Dataset Information

Air quality in Germany as a contributing factor to morbidity from COVID-19.

ABSTRACT:

Background

The SARS-CoV-2 virus has been spreading in Germany since January 2020, with regional differences in incidence, morbidity, and mortality. Long-term exposure to air pollutants as nitrogen dioxide (NO₂), nitrogen monoxide (NO), ozone (O₃), and particulate matter (<10 μm PM₁₀, <2.5 μm PM_2.5) has a negative impact on respiratory functions. We analyze the association between long-term air pollution and the outcome of SARS-CoV-2 infections in Germany.

Methods

We conducted an observational study in Germany on county-level, investigating the association between long-term (2010-2019) air pollutant exposure (European Environment Agency, AirBase data set) and COVID-19 incidence, morbidity, and mortality rate during the first outbreak of SARS-CoV-2 (open source data Robert Koch Institute). We used negative binominal models, including adjustment for risk factors (age, sex, days since first COVID-19 case, population density, socio-economic and health parameters).

Results

After adjustment for risk factors in the tri-pollutant model (NO₂, O₃, PM_2.5) an increase of 1 μg/m³ NO₂ was associated with an increase of the need for intensive care due to COVID-19 by 4.2% (95% CI 1.011-1.074), and mechanical ventilation by 4.6% (95% CI 1.010-1.084). A tendency towards an association of NO₂ with COVID-19 incidence was indicated, as the results were just outside of the defined statistical significance (+1.6% (95% CI 1.000-1.032)). Long-term annual mean NO₂ level ranged from 4.6 μg/m³ to 32 μg/m³.

Conclusions

Our results indicate that long-term NO₂ exposure may have increased susceptibility for COVID-19 morbidity in Germany. The results demonstrate the need to reduce ambient air pollution to improve public health.

SUBMITTER: Koch S

PROVIDER: S-EPMC9277987 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Air quality in Germany as a contributing factor to morbidity from COVID-19.

Koch Susanne S Hoffmann Christina C Caseiro Alexandre A Ledebur Marie M Menk Mario M von Schneidemesser Erika E

Environmental research 20220713 Pt 2

<h4>Background</h4>The SARS-CoV-2 virus has been spreading in Germany since January 2020, with regional differences in incidence, morbidity, and mortality. Long-term exposure to air pollutants as nitrogen dioxide (NO<sub>2</sub>), nitrogen monoxide (NO), ozone (O<sub>3</sub>), and particulate matter (<10 μm PM<sub>10</sub>, <2.5 μm PM<sub>2.5</sub>) has a negative impact on respiratory functions. We analyze the association between long-term air pollution and the outcome of SARS-CoV-2 infections ...[more]

PMID: 35841971

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Project description:BackgroundIn response to the COVID-19 pandemic, the Bavarian State government announced several COVID-19 mitigation measures beginning on March 16, 2020, which likely led to a reduction in traffic and a subsequent improvement in air quality. In this study, we evaluated the short-term effect of COVID-19 mitigation measures on NO2 concentrations in Munich, Germany.MethodsWe applied two quasi-experimental approaches, a controlled interrupted time-series (c-ITS) approach and a synthetic control (SC) approach. Each approach compared changes occurring in 2020 to changes occurring in 2014-2019, and accounted for weather-related and other potential confounders. We hypothesized that the largest reductions in NO2 concentrations would be observed at traffic sites, with smaller reductions at urban background sites, and even small reductions, if any, at background sites. All hypotheses, as well as the main and additional analyses were defined a priori. We also conducted post-hoc analyses to ensure that observed effects were not due to factors other than the intervention.ResultsMain analyses largely supported our hypotheses. Specifically, at the two traffic sites, using the c-ITS approach we observed reductions of 9.34 ?g/m3 (95% confidence interval: -23.58; 4.90) and 10.02 ?g/m3 (-19.25; -0.79). Using the SC approach we observed reductions of 15.65 ?g/m3 (-27.58; -4.09) and 15.1 ?g/m3 (-24.82; -9.83) at these same sites. We observed effects ranging from smaller in magnitude to no effect at urban background and background sites. Additional analyses showed that the effect was largest in the first two weeks following introduction of measures, and that a 3-day lagged intervention time also showed a larger effect. Post-hoc analyses suggested that at least some of the observed effects may have been attributable to changes in air quality occurring before the intervention, as well as unusually high concentrations in January 2020.ConclusionWe applied two quasi-experimental approaches in assessing the impact of the COVID-19 mitigation measures on NO2 concentrations in Munich. Taking the 2020 pre-intervention average concentrations as a reference, we observed reductions in NO2 concentrations of approximately 15-25% and 24-36% at traffic sites, suggesting that reducing traffic may be an effective measure to reduce NO2 concentrations in heavily trafficked areas by margins which could translate to public health benefits.

Dataset Information

Air quality in Germany as a contributing factor to morbidity from COVID-19.

Background

Methods

Results

Conclusions

Publications

Air quality in Germany as a contributing factor to morbidity from COVID-19.

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