Does airborne pollen influence COVID-19 outbreak?

Pollen and sub-pollen particles: External interactions shaping the allergic potential of pollen

Pollen allergies, such as allergic rhinitis, are triggered by exposure to airborne pollen. They are a considerable global health burden, with their numbers expected to rise in the coming decades due to the advent of climate change and air pollution. The relationships that exist between pollens, meteorological, and environmental conditions are complex due to a lack of clarity on the nature and conditions associated with these interactions; therefore, it is challenging to describe their direct impacts on allergenic potential clearly. This article attempts to review evidence pertaining to the possible influence of meteorological factors and air pollutants on the allergic potential of pollen by studying the interactions that pollen undergoes, from its inception to atmospheric traversal to human exposure. This study classifies the evidence based on the nature of these interactions as physical, chemical, source, and biological, thereby simplifying the complexities in describing these interactions. Physical conditions facilitating pollen rupturing for tree, grass, and weed pollen, along with their mechanisms, are studied. The effects of pollen exposure to air pollutants and their impact on pollen allergenic potential are presented along with the possible outcomes following these interactions, such as pollen fragmentation (SPP generation), deposition of particulate matter on pollen exine, and modification of protein levels in-situ of pollen. This study also delves into evidence on plant-based (source and biological) interactions, which could indirectly influence the allergic potential of pollen. The current state of knowledge, open questions, and a brief overview of future research directions are outlined and discussed. We suggest that future studies should utilise a multi-disciplinary approach to better understand this complex system of pollen interactions that occur in nature.

Atmospheric pollen concentrations and chronic obstructive pulmonary disease (COPD) patients visits in Beijing: time series analysis using a generalized additive model

To investigate the correlation between the daily visits of chronic obstructive pulmonary disease (COPD) patients in hospital clinic and pollen concentrations in Beijing. We collected daily visits of COPD patients of Beijing Shijitan Hospital from April 1st, 2019 to September 30th, 2019. The relationship between pollen concentrations and COPD patient number was analyzed with meteorological factors, time trend, day of the week effect and holiday effect being controlled by the generalized additive model of time series analysis. R4.1.2 software was applied to generate Spearman correlation coefficient, specific and incremental cumulative effect curves of relative risks as well as the response and three-dimensional diagrams for the exposure lag effect prediction. The fitting models were used to predict the lag relative risk and 95% confidence intervals for specific and incremental cumulative effects of specific pollen concentrations. The number of COPD patients was positively correlated with pollen concentration. When pollen concentration increased by 10 grains/1000 mm2, the peak value of the specific cumulative effect appeared on day0, with the effect gone on day4 and a lag time of 4 days observed, whereas the incremental cumulative effect's peak value was shown on day17, and the effect disappeared on day18, with a lag time of 18 days. The results showed that pollen concentration was not only positively correlated with the number of COPD patients, but also had a bimodal lag effect on COPD visits in the hospital at Beijing.

Crowding on public transport using smart card data during the COVID-19 pandemic: New methodology and case study in Chile

Most crowding measures in public transportation are usually aggregated at a service level. This type of aggregation does not help to analyze microscopic behavior such as exposure risk to viruses. To bridge such a gap, our paper proposes four novel crowding measures that might be well suited to proxy virus exposure risk at public transport. In addition, we conduct a case study in Santiago, Chile, using smart card data of the buses system to compute the proposed measures for three different and relevant periods of the COVID-19 pandemic: before, during, and after Santiago's lockdown. We find that the governmental policies diminished public transport crowding considerably for the lockdown phase. The average exposure time when social distancing is not possible passes from 6.39 min before lockdown to 0.03 min during the lockdown, while the average number of encountered persons passes from 43.33 to 5.89. We shed light on how the pandemic impacts differ across various population groups in society. Our findings suggest that poorer municipalities returned faster to crowding levels similar to those before the pandemic.

A Review of the Role of Pollen in COVID-19 Infection

There is current interest in the role of ambient pollen in the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 or COVID-19) infection risk. The aim of this review is to summarise studies published up until January 2023 investigating the relationship between airborne pollen and the risk of COVID-19 infection. We found conflicting evidence, with some studies showing that pollen may increase the risk of COVID-19 infection by acting as a carrier, while others showed that pollen may reduce the risk by acting as an inhibiting factor. A few studies reported no evidence of an association between pollen and the risk of infection. A major limiting factor of this research is not being able to determine whether pollen contributed to the susceptibility to infection or just the expression of symptoms. Hence, more research is needed to better understand this highly complex relationship. Future investigations should consider individual and sociodemographic factors as potential effect modifiers when investigating these associations. This knowledge will help to identify targeted interventions.

