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Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study

Journal Article · · CMAJ. Canadian Medical Association Journal
DOI:https://doi.org/10.1503/cmaj.220068· OSTI ID:1904012
 [1];  [2];  [2];  [2];  [3];  [3];  [4];  [5];  [6];  [7];  [7];  [8];  [2]
  1. University of California, San Diego, CA (United States). Scripps Inst. of Oceanography; OSTI
  2. University of California, La Jolla, CA (United States)
  3. University of Toronto, ON (Canada)
  4. Washington University, St. Louis, MO (United States)
  5. Oregon State University, Corvallis, OR (United States)
  6. Conservation and Parks, Toronto (Canada)
  7. Health Canada, Ottawa (Canada)
  8. University of California, San Diego, CA (United States). Scripps Inst. of Oceanography
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The tremendous global health burden related to COVID-19 means that identifying determinants of COVID-19 severity is important for prevention and intervention. We aimed to explore long-term exposure to ambient air pollution as a potential contributor to COVID-19 severity, given its known impact on the respiratory system. Methods: We used a cohort of all people with confirmed SARS-CoV-2 infection, aged 20 years and older and not residing in a long-term care facility in Ontario, Canada, during 2020. We evaluated the association between long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ground-level ozone (O3), and risk of COVID-19-related hospital admission, intensive care unit (ICU) admission and death. We ascertained individuals’ longterm exposures to each air pollutant based on their residence from 2015 to 2019. We used logistic regression and adjusted for confounders and selection bias using various individual and contextual covariates obtained through data linkage. Results: Among the 151105 people with confirmed SARS-CoV-2 infection in Ontario in 2020, we observed 8630 hospital admissions, 1912 ICU admissions and 2137 deaths related to COVID-19. For each interquartile range increase in exposure to PM2.5 (1.70 µg/m3 ), we estimated odds ratios of 1.06 (95% confidence interval [CI] 1.01–1.12), 1.09 (95% CI 0.98–1.21) and 1.00 (95% CI 0.90–1.11) for hospital admission, ICU admission and death, respectively. Estimates were smaller for NO2. We also estimated odds ratios of 1.15 (95% CI 1.06–1.23), 1.30 (95% CI 1.12–1.50) and 1.18 (95% CI 1.02–1.36) per interquartile range increase of 5.14 ppb in O3 for hospital admission, ICU admission and death, respectively.
Research Organization:
University of California, San Diego, CA (United States)
Sponsoring Organization:
Health Canada; USDOE; University of Toronto
OSTI ID:
1904012
Journal Information:
CMAJ. Canadian Medical Association Journal, Journal Name: CMAJ. Canadian Medical Association Journal Journal Issue: 20 Vol. 194; ISSN 0820-3946
Publisher:
Ottawa Canadian Medical AssociationCopyright Statement
Country of Publication:
United States
Language:
English

References (1)

Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review collection January 2021

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Related Subjects

60 APPLIED LIFE SCIENCES
environmental issues
infectious diseases
public health
respiratory medicine