About 15% of COVID-19-related deaths linked to long-term exposure to air pollution

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About 15% of COVID-19-related deaths linked to long-term exposure to air pollution

Post by trader32176 »

About 15% of COVID-19-related deaths linked to long-term exposure to air pollution


https://www.news-medical.net/news/20201 ... ution.aspx

Long-term exposure to air pollution has been linked to an increased risk of dying from COVID-19 and, for the first time, a study has estimated the proportion of deaths from the coronavirus that could be attributed to the exacerbating effects of air pollution for every country in the world.

The study, published in Cardiovascular Researchtoday (Tuesday), estimated that about 15% of deaths worldwide from COVID-19 could be attributed to long-term exposure to air pollution. In Europe the proportion was about 19%, in North America it was 17%, and in East Asia about 27%.

In their CVR paper, the researchers write that these proportions are an estimate of "the fraction of COVID-19 deaths that could be avoided if the population were exposed to lower counterfactual air pollution levels without fossil fuel-related and other anthropogenic [caused by humans] emissions".

They add that this "attributable fraction does not imply a direct cause-effect relationship between air pollution and COVID-19 mortality (although it is possible). Instead it refers to relationships between two, direct and indirect, i.e. by aggravating co-morbidities [other health conditions] that could lead to fatal health outcomes of the virus infection".

The research team includes Professor Jos Lelieveld, of the Max Planck Institute for Chemistry, Mainz, Germany, and the Cyprus Institute Nicosia, Cyprus, Professor Thomas Münzel, from the University Medical Center of the Johannes Gutenberg University, Mainz, and the German Center for Cardiovascular Research, Mainz, and Dr. Andrea Pozzer, from the Max Planck Institute for Chemistry.

The researchers used epidemiological data from previous US and Chinese studies of air pollution and COVID-19 and the SARS outbreak in 2003, supported by additional data from Italy.

They combined this with satellite data showing global exposure to polluting fine particles known as 'particulate matter' that are less than or equal to 2.5 microns in diameter (known as PM2.5), information on atmospheric conditions and ground-based pollution monitoring networks, to create a model to calculate the fraction of coronavirus deaths that could be attributable to long-term exposure to PM2.5.

The results are based on epidemiological data collected up the third week in June 2020 and the researchers say a comprehensive evaluation will need to follow after the pandemic has subsided.

Estimates for individual countries show, for example, that air pollution contributed to 29% of coronavirus deaths in the Czech Republic, 27% in China, 26% in Germany, 22% in Switzerland, 21% in Belgium, 19% in The Netherlands, 18% in France, 16% in Sweden, 15% in Italy, 14% in the UK, 12% in Brazil, 11% in Portugal, 8% in the Republic of Ireland, 6% in Israel, 3% in Australia and just 1% in New Zealand.

Professor Jos Lelieveld said:

Since the numbers of deaths from COVID-19 are increasing all the time, it's not possible to give exact or final numbers of COVID-19 deaths per country that can be attributed to air pollution.

However, as an example, in the UK there have been over 44,000 coronavirus deaths and we estimate that the fraction attributable to air pollution is 14%, meaning that more than 6,100 deaths could be attributed to air pollution.

In the USA, more than 220,000 COVID deaths with a fraction of 18% yields about 40,000 deaths attributable to air pollution."

Prof. Münzel said: "When people inhale polluted air, the very small polluting particles, the PM2.5, migrate from the lungs to the blood and blood vessels, causing inflammation and severe oxidative stress, which is an imbalance between free radicals and oxidants in the body that normally repair damage to cells. This causes damage to the inner lining of arteries, the endothelium, and leads to the narrowing and stiffening of the arteries. The COVID-19 virus also enters the body via the lungs, causing similar damage to blood vessels, and it is now considered to be an endothelial disease.

"If both long-term exposure to air pollution and infection with the COVID-19 virus come together then we have an additive adverse effect on health, particularly with respect to the heart and blood vessels, which leads to greater vulnerability and less resilience to COVID-19. If you already have heart disease, then air pollution and coronavirus infection will cause trouble that can lead to heart attacks, heart failure and stroke."

Referring to previous work that suggests that the fine particulates in air pollution may prolong the atmospheric lifetime of infectious viruses and help them to infect more people [1], Prof. Lelieveld said: "It's likely that particulate matter plays a role in 'super-spreading events' by favouring transmission."