Antimicrobial Nanomaterials as Advanced Coatings for Self-Sanitizing of Textile Clothing and Personal Protective Equipment

Controlling bioaerosols has become increasingly critical in affecting human health. Natural product treatment in the nano form is a potential method since it has lower toxicity than inorganic nanomaterials like silver nanoparticles. This research is important for the creation of a bioaerosol control system that is effective. Nanoparticles (NPs) are gradually being employed to use bacteria as a nonantibiotic substitute for treating bacterial infections. The present study looks at nanoparticles' antimicrobial properties, their method of action, their impact on drug-opposing bacteria, and the hazards connected with their operation as antimicrobial agents. The aspects that influence nanoparticle conduct in clinical settings, as well as their distinctive features and mode of action as antibacterial assistants, are thoroughly examined. Nanoparticles' action on bacterial cells is presently accepted by way of the introduction of oxidative stress induction, metal-ion release, and nonoxidative methods. Because many concurrent mechanisms of action against germs would necessitate multiple simultaneous gene modifications in the same bacterial cell for antibacterial protection to evolve, bacterial cells developing resistance to NPs is difficult. This review discusses the antimicrobial function of NPs against microbes and presents a comprehensive discussion of the bioaerosols: their origin, hazards, and their prevention. This state of the art method is dependent upon the use of personal protective gear against these bioaerosols. The benefit of the utmost significant categories of metal nanoparticles as antibacterial agents is given important consideration. The novelty of this review depends upon the antimicrobial properties of (a) silver (Ag), (b) zinc oxide (ZnO), and (c) copper oxide (CuO) nanoparticles. The value-added features of these nanoparticles are discussed, as well as their physicochemical characterization and pharmacokinetics, including the toxicological danger they pose to people. Lastly, the effective role of nanomaterials and their future in human wellness is discussed.

Identification of prominent airborne pollen in a city situated in foot-hills of Himalayas, Chandigarh, India

Pollen allergy is considered one of the important critical thrust areas, as 20-30% of the world population suffers from allergic rhinitis. The increase in global surface temperature directly affects pollen physiological (e.g., pollen production) and morphological parameters and indirectly affects the distribution pattern, the allergenic potential of pollen, and plant species. Therefore, periodic sampling and pollen studies of a region have become necessary to assess the status of change in species and its morphological characteristics of different taxa. The current study is conducted to identify the airborne pollen based on studying their unique and distinctive morphological characters to serve as a reference pollen guide for future research. The airborne pollens were trapped using the Burkard volumetric sampler at three different locations in Chandigarh from 2018 to 2020 and analyzed under Leica DM5500B-Automated Upright Microscope System. The study investigated various pollen features such as shape, size, aperture type, and exine/surface pattern for taxonomic classification of plant groups. The majority of LM-analyzed pollen grains were prolate-spheroidal or oblate, whereas the aperture types were 3-zonocolporate, 3-colpate, and 3-zonocolporate. Exine patterns were predominantly psilate, reticulate, and straite and were easily discernible. Nonetheless, the vast majority of airborne pollen belonging to both arboreal and non-arboreal was quite small and fall into small pollen size classes, i.e., 10-24 μm. The exine pattern was readily apparent and were predominantly psilate, reticulate, and straight. The current study improved the knowledge on airborne pollen biodiversity, which will help to understand the regional distribution, long-range transport, and construct the current status of morphological features of species/taxa.

Impact of Different Air Pollutants (PM10, PM2.5, NO2, and Bacterial Aerosols) on COVID-19 Cases in Gliwice, Southern Poland

Many studies have shown that air pollution may be closely associated with increased morbidity and mortality due to COVID-19. It has been observed that exposure to air pollution leads to reduced immune response, thereby facilitating viral penetration and replication. In our study, we combined information on confirmed COVID-19 daily new cases (DNCs) in one of the most polluted regions in the European Union (EU) with air-quality monitoring data, including meteorological parameters (temperature, relative humidity, atmospheric pressure, wind speed, and direction) and concentrations of particulate matter (PM₁₀ and PM_2.5), sulfur dioxide (SO₂), nitrogen oxides (NO and NO₂), ozone (O₃), and carbon monoxide (CO). Additionally, the relationship between bacterial aerosol (BA) concentration and COVID-19 spread was analyzed. We confirmed a significant positive correlation (p < 0.05) between NO₂ concentrations and numbers of confirmed DNCs and observed positive correlations (p < 0.05) between BA concentrations and DNCs, which may point to coronavirus air transmission by surface deposits on bioaerosol particles. In addition, wind direction information was used to show that the highest numbers of DNCs were associated with the dominant wind directions in the region (southern and southwestern parts).

