1
|
Marian B, Yan Y, Chen Z, Lurmann F, Li K, Gilliland F, Eckel SP, Garcia E. Independent associations of short- and long-term air pollution exposure with COVID-19 mortality among Californians. Environ Adv 2022; 9:100280. [PMID: 35966412 PMCID: PMC9361629 DOI: 10.1016/j.envadv.2022.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/30/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
The growing literature demonstrating air pollution associations on COVID-19 mortality contains studies predominantly examining long-term exposure, with few on short-term exposure, and rarely both together to estimate independent associations. Because mechanisms by which air pollution may impact COVID-19 mortality risk function over timescales ranging from years to days, and given correlation among exposure time windows, consideration of both short- and long-term exposure is of importance. We assessed the independent associations between COVID-19 mortality rates with short- and long-term air pollution exposure by modeling both concurrently. Using California death certificate data COVID-19-related deaths were identified, and decedent residential information used to assess short- (4-week mean) and long-term (6-year mean) exposure to particulate matter <2.5µm (PM2.5), nitrogen dioxide (NO2), and ozone (O3). Negative binomial mixed models were fitted on weekly census tract COVID-19 mortality adjusting for potential confounders with random effects for county and census tract and an offset for population. Data were evaluated separately for two time periods March 16, 2020-October 18, 2020 and October 19, 2020-April 25, 2021, representing the Spring/Summer surges and Winter surge. Independent positive associations with COVID-19 mortality were observed for short- and long-term PM2.5 in both study periods, with strongest associations observed in the first study period: COVID-19 mortality rate ratio for a 2-μg/m3 increase in long-term PM2.5 was 1.13 (95%CI:1.09,1.17) and for a 4.7-μg/m3 increase in short-term PM2.5 was 1.05 (95%CI:1.02,1.08). Statistically significant positive associations were seen for both short- and long-term NO2 in study period 1, but short-term NO2 was not statistically significant in study period 2. Results for long-term O3 indicate positive associations, however, only marginal significance is achieved in study period 1. These findings support an adverse effect of long-term PM2.5 and NO2 exposure on COVID-19 mortality risk, independent of short-term exposure, and a possible independent effect of short-term PM2.5.
Collapse
Affiliation(s)
- Brittney Marian
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States of America
| | - Ying Yan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States of America
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States of America
| | - Fred Lurmann
- Sonoma Technology, Inc, Petaluma, CA, United States of America
| | - Kenan Li
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States of America
| | - Frank Gilliland
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States of America
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States of America
| | - Erika Garcia
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States of America
| |
Collapse
|