Individual and Environmental Risk Factors for COVID- 19 Mortality in Elderly

Abstract Several studies have already explored individual and environmental risk factors for COVID-19 morality, however most study populations consisted of the overall population and mainly from China or the US. Our study focused on COVID-19 mortality in the elderly in seven European cities. Long-term exposure to air pollution was estimated through annual pollutant concentrations at the residential address averaged over the last two years of the study period between February and May 2020. We focused on the main outdoor air pollutants PM10, PM2.5, NO2 and O3. Short-term variations in air pollutants and weather parameters (e.g. temperature, UV, relative humidity) were also examined through a 20-day period before the confirmed PCR diagnostic of COVID-19. Individual risk factors such as smoking status, sex, body mass index (BMI), ischemic heart disease, diabetes, hypertension, chronic renal failure, history of cancer, COPD, and lung fibrosis, were taken into account. We found positive associations for diabetes and COVID-19 mortality (OR 2.2 CI 95% :1.1, 4.4). Using a multivariate logistic regression model adjusted for all patient characteristics and city, we fail to reject the null hypothesis of no association between COVID-19 mortality and long-term and short-term increase in PM2.5, PM10, NO2 and O3. Our study suffers from the fact that patient profiles strongly differ between high-polluted and less-polluted cities. Strong differences in COVID-19 mortalities were observed between cities, which could be due to differences in COVID-19 management and treatment, such as accessibility to reanimation and intensive units between cities. Overall, our study highlights the need to improve estimation of individual exposure to air pollution. Indeed, even with the high-efficiency modelisation systems used in our study, we were unable to estimate the effect of air pollution within each city, because variations in air pollution exposure were too small. Individual markers of air pollution exposure such as recently demonstrated with urinary black carbon or passive individual samplers, would be most suitable for future explorations. Concerning weather parameters, although previous studies concluded that increase in temperature and UV index could decrease COVID-19 morality, our data did not allow us to reject the null hypotheses.

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Long-term air pollution exposure and risk factors for cardiovascular diseases among the elderly in Taiwan

Occupational and Environmental Medicine ◽

10.1136/oem.2009.052704 ◽

2010 ◽

Vol 68 (1) ◽

pp. 64-68 ◽

Cited By ~ 153

Author(s):

K.-J. Chuang ◽

Y.-H. Yan ◽

S.-Y. Chiu ◽

T.-J. Cheng

Keyword(s):

Risk Factors ◽

Air Pollution ◽

Cardiovascular Diseases ◽

The Elderly ◽

Air Pollution Exposure ◽

Pollution Exposure

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Design and evaluation of mobile monitoring campaigns for air pollution exposure assessment in epidemiologic cohorts

10.1101/2021.04.21.21255641 ◽

2021 ◽

Author(s):

Magali N. Blanco ◽

Annie Doubleday ◽

Elena Austin ◽

Julian D. Marshall ◽

Edmund Seto ◽

...

Keyword(s):

