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Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners.

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Title: Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners.
Authors: Honghyok Kim1,2 honghyok@uic.edu, Samet, Jonathan M.3,4, Bell, Michelle L.2
Source: Environmental Health Perspectives. Nov2022, Vol. 130 Issue 11, p117006-1-117006-12. 12p. 3 Charts, 5 Graphs, 1 Map.
Subject Terms: *Air pollution, *Particulate matter, *Ozone, Mortality risk factors, COVID-19, Confidence intervals, Inhalation injuries, Acquisition of data, Risk assessment, Medical records, Population-based case control, Descriptive statistics, Crossover trials
Geographic Terms: Illinois
Abstract: BACKGROUND: Studies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed. OBJECTIVES: We aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19. METHODS: The Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤ 2.5 μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend). RESULTS: Of the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35μg/m³); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7μg/m³ or 70 parts per billion). An interquartile range (IQR) increase (5.2μg/m³) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2μg/m³) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions. DISCUSSION: Short-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. [ABSTRACT FROM AUTHOR]
Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners.
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  Data: <searchLink fieldCode="AR" term="%22Honghyok+Kim%22">Honghyok Kim</searchLink><relatesTo>1,2</relatesTo><i> honghyok@uic.edu</i><br /><searchLink fieldCode="AR" term="%22Samet%2C+Jonathan+M%2E%22">Samet, Jonathan M.</searchLink><relatesTo>3,4</relatesTo><br /><searchLink fieldCode="AR" term="%22Bell%2C+Michelle+L%2E%22">Bell, Michelle L.</searchLink><relatesTo>2</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Environmental+Health+Perspectives%22">Environmental Health Perspectives</searchLink>. Nov2022, Vol. 130 Issue 11, p117006-1-117006-12. 12p. 3 Charts, 5 Graphs, 1 Map.
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  Data: *<searchLink fieldCode="DE" term="%22Air+pollution%22">Air pollution</searchLink><br />*<searchLink fieldCode="DE" term="%22Particulate+matter%22">Particulate matter</searchLink><br />*<searchLink fieldCode="DE" term="%22Ozone%22">Ozone</searchLink><br /><searchLink fieldCode="DE" term="%22Mortality+risk+factors%22">Mortality risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Inhalation+injuries%22">Inhalation injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Acquisition+of+data%22">Acquisition of data</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+records%22">Medical records</searchLink><br /><searchLink fieldCode="DE" term="%22Population-based+case+control%22">Population-based case control</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Crossover+trials%22">Crossover trials</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Illinois%22">Illinois</searchLink>
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  Label: Abstract
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  Data: BACKGROUND: Studies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed. OBJECTIVES: We aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19. METHODS: The Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤ 2.5 μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend). RESULTS: Of the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35μg/m³); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7μg/m³ or 70 parts per billion). An interquartile range (IQR) increase (5.2μg/m³) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2μg/m³) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions. DISCUSSION: Short-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1289/EHP10836
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 12
        StartPage: 117006-1
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      – SubjectFull: Air pollution
        Type: general
      – SubjectFull: Particulate matter
        Type: general
      – SubjectFull: Ozone
        Type: general
      – SubjectFull: Mortality risk factors
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      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Confidence intervals
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      – SubjectFull: Inhalation injuries
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      – SubjectFull: Population-based case control
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Crossover trials
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      – SubjectFull: Illinois
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    Titles:
      – TitleFull: Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners.
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              Text: Nov2022
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