Influencing Factors on Airflow and Pollutant Dispersion around Buildings under the Combined Effect of Wind and Buoyancy-A Review

With the rapid growth of populations worldwide, air quality has become an increasingly important issue related to the health and safety of city inhabitants. There are quite a few factors that contribute to urban air pollution; the majority of studies examining the issue are concerned with environmental conditions, building geometries, source characteristics and other factors and have used a variety of approaches, from theoretical modelling to experimental measurements and numerical simulations. Among the environmental conditions, solar-radiation-induced buoyancy plays an important role in realistic conditions. The thermal conditions of the ground and building façades directly affect the wind field and pollutant dispersion patterns in the microclimate. The coupling effect of wind and buoyancy on the urban environment are currently hot and attractive research topics. Extensive studies have been devoted to this field, some focused on the street canyon scale, and have found that thermal effects do not significantly affect the main airflow structure in the interior of the street canyon but strongly affect the wind velocity and pollutant concentration at the pedestrian level. Others revealed that the pollutant dispersion routes can be obviously different under various Richardson numbers at the scale of the isolated building. The purpose of this review is therefore to systematically articulate the approaches and research outcomes under the combined effect of wind and buoyancy from the street canyon scale to an isolated building, which should provide some insights into future modelling directions in environmental studies.

Environmental contributions to the interactions of COVID-19 and asthma: A secondary publication and update

An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) started in Wuhan, Hubei Province, China and quickly spread around the world. Current evidence is contradictory on the association of asthma with COVID-19 and associated severe outcomes. Type 2 inflammation may reduce the risk for severe COVID-19. Whether asthma diagnosis may be a risk factor for severe COVID-19, especially for those with severe disease or non-allergic phenotypes, deserves further attention and clarification. In addition, COVID-19 does not appear to provoke asthma exacerbations, and asthma therapeutics should be continued for patients with exposure to COVID-19. Changes in the intensity of pollinization, an earlier start and extension of the pollinating season, and the increase in production and allergenicity of pollen are known direct effects that air pollution has on physical, chemical, and biological properties of the pollen grains. They are influenced and triggered by meteorological variables that could partially explain the effect on COVID-19. SARS-CoV-2 is capable of persisting in the environment and can be transported by bioaerosols which can further influence its transmission rate and seasonality. The COVID-19 pandemic has changed the behavior of adults and children globally. A general trend during the pandemic has been human isolation indoors due to school lockdowns and loss of job or implementation of virtual work at home. A consequence of this behavior change would presumably be changes in indoor allergen exposures and reduction of inhaled outdoor allergens. Therefore, lockdowns during the pandemic might have improved some specific allergies, while worsening others, depending on the housing conditions.

High altitude Relieves transmission risks of COVID-19 through meteorological and environmental factors: Evidence from China

Existing studies reported higher altitudes reduce the COVID-19 infection rate in the United States, Colombia, and Peru. However, the underlying reasons for this phenomenon remain unclear. In this study, regression analysis and mediating effect model were used in a combination to explore the altitudes relation with the pattern of transmission under their correlation factors. The preliminary linear regression analysis indicated a negative correlation between altitudes and COVID-19 infection in China. In contrast to environmental factors from low-altitude regions (<1500 m), high-altitude regions (>1500 m) exhibited lower PM2.5, average temperature (AT), and mobility, accompanied by high SO2 and absolute humidity (AH). Non-linear regression analysis further revealed that COVID-19 confirmed cases had a positive correlation with mobility, AH, and AT, whereas negatively correlated with SO2, CO, and DTR. Subsequent mediating effect model with altitude-correlated factors, such as mobility, AT, AH, DTR and SO2, suffice to discriminate the COVID-19 infection rate between low- and high-altitude regions. The mentioned evidence advance our understanding of the altitude-mediated COVID-19 transmission mechanism.