Prof. Münzel added: "Particulate matter seems to increase the activity of a receptor on cell surfaces, called ACE-2, that is known to be involved in the way COVID-19 infects cells. So we have a 'double hit': air pollution damages the lungs and increases the activity of ACE-2, which in turn leads to enhanced uptake of the virus by the lungs and probably by the blood vessels and the heart."

In their paper, the authors conclude: "Our results suggest the potential for substantial benefits from reducing air pollution exposure, even at relatively low PM2.5 levels. . . . A lesson from our environmental perspective of the COVID-19 pandemic is that the quest for effective policies to reduce anthropogenic emissions, which cause both air pollution and climate change, needs to be accelerated. The pandemic ends with the vaccination of the population or with herd immunity through extensive infection of the population.

"However, there are no vaccines against poor air quality and climate change. The remedy is to mitigate emissions. The transition to a green economy with clean, renewable energy sources will further both environmental and public health locally through improved air quality and globally by limiting climate change."

The study is also the first of its kind to distinguish between fossil fuel-related and other human-made sources of air pollution.

One limitation of the research is that epidemiological data from the US were collected at the level of counties rather than from individuals, which means that it is more difficult to exclude confounding factors. Even though 20 factors that could affect the results were accounted for, additional factors cannot be excluded.

A second limitation is that data have been collected in middle- to high-income countries (China, US, and corroborated by data from Europe); the calculations were carried out for the whole world, meaning that the results for low-income countries may be less robust.


European Society of Cardiology
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Re: About 15% of COVID-19-related deaths linked to long-term exposure to air pollution

Post by trader32176 »

Exposure to environmental immunotoxicants may worsen outcome of SARS-CoV-2 infection


https://www.news-medical.net/news/20201 ... ction.aspx

Several studies have shown that increased exposure to polluted air is associated with the severity of disease. Air pollution has also been shown to aggravate the course of the coronavirus disease 2019 (COVID-19) pandemic. Many industrial chemicals are known to suppress immune functions and worsen the disease course in many infections. Globally disseminated and immunotoxic industrial chemicals like perfluorinated alkylate substances (PFAS) may contribute to this as well.

Thus, elevated background exposure to PFAS is associated with decreased antibody responses to vaccinations in children and adults. Also, children with higher levels of exposure to these chemicals are more prone to infectious diseases. Moreover, major PFAS are said to interfere with proteins involved in critical pathways linked to severe clinical outcomes for COVID-19.
Assessing the impact of elevated PFAS exposures on the course of SARS-CoV-2 infection

A team of researchers from the Harvard T.H.Chan School of Public Health, Boston, MA; University of Southern Denmark; Odense University Hospital, Denmark; Statens Serum Institut, Copenhagen, Denmark; National University Hospital, Copenhagen, Denmark; and the University of Copenhagen recently carried out a study in Denmark in which they determined the plasma PFAS concentrations in individuals with a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

They wanted to assess the impact of elevated background exposures to immunotoxic PFAS on the infection's clinical course and study the association of PFAS exposure with the COVID-19 severity. Their work is published on the preprint server medRxiv*.

Using ordinal and ordered logistic regression analyses to identify links between PFAS levels and disease severity.

The team obtained plasma samples of 323 individuals with confirmed SARS-CoV-2 infection from Danish biobanks. The subjects belonged to the age group of 30-70 years. The concentrations of PFAS were measured at the background exposures, and the study included 5 PFAS that are known to be immunotoxic.

Registration data of the subjects was obtained to classify them based on disease status and demographic variables. The team used ordinal and ordered logistic regression analyses to study the associations between PFAS levels and clinical outcomes.

The study results showed that plasma-PFAS levels were higher in males and patients with Western European background. While the PFAS levels tend to increase with age, they were not necessarily associated with the presence of chronic disease. Out of 323 subjects, 108 (33%) were not hospitalized, and among those who were hospitalized, 53 (16%) were either in intensive care or deceased.

"The results of this study are parallel to findings in regard to other environmental toxicants, viz., air pollutants and suggests a need to ascertain the impact of relevant occupational or environmental exposures on COVID-19 severity."

Among the five immunotoxic PFAS studied, perfluorobutanoic acid (PFBA) had an odds ratio (OR) of 2.19 for increasing disease severity. However, OR decreased to 1.77 after it was adjusted for sex, age, sampling site, blood sampling, and diagnosis interval.

