Long-term exposure to air-pollution and COVID-19 mortality in England: a hierarchical spatial analysis
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Published version
Author(s)
Konstantinoudis, Garyfallos
Padellini, Tullia
Bennett, James
Davies, Bethan
Blangiardo, Marta
Type
Journal Article
Abstract
Recent studies suggested a link between long-term exposure to air-pollution and COVID-19 mortality. However, due to their ecological design based on large spatial units, they neglect the strong localised air-pollution patterns, and potentially lead to inadequate confounding adjustment. We investigated the effect of long-term exposure to NO2 and PM2.5 on COVID-19 mortality in England using high geographical resolution. In this nationwide cross-sectional study in England, we included 38,573 COVID-19 deaths up to June 30, 2020 at the Lower Layer Super Output Area level (n = 32,844 small areas). We retrieved averaged NO2 and PM2.5 concentration during 2014–2018 from the Pollution Climate Mapping. We used Bayesian hierarchical models to quantify the effect of air-pollution while adjusting for a series of confounding and spatial autocorrelation. We find a 0.5% (95% credible interval: −0.2%, 1.2%) and 1.4% (95% CrI: −2.1%, 5.1%) increase in COVID-19 mortality risk for every 1 μg/m3 increase in NO2 and PM2.5 respectively, after adjusting for confounding and spatial autocorrelation. This corresponds to a posterior probability of a positive effect equal to 0.93 and 0.78 respectively. The spatial relative risk at LSOA level revealed strong patterns, similar for the different pollutants. This potentially captures the spread of the disease during the first wave of the epidemic. Our study provides some evidence of an effect of long-term NO2 exposure on COVID-19 mortality, while the effect of PM2.5 remains more uncertain.
Date Issued
2021-01-01
Date Acceptance
2020-11-30
Citation
Environment International, 2021, 146
ISSN
0160-4120
Publisher
Elsevier
Journal / Book Title
Environment International
Volume
146
Copyright Statement
© 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
License URL
Sponsor
Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council
Grant Number
MR/T03226X/1
MR/S019669/1
P82059
Subjects
Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Environmental Sciences & Ecology
COVID-19
Mortality
Nitrogen dioxide
Particular matter
Air-pollution
Bayesian spatial models
MODELS
RISK
Air-pollution
Bayesian spatial models
COVID-19
Mortality
Nitrogen dioxide
Particular matter
Air Pollutants
Air Pollution
Bayes Theorem
COVID-19
Cross-Sectional Studies
England
Environmental Exposure
Humans
Nitrogen Dioxide
Particulate Matter
SARS-CoV-2
Spatial Analysis
Humans
Nitrogen Dioxide
Air Pollutants
Bayes Theorem
Cross-Sectional Studies
Air Pollution
Environmental Exposure
England
Particulate Matter
Spatial Analysis
COVID-19
SARS-CoV-2
Environmental Sciences
Publication Status
Published
Article Number
ARTN 106316
Date Publish Online
2020-12-07