Characteristics of inhalable bioaerosols on foggy and hazy days and their deposition in the human respiratory tract

Atmospheric bioaerosols contain live and dead biological components that can enter the human respiratory tract (HRT) and affect human health. Here, the total microorganisms in a coastal megacity, Qingdao, were characterized on the basis of long-term observations from October 2013 to January 2021. Particular attention was given to the size dependence of inhalable bioaerosols in concentration and respiratory deposition in different populations on foggy and hazy days. Bioaerosol samples stained with 4,6-diamidino-2-phenylindole (DAPI) were selected to measure the total airborne microbe (TAM) concentrations with an epifluorescence microscope, while a multiple-path particle dosimetry model was employed to calculate respiratory deposition. The mean TAM concentrations in the particle size range of 0.65-1.1 μm (TAM_0.65-1.1) were 1.23, 2.02, 1.60 and 2.33 times those on sunny reference days relative to the corresponding values on days with slight, mild, moderate and severe levels of haze, respectively. The mean concentration of TAMs in the particle size range of 0.65-2.1 μm (TAM_0.65-2.1) on severely hazy days was (2.02 ± 3.28) × 10⁵ cells/m³, with a reduction of 4.16% relative to that on the reference days. The mean TAM_0.65-2.1 concentration changed from (1.50 ± 1.37) × 10⁵ cells/m³ to (1.76 ± 1.36) × 10⁵ cells/m³, with TAM_0.65-1.1 increasing from (7.91 ± 7.97) × 10⁴ cells/m³ to (1.76 ± 1.33) × 10⁵ cells/m³ on days with light fog days and medium fog, respectively. The modeling results showed that the majority of TAM_0.65-2.1 deposition occurred in the extrathoracic (ET) region, followed by the alveolar (AL) region. When different populations were examined separately, the deposition doses (DDs) in adult females and in children ranked at the minimum value (6.19 × 10³ cells/h) and maximum value (1.08 × 10⁴ cells/h), respectively. However, the inhalation risks on polluted days, such as hazy, foggy and mixed hazy-foggy (HF) days, were still below the threshold for adverse impacts on human health.

On male urination and related environmental disease transmission in restrooms: From the perspectives of fluid dynamics

Indoor transmission of COVID-19 is highly probable. Multiple sources have verified that the SARS-CoV-2 can be detected within toilets, and people can be infected in restrooms. There is a huge gap in the coronavirus transmission mechanism in restrooms. Understanding it can help to flatten the curve of the infected cases as well as prevent other viruses transmitted through the sewage or human body fluid. Previous studies have shown how simple actions in daily life (coughing, sneezing, or toilet flushing) contribute to virus transmission. This paper visually and quantitatively demonstrates that male urination, which is also a daily action, can agitate virus particles within the toilet and raise them, which may be the main promoter of cross-infection of COVID-19 in restrooms. Adopting numerical and experimental methods, we demonstrate that male urination can cause strong turbulent flow with an averaged urine impinging velocity of 2.3 m/s, which can act as an agitator to raise the virus particles. The climbing velocity of the airflow can be 0.75-1.05 m/s. The observed upwards flow will disturb and spread any lurking virus particles (not limited to SARS-CoV-2). Experiments demonstrated that the concentration of the airborne particle could be tripled during male urination. Corresponding precautions are offered as well to prepare the public to act properly when and after using facilities in restrooms for preventing emerging and re-emerging pandemics not limited to the current COVID-19, contributing to the sustainability of human society.

Analysis of the Association Among Air Pollutants, Allergenic Pollen, and Respiratory Virus Infection of Children in Guri, Korea During Recent 5 Years

PURPOSE

Concerns about the spread of infectious diseases have increased due to the coronavirus disease pandemic. Knowing the factors that exacerbate or increase the contagiousness of a virus could be a key to pandemic prevention. Therefore, we investigated whether the pandemic potential of infectious diseases correlates with the concentration of atmospheric substances. We also investigated whether environmental deterioration causes an increase in viral infections.

