Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study
Abstract
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)more »
- Authors:
-
- University of California, San Diego, CA (United States). Scripps Inst. of Oceanography
- University of California, La Jolla, CA (United States)
- University of Toronto, ON (Canada)
- Washington University, St. Louis, MO (United States)
- Oregon State University, Corvallis, OR (United States)
- Conservation and Parks, Toronto (Canada)
- Health Canada, Ottawa (Canada)
- Publication Date:
- Research Org.:
- Univ. of California, San Diego, CA (United States)
- Sponsoring Org.:
- USDOE; University of Toronto; Health Canada
- OSTI Identifier:
- 1904012
- Grant/Contract Number:
- 810630
- Resource Type:
- Accepted Manuscript
- Journal Name:
- CMAJ. Canadian Medical Association Journal
- Additional Journal Information:
- Journal Volume: 194; Journal Issue: 20; Journal ID: ISSN 0820-3946
- Publisher:
- Ottawa Canadian Medical Association
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 60 APPLIED LIFE SCIENCES; environmental issues; infectious diseases; public health; respiratory medicine
Citation Formats
Chen, Chen, Wang, John, Kwong, Jeff, Kim, JinHee, van Donkelaar, Aaron, Martin, Randall V., Hystad, Perry, Su, Yushan, Lavigne, Eric, Kirby-McGregor, Megan, Kaufman, Jay S., Benmarhnia, Tarik, and Chen, Hong. Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study. United States: N. p., 2022.
Web. doi:10.1503/cmaj.220068.
Chen, Chen, Wang, John, Kwong, Jeff, Kim, JinHee, van Donkelaar, Aaron, Martin, Randall V., Hystad, Perry, Su, Yushan, Lavigne, Eric, Kirby-McGregor, Megan, Kaufman, Jay S., Benmarhnia, Tarik, & Chen, Hong. Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study. United States. https://doi.org/10.1503/cmaj.220068
Chen, Chen, Wang, John, Kwong, Jeff, Kim, JinHee, van Donkelaar, Aaron, Martin, Randall V., Hystad, Perry, Su, Yushan, Lavigne, Eric, Kirby-McGregor, Megan, Kaufman, Jay S., Benmarhnia, Tarik, and Chen, Hong. Tue .
"Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study". United States. https://doi.org/10.1503/cmaj.220068. https://www.osti.gov/servlets/purl/1904012.
@article{osti_1904012,
title = {Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study},
author = {Chen, Chen and Wang, John and Kwong, Jeff and Kim, JinHee and van Donkelaar, Aaron and Martin, Randall V. and Hystad, Perry and Su, Yushan and Lavigne, Eric and Kirby-McGregor, Megan and Kaufman, Jay S. and Benmarhnia, Tarik and Chen, Hong},
abstractNote = {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.},
doi = {10.1503/cmaj.220068},
journal = {CMAJ. Canadian Medical Association Journal},
number = 20,
volume = 194,
place = {United States},
year = {Tue May 24 00:00:00 EDT 2022},
month = {Tue May 24 00:00:00 EDT 2022}
}
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