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Effect of Short-Term Exposure to Air Pollution on Covid-19 Mortality and Morbidity in Iranian Cities Publisher



Hadei M1 ; Hopke PK2, 3 ; Shahsavani A4, 5 ; Raeisi A6 ; Jafari AJ7 ; Yarahmadi M8 ; Farhadi M8 ; Rahmatinia M5 ; Bazazpour S5 ; Bandpey AM4 ; Zali A9 ; Kermani M7 ; Vaziri MH10 ; Aghazadeh M8
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Center for Air Resources Engineering and Science, Clarkson University, Potsdam, 13699, NY, United States
  3. 3. Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, 14642, NY, United States
  4. 4. Air Quality and Climate Change Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Shiraz, Iran
  7. 7. Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
  8. 8. Environmental and Occupational Health Center, Ministry of Health and Medical Education, Tehran, Iran
  9. 9. Department of Neurosurgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  10. 10. Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Journal of Environmental Health Science and Engineering Published:2021


Abstract

Purpose: The association between air pollutant (PM2.5, PM10, NO2, and O3) concentrations and daily number of COVID-19 confirmed cases and related deaths were evaluated in three major Iranian cities (Tehran, Mashhad, and Tabriz). Methods: Hourly concentrations of air pollutants and daily number of PCR-confirmed cases and deaths of COVID-19 were acquired (February 20th, 2020 to January 4th, 2021). A generalized additive model (GAM) assuming a quasi-Poisson distribution was used to model the associations in each city up to lag-day 7 (for mortality) and 14 (for morbidity). Then, the city-specific estimates were meta-analyzed using a fixed effect model to obtain the overall relative risks (RRs). Results: A total of 114,964 confirmed cases and 21,549 deaths were recorded in these cities. For confirmed cases, exposure to PM2.5, NO2, and O3 for several lag-days showed significant associations. In case of mortality, meta-analysis estimated that the RRs for PM2.5, PM10, NO2, and O3 concentrations were 1.06 (95% CI: 0.99, 1.13), 1.06 (95% CI: 0.93, 1.19), 1.15 (95% CI: 0.93, 1.38), and 1.07 (95% CI: 0.84, 1.31), respectively. Despite several positive associations with all air pollutants over multiple lag-days, COVID-19 mortality was only significantly associated with NO2 on lag-days 0–1 and 1 with the RRs of 1.35 (95% CI: 1.04, 1.67) and 1.16 (95% CI: 1.02, 1.31), respectively. Conclusion: This study showed that air pollution can be a factor exacerbating COVID-19 infection and clinical outcomes. Actions should be taken to reduce the exposure of the public and particularly patients to ambient air pollutants. © 2021, Springer Nature Switzerland AG.
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