingning Tang
- National Special Purpose Vehicle Product Quality Inspection and Testing Center, Suizhou City, Hubei Province, China
| | - Isaac Oyeyemi Olayode
- Department of Mechanical and Industrial Engineering Technology, University of Johannesburg, P. O. Box 2028, Johannesburg, South Africa
| | - Sampson Kofi Kyei
- Department of Chemical Engineering, Kumasi Technical University, Kumasi, Ghana
| | - Prince Owusu-Ansah
- Department of Automotive and Agricultural Mechanization Engineering, Kumasi Technical University, Kumasi, Ghana
| | - Philip Kwabena Agyeman
- School of Automotive Engineering, Wuhan University of Technology, Wuhan, 430070, China; Suizhou-WUT Industrial Research Institute, Suizhou Economic Development Zone, Zengdu District, Suizhou City, Hubei Province, China
| | - Jamshid Valiev Fayzullayevich
- School of Automotive Engineering, Wuhan University of Technology, Wuhan, 430070, China; Suizhou-WUT Industrial Research Institute, Suizhou Economic Development Zone, Zengdu District, Suizhou City, Hubei Province, China; School of Automobile and Automotive Economy, Tashkent State Transport University, Tashkent, Uzbekistan
| | - Gangfeng Tan
- School of Automotive Engineering, Wuhan University of Technology, Wuhan, 430070, China; Suizhou-WUT Industrial Research Institute, Suizhou Economic Development Zone, Zengdu District, Suizhou City, Hubei Province, China.
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