Long-term exposure to fine particulate matter air pollution: An ecological study of its effect on COVID-19 cases and fatality in Germany

Abstract

Background COVID-19 is a lung disease, and there is medical evidence that air pollution is one of the external causes of lung diseases. Fine particulate matter is one of the air pollutants that damages pulmonary tissue. The combination of the coronavirus and fine particulate matter air pollution may exacerbate the coronavirus’ effect on human health. Research question This paper considers whether the long-term concentration of fine particulate matter of different sizes changes the number of detected coronavirus infections and the number of COVID-19 fatalities in Germany. Study design Data from 400 German counties for fine particulate air pollution from 2002 to 2020 are used to measure the long-term impact of air pollution. Kriging interpolation is applied to complement data gaps. With an ecological study, the correlation between average particulate matter air pollution and COVID-19 cases, as well as fatalities, are estimated with OLS regressions. Thereby, socioeconomic and demographic covariates are included. Main findings An increase in the average long-term air pollution of 1 μg/m 3 particulate matter PM 2.5 is correlated with 199.46 (SD = 29.66) more COVID-19 cases per 100,000 inhabitants in Germany. For PM 10 the respective increase is 52.38 (SD = 12.99) more cases per 100,000 inhabitants. The number of COVID-19 deaths were also positively correlated with PM 2.5 and PM 10 (6.18, SD = 1.44, respectively 2.11, SD = 0.71, additional COVID-19 deaths per 100,000 inhabitants). Conclusion Long-term fine particulate air pollution is suspected as causing higher numbers of COVID-19 cases. Higher long-term air pollution may even increase COVID-19 death rates. We find that the results of the correlation analysis without controls are retained in a regression analysis with controls for relevant confounding factors. Nevertheless, additional epidemiological investigations are required to test the causality of particulate matter air pollution for COVID-19 cases and the severity.

Effects of short-term ambient particulate matter exposure on the risk of severe COVID-19

“…Excessive free radicals weaken the cellular antioxidant capacity, leading to lipid peroxidation and increased intracellular calcium concentrations, further inducing cellular damage (Xing et al 2016). Finally, SARS-CoV-2 enters the cell through binding to the angiotensin-converting enzyme 2 (ACE2) receptor, and this process can be enhanced by PM exposure (Tung et al 2021). The binding of SARS-CoV-2 and the ACE2 receptor resulted in the downregulation of the latter.…”

“…For example, a multicity study in China found that for each 10 μg/m 3 increase in PM 10 and PM 2.5 , the risk of COVID-19 increased by 5% and 6%, respectively ( Wang et al 2020 ). Another study in Germany showed that every 1 μg/m 3 increase in PM 10 and PM 2.5 was associated with 52.38 and 199.46 more confirmed COVID-19 cases per 100,000 inhabitants, respectively ( Prinz and Richter 2022 ). The associations between ambient PM exposure and the risk of COVID-19 have been ardently discussed.…”

Impacts of exposure to air pollution, radon and climate drivers on the COVID-19 pandemic in Bucharest, Romania: A time series study

“…Particulate matter -PM in different size fractions (PM1 μm, PM2.5 μm, and PM10 μm) and gaseous air pollutants (ozone-O 3 , nitrogen dioxide-NO 2 , sulfur dioxide-SO 2 , carbon monoxide-CO) may have an important impact on COVID-19 disease transmission ( Marquès and Domingo, 2021 , 2022 ; Marquès et al, 2022 ; Zoran et al, 2021 , 2022 ; Domingo et al, 2020 ; López-Feldman et al, 2021 ). Due to their increased oxidative toxicity, epidemiologic studies have shown a connection between outdoor ( Shao et al, 2022 ; Xu et al, 2022 ; Ho et al, 2021 ; Bakadia et al, 2021 ; Cao et al, 2021 ; Copat et al, 2020 ; Mu et al, 2021 ; Rahimi et al, 2021 ) acute and chronic exposure ( Wang et al, 2022 ) to high levels of air pollutants in large urban areas, that are responsible for respiratory and cardiovascular morbidity and higher mortality rates ( Hvidtfeldt et al, 2021 ; Domingo and Rovira, 2020 ; Leirião et al, 2022 ; Prinz and Richter, 2022 ; Khan et al, 2019 ; Travaglio et al, 2021 ). Was demonstrated that long-term exposure to particulate matter PM10 concentrations above WHO guidelines implemented by the Directive 2008/50/EU and the US-EPA, exacerbate COVID-19 health outcomes.…”

Research on COVID-19 and air pollution: A path towards advancing exposure science

“…There were mixed views regarding whether particulate matter in air facilitates spread of infectious disease(s) like COVID-19, whether the combination of respiratory disease and air pollution is a risk factor for more severe symptoms and prognosis of COVID-19, or whether pandemic-related societal restrictions led to improved air quality. The lack of agreement on these issues parallels results from current assessments of the literature ( Adam et al, 2021 ; Marquès and Domingo, 2022 ; Prinz and Richter, 2022 ; Ram et al, 2021 ).…”