Vulnerability and Burden of All-Cause Mortality Associated with Particulate Air Pollution during COVID-19 Pandemic: A Nationwide Observed Study in Italy

Abstract

Background: Limited evidence is available on the health effects of particulate matter (PM including PM2.5 with an aerodynamic diameter ≤ 2.5 μm; PM10, ≤ 10 μm; PM2.5–10, 2.5–10 μm) during the pandemic of COVID-19 in Italy. The aims of the study were to examine the associations between all-cause mortality and PM in the pandemic period and compare them to the normal periods (2015–2019). Methods: We collected daily data regarding all-cause mortality (stratified by age and gender), and PM concentrations for 107 Italian provinces from 1 January 2015 to 31 May 2020. A time-stratified case-cross design with the distributed lag non-linear model was used to examine the association between PM and all-cause mortality. We also compared the counts and fractions of death attributable to PM in two periods. Results: Italy saw an increase in daily death counts while slight decreases in PM concentrations in pandemic period. Each 10 µg/m3 increase in PM was associated with much higher increase in daily all-cause mortality during the pandemic period compared to the same months during 2015–2019 (increased mortality rate: 7.24% (95%CI: 4.84%, 9.70%) versus 1.69% (95%CI: 1.12%, 2.25%) for PM2.5; 3.45% (95%CI: 2.58%, 4.34%) versus 1.11% (95%CI: 0.79%, 1.42%) for PM10; 4.25% (95%CI: 2.99%, 5.52%) versus 1.76% (95%CI: 1.14%, 2.38%) for PM2.5–10). The counts and fractions of deaths attributable to PM were higher in 2020 for PM2.5 (attributable death counts: 20,062 versus 3927 per year in 2015–2019; attributable fractions: 10.2% versus 2.4%), PM10 (15,112 versus 3999; 7.7% versus 2.5%), and PM2.5–10 (7193 versus 2303; 3.7% versus 1.4%). Conclusion: COVID-19 pandemic increased the vulnerability and excess cases of all-cause mortality associated with short-term exposure to PM2.5, PM2.5–10, and PM10 in Italy, despite a decline in air pollution level.

Effects of environmental parameters and their interactions on the spreading of SARS-CoV-2 in North Italy under different social restrictions. A new approach based on multivariate analysis

“…The evaluation of several polluting factors (O 3 , NO 2 , SO 2 in addition to PM10 and PM2.5) by Ho et al (2021) has led to finding that only the chronic pollution by particulate matter is significant for COVID-19 effects in Lombardia and Veneto, whereas on a daily basis the PM10 and PM2.5, are not, up to May 2020. A different conclusion was proposed by Ye et al (2021) in the same time period (up to May 2020). The researchers have observed a significant impact of PM on all-cause mortality during the pandemic period.…”

“…These investigations have examined the effect of atmospheric parameters on the COVID-19 diffusion in the most impacted zone (especially Lombardia, and its main city: Milano), and during the most dramatic period, up to March 2020, i.e. the first month ( Pivato et al, 2021 ; Pirouz et al, 2020 ; Collivignarelli et al, 2021 ; Haghshenas et al, 2020 ; Bontempi, 2020 ; Passerini et al, 2020 ; Ye et al, 2021 ; Sfîcă et al, 2020 ; Khursheed et al, 2021 ; Coker et al, 2020 ; Bianconi et al, 2020 ; Accarino et al, 2021 ; Perone, 2021 ; Filippini et al, 2021 ; Kotsiou et al, 2021 ), or up to April 2020 ( Coccia, 2020 ; Delnevo et al, 2020 ; Fazzini et al, 2020 ; Filippini et al, 2020 ; Fattorini and Regoli, 2020 ; Zoran et al, 2020 ; De Angelis et al, 2021 ; Benedetti et al, 2020 ; Agnoletti et al, 2020 ). Only a few works have considered a wider time span, up to the end of spring ( Ho et al, 2021 ; Pansini and Fornacca, 2021 ; Lolli et al, 2020 ; Cascetta et al, 2021 ).…”

“…Despite the daily variations of PM does not seem to represent an essential factor in highly populated plain areas from our data, a different role emerges when the effect of long-term pollution of particulate matter (years-months) is taken into account, according to the evidence available in the literature. Several studies have considered this effect in Italy and have reported higher pandemic diffusion in more historically polluted areas ( Bianconi et al, 2020 ; Coker et al, 2020 ; Fattorini and Regoli, 2020 ; Cascetta et al, 2021 ; De Angelis et al, 2021 ; Fiasca et al, 2021; Ho et al, 2021 ; Kotsiou et al, 2021 ; Pansini and Fornacca, 2021 ; Perone, 2021 ; Ye et al, 2021 ). The wide plain area of the Northern Italy ( Fig.…”

Temperature-mortality association during and before the COVID-19 pandemic in Italy: A nationwide time-stratified case-crossover study

“…We calibrated the ERA5 daily mean temperature and ERA5 daily mean dew point temperature using their relationship with observations of weather stations by building random forest models. The calibration details can be found in another article ( Ye et al, 2021 ). After calibration, the ERA5 daily mean temperature and ERA5 daily mean dew point temperatures were linked to the geographical center of each of the 7904 municipalities based on longitude and latitude.…”

Bayesian profile regression to study the ecologic associations of correlated environmental exposures with excess mortality risk during the first year of the Covid-19 epidemic in lombardy, Italy

“…The significant spatial heterogeneity of Covid-19 case fatality rates suggests that a confluence of spatial determinants of health can make some sub-populations more vulnerable to severe Covid-19 outcomes. Extensive epidemiological data has emerged showing that different place-based factors, such as underlying distributions of age and sex of the population, access to health care or health facilities, ambient temperature, and air pollution, appear to explain some of the observed spatial heterogeneity of Covid-19-related mortality ( Aloisi et al, 2022 ; Biggeri et al, 2020 ; Blangiardo et al, 2020 ; Calderón-Larrañaga et al, 2020 ; Coker et al, 2020 ; Conti et al, 2020 ; De Angelis et al, 2021 ; Gibertoni et al, 2021 ; Kejžar and Lusa, 2020 ; Mannucci et al, 2020 ; Michelozzi et al,020; Sandrini et al, 2020 ; Scortichini et al, 2021 ; Ye et al, 2021 ).…”