Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study
Background: Ecologic analyses suggest that living in areas with higher levels of ambient fine particulate matter air pollution (PM2.5) is associated with higher risk of adverse COVID-19 outcomes. Studies accounting for individual-level health characteristics are lacking. Methods: We leveraged the br...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | Environment International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412021001896 |
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| author | Benjamin Bowe Yan Xie Andrew K. Gibson Miao Cai Aaron van Donkelaar Randall V. Martin Richard Burnett Ziyad Al-Aly |
| author_facet | Benjamin Bowe Yan Xie Andrew K. Gibson Miao Cai Aaron van Donkelaar Randall V. Martin Richard Burnett Ziyad Al-Aly |
| author_sort | Benjamin Bowe |
| collection | DOAJ |
| description | Background: Ecologic analyses suggest that living in areas with higher levels of ambient fine particulate matter air pollution (PM2.5) is associated with higher risk of adverse COVID-19 outcomes. Studies accounting for individual-level health characteristics are lacking. Methods: We leveraged the breadth and depth of the US Department of Veterans Affairs national healthcare databases and built a national cohort of 169,102 COVID-19 positive United States Veterans, enrolled between March 2, 2020 and January 31, 2021, and followed them through February 15, 2021. Annual average 2018 PM2.5 exposure, at an approximately 1 km2 resolution, was linked with residential street address at the year prior to COVID-19 positive test. COVID-19 hospitalization was defined as first hospital admission between 7 days prior to, and 15 days after, the first COVID-19 positive date. Adjusted Poisson regression assessed the association of PM2.5 with risk of hospitalization. Results: There were 25,422 (15.0%) hospitalizations; 5,448 (11.9%), 5,056 (13.0%), 7,159 (16.1%), and 7,759 (19.4%) were in the lowest to highest PM2.5 quartile, respectively. In models adjusted for State, demographic and behavioral factors, contextual characteristics, and characteristics of the pandemic a one interquartile range increase in PM2.5 (1.9 µg/m3) was associated with a 10% (95% CI: 8%–12%) increase in risk of hospitalization. The association of PM2.5 and risk of hospitalization among COVID-19 individuals was present in each wave of the pandemic. Models of non-linear exposure–response suggested increased risk at PM2.5 concentrations below the national standard 12 µg/m3. Formal effect modification analyses suggested higher risk of hospitalization associated with PM2.5 in Black people compared to White people (p = 0.045), and in those living in socioeconomically disadvantaged neighborhoods (p < 0.001). Conclusions: Exposure to higher levels of PM2.5 was associated with increased risk of hospitalization among COVID-19 infected individuals. The risk was evident at PM2.5 levels below the regulatory standards. The analysis identified those of Black race and those living in disadvantaged neighborhoods as population groups that may be more susceptible to the untoward effect of PM2.5 on risk of hospitalization in the setting of COVID-19. |
| first_indexed | 2024-12-17T06:06:31Z |
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| id | doaj.art-6734ee005e40494a88a1ae2f9d45a945 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-12-17T06:06:31Z |
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| spelling | doaj.art-6734ee005e40494a88a1ae2f9d45a9452022-12-21T22:00:44ZengElsevierEnvironment International0160-41202021-09-01154106564Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort studyBenjamin Bowe0Yan Xie1Andrew K. Gibson2Miao Cai3Aaron van Donkelaar4Randall V. Martin5Richard Burnett6Ziyad Al-Aly7Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, Saint Louis, MO 63104, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United StatesClinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, Saint Louis, MO 63104, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United StatesClinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United StatesClinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United StatesDepartment of Physics and Atmospheric Science, Dalhousie University, 6310 Coburg Rd, Halifax, Nova Scotia B3H 4J5, Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in Saint Louis, 1 Brookings Drive, CB1100, Saint Louis, MO 63130, United StatesDepartment of Physics and Atmospheric Science, Dalhousie University, 6310 Coburg Rd, Halifax, Nova Scotia B3H 4J5, Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in Saint Louis, 1 Brookings Drive, CB1100, Saint Louis, MO 63130, United StatesDepartment of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, United StatesClinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Department of Medicine, Washington University in Saint Louis, 4921 Parkview Pl, Saint Louis, MO 63110, United States; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, 915 N Grand Blvd, Saint Louis, MO 63106, United States; Institute for Public Health, Washington University in Saint Louis, 600 S Taylor Ave, Saint Louis, MO 63110, United States; Corresponding author at: VA Saint Louis Health Care System, 915 North Grand Boulevard, 151-JC, Saint Louis, MO 63106, United States.Background: Ecologic analyses suggest that living in areas with higher levels of ambient fine particulate matter air pollution (PM2.5) is associated with higher risk of adverse COVID-19 outcomes. Studies accounting for individual-level health characteristics are lacking. Methods: We leveraged the breadth and depth of the US Department of Veterans Affairs national healthcare databases and built a national cohort of 169,102 COVID-19 positive United States Veterans, enrolled between March 2, 2020 and January 31, 2021, and followed them through February 15, 2021. Annual average 2018 PM2.5 exposure, at an approximately 1 km2 resolution, was linked with residential street address at the year prior to COVID-19 positive test. COVID-19 hospitalization was defined as first hospital admission between 7 days prior to, and 15 days after, the first COVID-19 positive date. Adjusted Poisson regression assessed the association of PM2.5 with risk of hospitalization. Results: There were 25,422 (15.0%) hospitalizations; 5,448 (11.9%), 5,056 (13.0%), 7,159 (16.1%), and 7,759 (19.4%) were in the lowest to highest PM2.5 quartile, respectively. In models adjusted for State, demographic and behavioral factors, contextual characteristics, and characteristics of the pandemic a one interquartile range increase in PM2.5 (1.9 µg/m3) was associated with a 10% (95% CI: 8%–12%) increase in risk of hospitalization. The association of PM2.5 and risk of hospitalization among COVID-19 individuals was present in each wave of the pandemic. Models of non-linear exposure–response suggested increased risk at PM2.5 concentrations below the national standard 12 µg/m3. Formal effect modification analyses suggested higher risk of hospitalization associated with PM2.5 in Black people compared to White people (p = 0.045), and in those living in socioeconomically disadvantaged neighborhoods (p < 0.001). Conclusions: Exposure to higher levels of PM2.5 was associated with increased risk of hospitalization among COVID-19 infected individuals. The risk was evident at PM2.5 levels below the regulatory standards. The analysis identified those of Black race and those living in disadvantaged neighborhoods as population groups that may be more susceptible to the untoward effect of PM2.5 on risk of hospitalization in the setting of COVID-19.http://www.sciencedirect.com/science/article/pii/S0160412021001896Air pollutionCOVID-19HospitalizationAmbient fine particulate matterSeverityCOVID-19 outcomes |
| spellingShingle | Benjamin Bowe Yan Xie Andrew K. Gibson Miao Cai Aaron van Donkelaar Randall V. Martin Richard Burnett Ziyad Al-Aly Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study Environment International Air pollution COVID-19 Hospitalization Ambient fine particulate matter Severity COVID-19 outcomes |
| title | Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study |
| title_full | Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study |
| title_fullStr | Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study |
| title_full_unstemmed | Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study |
| title_short | Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study |
| title_sort | ambient fine particulate matter air pollution and the risk of hospitalization among covid 19 positive individuals cohort study |
| topic | Air pollution COVID-19 Hospitalization Ambient fine particulate matter Severity COVID-19 outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S0160412021001896 |
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