METHODS

Pediatric patients (0-18 years old; n = 6,223) were recruited from those hospitalized for aggravated respiratory symptoms at Hanyang University Guri Hospital between January 1, 2015 and December 31, 2019. The number of viral infections was defined as the total number of virus-infected patients hospitalized for respiratory symptoms. We analyzed the association between the number of viral infections/week and the average concentrations of atmospheric substances including particulate matter (PM)10, PM2.5, O₃, NO₂, CO, SO₂, and allergenic pollen) for that week. The cross-correlation coefficient between the weekly measures of pollens and viral infections was checked to determine which time point had the most influence. The association of atmospheric substances in that time, with the number of viral infections/week was investigated using multiple linear regression analysis to identify factors with the greatest influence.

RESULTS

In spring the tree pollen average concentration one week earlier (t-1) had the greatest correlation with the average virus infection of a given week (t) (ρXY (h) =0.5210). The number of viral infections showed a statistically significant correlation with especially tree pollen concentration of 1 week prior (adj R²=0.2280). O₃ concentration was correlated to the number of viral infections within that week (adj R²=0.2552) in spring, and weed pollen and CO concentration correlated (adj R²=0.1327) in autumn.

CONCLUSIONS

Seasonal co-exposure to air pollutants and allergenic pollens may enhance respiratory viral infection susceptibility in children. Therefore, reducing the concentrations of air pollutants and pollens may help prevent future epidemics.

Influence of meteorological parameters and air pollutants on the airborne pollen of city Chandigarh, India

Pollen, climatic variables and air pollutants coexist in nature with the potential to interact with one another and play a crucial role in increasing allergic diseases. The current study evaluates the influence of meteorological parameters and air pollutants on the airborne pollen in an urban city, Chandigarh, situated in the Indo-Gangetic Plains. Airborne pollen monitoring was done following Spanish Aerobiological Network guidelines and dynamics of daily total pollen and six most abundant taxa were studied from June 2018 to June 2020. Among meteorological parameters, temperature and wind were the most correlated and influential parameters to airborne pollen concentration. Annual Pollen Integral (APIn) of Cannabis sativa (r = 0.52), Parthenium hysterophorus (r = 0.27), Poaceae (r = 0.32) and total pollen concentration (r = 0.30) showed a statistically significant positive correlation with temperature. In contrast, precipitation and relative humidity negatively correlated with APIn of total pollen concentration, Eucalyptus sp. and Poaceae except for Parthenium hysterophorus and Celtis occidentalis. Similar results were found with Seasonal Pollen Integral (SPIn) of total pollen concentration, six major taxa and meteorological variables. Spearman correlation performed for NOx showed a significant positive correlation among APIn and SPIn of Celtis occidentalis and insignificant among APIn and SPIn of Eucalyptus sp. and Morus alba. In contrast, except for Eucalyptus sp., PM₁₀ and PM_2.5 were negatively correlated among APIn and SPIn of total pollen concentration and other major taxa. Spearman's correlation of APIn and SPIn for each pollen taxon, meteorological parameters and air pollutants suggests that each taxon has a different pattern in response to all parameters. The study findings suggest that pollen response must be examined at the taxon level, not the assemblage level, having long time-series data. This will help to compute future scenarios of changing environmental factors and comprehend the relationships and trends among meteorology, air pollutants and aerobiology.

Pollen allergy: Developing multi-sectorial strategies for its prevention and control in lower and middle-income countries

Pollen allergy is considered a major public health problem that causes morbidity and subsequently affects a patient's quality of life. Pollen due to their large size cannot enter the thoracic regions of the respiratory tract but can affect the nasopharyngeal mucous membrane. At the same time, the submicronic-pollen particles can act as respirable particles reaching deeper into the upper airways leading to exacerbation of asthma, chronic obstructive pulmonary disease (COPD) and other allergic reactions. Based on the existing literature, expanding evidence shows that climate change and air pollutants could affect the pollen number, morphology, season, allergen content, and distribution pattern. Hence, this will influence the prevalence and occurrence of allergies linked to pollen exposure. Being a part of biogenic pollutants, pollen allergens are not expected to diminish in the foreseeable future. Therefore, it is imperative that steps need to be strengthened to improve and optimize preventive/adaptive strategies. This paper aims to review the major causes of widespread allergy, identify the major gaps, and suggest key preventive/adaptive measures to address the onset and exacerbation of pollen-related allergic diseases with a major focus on lower and middle-income countries. The study also discusses how-to implement the prevention and control measures at the individual, health care communities and organizations, Local Governments, National/International Governments levels to decrease the risk of illnesses associated with pollen allergy.