Increased plasma concentrations of PFBA is associated with severe COVID-19 prognosis

This study aimed at evaluating the potential worsening of COVID-19 disease associated with increased background exposure to PFAS. Several PFAS have been shown to be immunotoxic agents in experiments with lab animals and also in humans.

According to the authors, this study's results agree with the findings of previous studies on other environmental toxicants or air pollutants and highlights the need to confirm the impact of occupational or environmental exposures to air pollutants on the severity of COVID-19.

The team says that while existing evidence on air pollution is solely based on ecological studies that don't take into account individual exposure levels, their present study benefits from determining the plasma-PFAS levels of the subjects.

The authors concluded that increased plasma PFBA levels were associated with more severe COVID-19 prognosis, even after adjustment for comorbidities, sex, age, origin, sampling time, and location. Although PFBA levels in plasma were lower than most PFAS studied, PBFA accumulates in the lungs, and hence they believe that PBFA exposure may contribute to the severity of disease.

"These findings at background exposure levels suggest a need to ascertain if exposures to environmental immunotoxicants may worsen the outcome of the SARS-CoV-2 infection."

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

Severity of COVID-19 at elevated exposure to perfluorinated alkylates Philippe Grandjean, Clara Amalie Gade Timmermann, Marie Kruse, Flemming Nielsen, Pernille Just Vinholt, Lasse Boding, Carsten Heilmann, Kaare Molbak medRxiv 2020.10.22.20217562; doi: https://doi.org/10.1101/2020.10.22.20217562, https://www.medrxiv.org/content/10.1101 ... 20217562v1
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Re: About 15% of COVID-19-related deaths linked to long-term exposure to air pollution

Post by trader32176 »

COVID-19 spread is linked to atmospheric pollutants exposure


https://www.news-medical.net/news/20201 ... osure.aspx

The spread of SARS-CoV-2, the coronavirus responsible for the current pandemic outbreak, has been speculated to be linked to short-term and long-term atmospheric pollutants exposure, mainly particulate matters (PMs).

It is in fact possible for people living in highly industrialized areas, therefore exposed to higher pollution levels, to show more severe symptoms. Further studies have pointed out that atmospheric pollutants can act as virus carriers and boost pandemic diffusion.

A study recently published on Environmental Pollution searched for any potential short-term correlation between these two phenomena.

The research led by the Euro-Mediterranean Center on Climate Change (CMCC) Foundation and carried out in collaboration with the University of Salento and the Italian National Institute of Health (ISS) focused on the analysis of atmospheric pollutants concentrations (PM10, PM2.5, NO2) along with the spatio-temporal distribution of cases and deaths (specifically incidence, mortality and lethality rates) across the whole Italian country, down to the level of individual territorial areas, including four of the most affected regions, i.e. Lombardy, Piedmont, Emilia-Romagna and Veneto.

" The data analysis has been limited to the first quarter of 2020 to reduce the lockdown-dependent biased effects on the atmospheric pollutant levels as much as possible. Our results suggest the hypothesis of a moderate-to-strong correlation between the number of days exceeding the annual regulatory limits of PM10, PM2.5 and NO2 atmospheric pollutants and COVID-19 incidence, mortality and lethality rates for all the 107 Italian territorial areas under investigation, whereas weak-to-moderate correlations where found when the analysis was limited to four of the most affected regions in Northern Italy (Lombardy, Piedmont, Emilia-Romagna and Veneto)."

- Giovanni Aloisio, Study Corresponding Author and Professor and Member of Strategic Board, Director of the CMCC Supercomputing Center and Full Professor, Department of Innovation Engineering, University of Salento

Overall, PM10 and PM2.5 showed a higher correlation than NO2 with COVID-19 incidence, mortality and lethality rates.

Finally, PM10 profiles have been further analyzed along with the COVID-19 incidence rate variation for three of the most affected territorial areas in Northern Italy (i.e., Milan, Brescia, and Bergamo) in March 2020. All areas showed a similar PM10 time trend but a different COVID-19 incidence rate variation, that was less severe in Milan compared with Brescia and Bergamo.

The investigation will be extended in the future to account for confounding factors and outbreak dynamics, such as for example population size, ethnicity, hospital beds, number of individuals tested for COVID-19, weather, socioeconomic and behavioral variables (e.g. income, obesity, smoking habits), days since the first reported case of COVID-19, population age distribution, and days since the issuance of the stay-at-home order, etc.