Air Pollution ◽

Study Design ◽

Monitoring Data ◽

Mobile Monitoring ◽

Short Term ◽

Balanced Design ◽

Air Pollution Exposure ◽

Balanced Designs ◽

Pollution Exposure

AbstractMobile monitoring makes it possible to estimate the long-term trends of less commonly measured pollutants through the collection of repeated short-term samples. While many different mobile monitoring approaches have been taken, few studies have looked at the importance of study design when the goal is application to epidemiologic cohort studies. Air pollution concentrations include random variability and systematic variability, and we hypothesize that mobile campaigns benefit from temporally balanced designs that randomly sample from all seasons of the year, days of the week, and hours of the day. We carried out a simulation study of fixed-site monitors to better understand the role of short-term mobile monitoring design on the prediction of long-term air pollution exposure surfaces. Specifically, we simulated three archetypal sampling designs using oxides of nitrogen (NOx) monitoring data from 69 California air quality system (AQS) sites: (1) a year-around, Balanced Design, (2) a Rush Hours Design, and (3) a Business Hours Design. We used Monte Carlo resampling to investigate the range of possible outcomes (i.e., the resulting annual average concentration prediction) from each design against the “truth”, the actual monitoring data. We found that the Balanced Design consistently yielded the most accurate annual averages; Rush Hours and Business Hours Designs generally resulted in comparatively more biased estimates and model predictions. Importantly, the superior performance of the Balanced Design was evident when predictions were evaluated against true concentrations but less detectable when predictions were evaluated against the measurements from the same sampling campaign since these were themselves biased. This result is important since mobile monitoring campaigns that use their own measurements to test the robustness of the results may underestimate the level of bias in their results. Appropriate study design is crucial for mobile monitoring campaigns aiming to assess accurate long-term exposure in epidemiologic cohorts. Campaigns should aim to implement balanced designs that sample during all seasons of the year, days of the week, and all or most hours of the day to produce generally unbiased, long-term averages. Furthermore, differential exposure misclassification could result from unbalanced designs, which may result in misleading health effect estimates in epidemiologic investigations.

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A Comparison of Short-term and Long-term Air Pollution Exposure Associations with Mortality in Two Cohorts in Scotland

Environmental Health Perspectives ◽

10.1289/ehp.1104509 ◽

2012 ◽

Vol 120 (9) ◽

pp. 1280-1285 ◽

Cited By ~ 43

Author(s):

Iain J. Beverland ◽

Geoffrey R. Cohen ◽

Mathew R. Heal ◽

Melanie Carder ◽

Christina Yap ◽

...

Keyword(s):

Air Pollution ◽

Short Term ◽

Air Pollution Exposure ◽

Pollution Exposure

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Long-term personal air pollution exposure and risk for acute exacerbation of idiopathic pulmonary fibrosis

Environmental Health ◽

10.1186/s12940-021-00786-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ioannis Tomos ◽

Konstantina Dimakopoulou ◽

Effrosyni D. Manali ◽

Spyros A. Papiris ◽

Anna Karakatsani

Keyword(s):

Air Pollution ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Acute Exacerbation ◽

Inflammatory Mediators ◽

Air Pollutants ◽

Urban Air Pollution ◽

Air Pollution Exposure ◽

Pollution Exposure

Abstract Background Urban air pollution is involved in the progress of idiopathic pulmonary fibrosis (IPF). Its potential role on the devastating event of Acute Exacerbation of IPF (AE-IPF) needs to be clarified. This study examined the association between long-term personal air pollution exposure and AE- IPF risk taking into consideration inflammatory mediators and telomere length (TL). Methods All consecutive IPF-patients referred to our Hospital from October 2013-June 2019 were included. AE-IPF events were recorded and inflammatory mediators and TL measured. Long-term personal air pollution exposures were assigned to each patient retrospectively, for O3, NO2, PM2.5 [and PM10, based on geo-coded residential addresses. Logistic regression models assessed the association of air pollutants’ levels with AE-IPF and inflammatory mediators adjusting for potential confounders. Results 118 IPF patients (mean age 72 ± 8.3 years) were analyzed. We detected positive significant associations between AE-IPF and a 10 μg/m3 increase in previous-year mean level of NO2 (OR = 1.52, 95%CI:1.15–2.0, p = 0.003), PM2.5 (OR = 2.21, 95%CI:1.16–4.20, p = 0.016) and PM10 (OR = 2.18, 95%CI:1.15–4.15, p = 0.017) independent of age, gender, smoking, lung function and antifibrotic treatment. Introduction of TL in all models of a subgroup of 36 patients did not change the direction of the observed associations. Finally, O3 was positively associated with %change of IL-4 (p = 0.014) whilst PM2.5, PM10 and NO2 were inversely associated with %changes of IL-4 (p = 0.003, p = 0.003, p = 0.032) and osteopontin (p = 0.013, p = 0.013, p = 0.085) respectively. Conclusions Long-term personal exposure to increased concentrations of air pollutants is an independent risk factor of AE-IPF. Inflammatory mediators implicated in lung repair mechanisms are involved.

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