Impact of the environment on the microbiome

OBJECTIVES

This review aimed to verify indoor and outdoor pollution, host and environmental microbiome, and the impact on the health of the pediatric population.

SOURCES

A review of the literature, non-systematic, with the search for articles since 2001 in PubMed with the terms "pollution" AND "microbiome" AND "children's health" AND "COVID-19".

SUMMARY OF THE FINDINGS

Prevention of allergic diseases includes the following aspects: avoid cesarean delivery, the unnecessary overuse of antibiotics, air pollution, smoking in pregnancy and second-hand tobacco smoke, stimulate breastfeeding, soil connection, consume fresh fruits and vegetables, exercise and outdoor activities and animal contact. The children's microbiota richness and diversity decrease the risk of immune disbalance and allergic disease development.

CONCLUSIONS

Lifestyle and exposure to pollutants, both biological and non-biological, modify the host and the environment microbiome provoking an immune disbalance with inflammatory consequences and development of allergic diseases.

COVID-19 pandemic: What can we learn for better air quality and human health?

The COVID-19 lockdown resulted in improved air quality in many cities across the world. With the objective of what could be the new learning from the COVID-19 pandemic and subsequent lockdowns for better air quality and human health, a critical synthesis of the available evidence concerning air pollution reduction, the population at risk and natural versus anthropogenic emissions was conducted. Can the new societal norms adopted during pandemics, such as the use of face cover, awareness regarding respiratory hand hygiene, and physical distancing, help in reducing disease burden in the future? The use of masks will be more socially acceptable during the high air pollution episodes in lower and middle-income countries, which could help to reduce air pollution exposure. Although post-pandemic, some air pollution reduction strategies may be affected, such as car-pooling and the use of mass transit systems for commuting to avoid exposure to airborne infections like coronavirus. However, promoting non-motorized modes of transportation such as cycling and walking within cities as currently being enabled in Europe and other countries could overshadow such losses. This demand focus on increasing walkability in a town for all ages and populations, including for a differently-abled community. The study highlighted that for better health and sustainability there. is also a need to promote other measures such as work-from-home, technological infrastructure, the extension of smart cities, and the use of information technology.

Using an Eigenvector Spatial Filtering-Based Spatially Varying Coefficient Model to Analyze the Spatial Heterogeneity of COVID-19 and Its Influencing Factors in Mainland China

The COVID-19 pandemic has led to many deaths and economic disruptions across the world. Several studies have examined the effect of corresponding health risk factors in different places, but the problem of spatial heterogeneity has not been adequately addressed. The purpose of this paper was to explore how selected health risk factors are related to the pandemic infection rate within different study extents and to reveal the spatial varying characteristics of certain health risk factors. An eigenvector spatial filtering-based spatially varying coefficient model (ESF-SVC) was developed to find out how the influence of selected health risk factors varies across space and time. The ESF-SVC was able to take good control of over-fitting problems compared with ordinary least square (OLS), eigenvector spatial filtering (ESF) and geographically weighted regression (GWR) models, with a higher adjusted R2 and lower cross validation RMSE. The impact of health risk factors varied as the study extent changed: In Hubei province, only population density and wind speed showed significant spatially constant impact; while in mainland China, other factors including migration score, building density, temperature and altitude showed significant spatially varying impact. The influence of migration score was less contributive and less significant in cities around Wuhan than cities further away, while altitude showed a stronger contribution to the decrease of infection rates in high altitude cities. The temperature showed mixed correlation as time passed, with positive and negative coefficients at 2.42 °C and 8.17 °C, respectively. This study could provide a feasible path to improve the model fit by considering the problem of spatial autocorrelation and heterogeneity that exists in COVID-19 modeling. The yielding ESF-SVC coefficients could also provide an intuitive method for discovering the different impacts of influencing factors across space in large study areas. It is hoped that these findings improve public and governmental awareness of potential health risks and therefore influence epidemic control strategies.