The results of this study suggest in fact that confounding factors should be considered to justify why the almost identical PM10 profiles observed in Milan, Brescia, and Bergamo during the first quarter of 2020 did not produce similar COVID-19 incidence rate variations.

In addition, confounders might justify the differences in the statistical significance of correlations found when comparing a 4-region subset with the whole Italian country. Finally, climate change negatively affects human health and its potential role in the pandemic spread deserves further investigation.


CMCC Foundation - Euro-Mediterranean Center on Climate Change

Journal reference:

Accarino, G., et al. (2020) Assessing correlations between short-term exposure to atmospheric pollutants and COVID-19 spread in all Italian territorial areas. Environmental Pollution. doi.org/10.1016/j.envpol.2020.115714.
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Re: About 15% of COVID-19-related deaths linked to long-term exposure to air pollution

Post by trader32176 »

Colorado study reveals potential link between air pollution and coronavirus deaths

The analysis by the Colorado Department of Public Health and Environment also underscores the disproportionate toll of COVID-19 on communities of color


https://coloradosun.com/2021/02/18/colo ... pollution/

Living in a community with higher rates of air pollution may be associated with a greater risk of coronavirus infection, hospitalization and death, according to a study released Thursday by the Colorado Department of Public Health and Environment.

The study also finds that there is a greater risk of coronavirus infection and severe outcomes in communities with larger proportions of people of color, higher numbers of essential workers, and higher rates of mobility.

While not yet formally peer reviewed, the research reinforces one of the most consistent findings throughout the pandemic — that inequity within Colorado and across the nation means the burden of the virus falls very differently on different communities.

“This study for us really underscores that higher rates of underlying health conditions, air pollution and worse COVID-19 outcomes go hand-in-hand with the disproportionate impact on communities of color,” said Kristy Richardson, Colorado’s state toxicologist and one of the authors of the study. CDPHE statistical analysts Kevin Berg and Paul Romer Present are also authors on the report.

But the study’s findings were also delivered with a note of caution. Richardson said measuring air pollution at the local level is difficult because there are not enough monitoring stations spread across the state. As a result, the study looked at four models that can be used to estimate fine-particle air pollution at the census-tract level. But census tracts can vary widely in size, from as small as a neighborhood in an urban area to as large as a whole rural county.

In analyses using three of the models, and taking into account things like the age of people living in the census tracts, the study found that an increase in air pollution was associated with an increase in the risk of coronavirus infection, hospitalization and death. But the results were only statistically significant for one of the models — one developed by the Environmental Protection Agency.

In the fourth model, the researchers found a non-statistically significant negative association — meaning an increase in air pollution was associated with lower COVID-19 risk.

Overall, it means the researchers can’t be conclusive about how air pollution impacts coronavirus cases.

“What we found in general is that long-term exposure to fine particles is associated with more COVID-19 infections, hospitalizations and deaths,” Richardson said. “But we don’t have enough localized pollution data to really be certain about that relationship.”

The researchers plan to submit the study for publication in a peer-reviewed journal. The study was informally reviewed by researchers at Harvard University who have conducted a similar study, as well as experts at Colorado universities.

More clear in the study is the disproportionate impact COVID-19 has on communities of color.

The researchers found that census tracts with larger proportions of Black residents were associated with a 4% greater relative risk of coronavirus infection and a 7% greater relative risk of hospitalization due to COVID-19. Census tracts with larger proportions of non-Black people of color — a group primarily made up of Hispanic Coloradans — have a 31% higher risk of infection, a 44% higher risk of hospitalization and a 59% higher risk of death.

The study also showed greater risks for neighborhoods with more essential workers and with higher levels of mobility — typically an indicator of people who cannot work from home.

Richardson said it’s difficult to disentangle all the variables. Due to social inequities, communities of color often have higher rates of chronic illness. People of color are also more likely to be essential workers and less likely to be able to work from home.

But she said the research provides valuable insight for health officials looking to use pandemic-blunting resources where they are most needed. And she said the study also shows the value in setting up more pollution-monitoring stations, something echoed by CDPHE executive director Jill Hunsaker Ryan in a statement.

“Centuries of structural discrimination in the U.S. housing system mean people of color and low-income populations often live near busy highways and industrial areas where pollution is worse,” Hunsaker Ryan said. “The resulting disproportionate harm to these communities is documented in many studies. We’ll accelerate our efforts to implement additional monitoring in areas that have higher levels of air pollution and will continue to do everything we can to ensure an equitable pandemic response.”
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