Who is more vulnerable to effects of long-term exposure to air pollution on COVID-19 hospitalisation?

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  • dc.contributor.author Ranzani, Otavio
  • dc.contributor.author Alari, Anna
  • dc.contributor.author Olmos, Sergio
  • dc.contributor.author Milà, Carles
  • dc.contributor.author Rico, Alex
  • dc.contributor.author Basagaña Flores, Xavier
  • dc.contributor.author Dadvand, Payam
  • dc.contributor.author Duarte Salles, Talita, 1985-
  • dc.contributor.author Forastiere, Francesco
  • dc.contributor.author Nieuwenhuijsen, Mark J.
  • dc.contributor.author Vivanco Hidalgo, Rosa María
  • dc.contributor.author Tonne, Cathryn
  • dc.date.accessioned 2024-07-02T06:22:19Z
  • dc.date.available 2024-07-02T06:22:19Z
  • dc.date.issued 2024
  • dc.description.abstract Objective: Factors that shape individuals' vulnerability to the effects of air pollution on COVID-19 severity remain poorly understood. We evaluated whether the association between long-term exposure to ambient NO2, PM2.5, and PM10 and COVID-19 hospitalisation differs by age, sex, individual income, area-level socioeconomic status, arterial hypertension, diabetes mellitus, and chronic obstructive pulmonary disease. Methods: We analysed a population-based cohort of 4,639,184 adults in Catalonia, Spain, during 2020. We fitted Cox proportional hazard models adjusted for several potential confounding factors and evaluated the interaction effect between vulnerability indicators and the 2019 annual average of NO2, PM2.5, and PM10. We evaluated interaction on both additive and multiplicative scales. Results: Overall, the association was additive between air pollution and the vulnerable groups. Air pollution and vulnerability indicators had a synergistic (greater than additive) effect for males and individuals with low income or living in the most deprived neighbourhoods. The Relative Excess Risk due to Interaction (RERI) was 0.21, 95 % CI, 0.15 to 0.27 for NO2 and 0.16, 95 % CI, 0.11 to 0.22 for PM2.5 for males; 0.13, 95 % CI, 0.09 to 0.18 for NO2 and 0.10, 95 % CI, 0.05 to 0.14 for PM2.5 for lower individual income and 0.17, 95 % CI, 0.12 to 0.22 for NO2 and 0.09, 95 % CI, 0.05 to 0.14 for PM2.5 for lower area-level socioeconomic status. Results for PM10 were similar to PM2.5. Results on multiplicative scale were inconsistent. Conclusions: Long-term exposure to air pollution had a larger synergistic effect on COVID-19 hospitalisation for males and those with lower individual- and area-level socioeconomic status.
  • dc.description.sponsorship This work was supported by Health Effects Institute (HEI) research agreement (grant No 4980-RFA20-1B/21-3). Research described in this article was conducted under contract to the HEI, an organisation jointly funded by the US Environmental Protection Agency (EPA) (assistance award No R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. OTR acknowledges support by a Sara Borrell fellowship from the Instituto de Salud Carlos III (CD19/00110). We acknowledge support from the grant CEX2018-000806-S funded by MCIN/AEI/ 10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Ranzani O, Alari A, Olmos S, Milà C, Rico A, Basagaña X, et al. Who is more vulnerable to effects of long-term exposure to air pollution on COVID-19 hospitalisation?. Environ Int. 2024 Mar;185:108530. DOI: 10.1016/j.envint.2024.108530
  • dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2024.108530
  • dc.identifier.issn 0160-4120
  • dc.identifier.uri http://hdl.handle.net/10230/60625
  • dc.language.iso eng
  • dc.publisher Elsevier
  • dc.relation.ispartof Environ Int. 2024 Mar;185:108530
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/CEX2018-000806-S
  • dc.rights © 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Air pollution
  • dc.subject.keyword COVID-19
  • dc.subject.keyword Effect modification
  • dc.subject.keyword Vulnerability
  • dc.title Who is more vulnerable to effects of long-term exposure to air pollution on COVID-19 hospitalisation?
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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