COVID-19 pandemic and sudden rise in crop residue burning in India: issues and prospects for sustainable crop residue management

The seasonal burning of crop residue significantly affects the environment, leading to poor air quality over Indo-Gangetic Plain (IGP) in India. Hence, there have been significant efforts to minimize crop residue burning through policy, innovations, and awareness measures. However, an abrupt increase in paddy residue burning was observed over IGP during 2020. Hence, the study explores the factors leading to this sharp rise. The business as usual trends analysis revealed that paddy crop residue burning activities increased significantly (60%) in 2020 compared to the previous year. The massive increase in crop residue burning consequently seems to be linked with the COVID-19 pandemic, which affected the farmer's income, including the poor compliance by the regulatory authorities. The study also highlights the issues and prospects for sustainable crop residue management and explores the solutions to minimize crop residue burning. There are few crops in India that have guaranteed minimum sale price and are also subsidized. These provisions encourage farmers to grow those particular crops, resulting in the generation of large amounts of crop residue from these specific crops. There have been several efforts by the Indian government, including based on recent court intervention. Still, there is no respite from burning activities and the occurrence of Delhi winter smog every year. Hence, the study emphasizes a need to adopt integrated approaches having in situ eco-friendly solutions, which enhances the farmer's income and focuses on employability, capacity building, awareness generation, and in situ economically viable solutions.

Understanding seasonal variation in ambient air quality and its relationship with crop residue burning activities in an agrarian state of India

In India, Indo-Gangetic Plains (IGP) is becoming the hotspot of air pollution due to increasing anthropogenic activities such as rapid industrial growth, infrastructure development, transportation activities, and seasonal practice of crop residue burning. In the current study, seasonal variation in ambient air quality for 14 parameters, i.e., particulate matter (PM), trace gases, and volatile organic compounds (VOCs), along with meteorological parameters, was studied in 21 districts of the Haryana state for year 2019, situated in IGP. To analyze spatial variation of pollutants, ambient air quality data of 23 continuous ambient air quality monitoring stations were divided into three zones based on ecology and cropping pattern. All the zones showed annual mean PM₁₀ and PM_2.5 concentrations much higher than national ambient air quality standards. Annual mean PM₁₀ concentration (±standard deviation) in Zones-1, 2, and 3 was 156±86, 174±93, and 143±74 μg m^-3, whereas for PM_2.5 was 71±44, 85±54, and 78±47 μg m^-3. The results showed a considerable seasonal variation in the concentration of all pollutants. Most of the pollutants peak in the post-monsoon season, followed by winters in which crop residue burning predominates in many parts of the Haryana. PM₁₀ concentrations increased by 65-112% and PM_2.5 concentrations increased by 131-147% in the post-monsoon season compared to monsoons. The post-monsoon season showed the highest concentration of PM₁₀, NO, and toluene (Zone-1); and PM_2.5, NH₃, CO, and benzene (Zone-2); whereas in winters, SO₂ (Zone-1); ethylbenzene, m,p-xylene, and xylene (Zone-2); and NO₂ and NOx (Zone-3) showed the maximum pollution levels. The O₃ concentration was highest in the pre-monsoon season (Zone-1). The satellite-based fire counts and PCA results show a significant influence of crop residue burning in the post-monsoon season and solid biomass burning in winters on Haryana's air quality. The study could help to understand seasonal variation in ambient air quality and the influence of factors such as crop residue burning in the IGP region, which could help to formulate season-specific control measures to improve regional air quality.

COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection

Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.

Exposure-lag-response associations between weather conditions and ankylosing spondylitis: a time series study

Background

Patients with ankylosing spondylitis (AS) have reported that their pain becomes worse when the local weather changes. However, there is limited evidence verifying the short-term associations between meteorological factors and outpatient visits for patients with AS. Therefore, this study evaluates this possible association.

Methods

Meteorological data and data on daily AS outpatient visits to a general hospital in Hefei, China, from 2014 to 2019 were collected and analysed. Distributed lag nonlinear models and Poisson regression models were employed to determine the association between weather conditions and outpatient visits; the results were also stratified by gender and age.

Results

High relative humidity is significantly associated with all patient visits in lag 1 (RR = 1.113, 95% CI 1.021 to 1.213) and lag 7 days (RR = 1.115, 95% CI 1.014 to 1.227). A low relative risk to the nadir is observed in lag 4 days (RR = 0.920, 95% CI 0.862 to 0.983). Male and young patients (< 65 years) are more vulnerable to damp weather, and elderly people (≥ 65 years) are significantly affected by high temperatures in lag 7 days (RR = 3.004, 95% CI 1.201 to 7.510).

Conclusions

Our findings suggest a potential relationship between exposure to weather conditions and increased risk of AS outpatient visits. These results can aid hospitals in preparing for and managing hospital visits by AS patients when the local weather conditions change.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04523-y.