About: Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study

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About: Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study
Creator	Wu, Xiao Benjamin, M Braun, Danielle Dominici, Francesca Gamble, Clarence Ma, Sabath Nethery, Rachel
source	MedRxiv; Medline
abstract	Objectives: United States government scientists estimate that COVID-19 may kill tens of thousands of Americans. Many of the pre-existing conditions that increase the risk of death in those with COVID-19 are the same diseases that are affected by long-term exposure to air pollution. We investigated whether long-term average exposure to fine particulate matter (PM2.5) is associated with an increased risk of COVID-19 death in the United States. Design: A nationwide, cross-sectional study using county-level data. Data sources: COVID-19 death counts were collected for more than 3,000 counties in the United States (representing 98% of the population) up to April 22, 2020 from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. Main outcome measures: We fit negative binomial mixed models using county-level COVID-19 deaths as the outcome and county-level long-term average of PM2.5 as the exposure. In the main analysis, we adjusted by 20 potential confounding factors including population size, age distribution, population density, time since the beginning of the outbreak, time since state issuance of the stay-at-home order, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables such as obesity and smoking. We included a random intercept by state to account for potential correlation in counties within the same state. We conducted more than 68 additional sensitivity analyses. Results: We found that an increase of only 1 μg/m3 in PM2.5 is associated with an 8% increase in the COVID-19 death rate (95% confidence interval [CI]: 2%, 15%). The results were statistically significant and robust to secondary and sensitivity analyses. Conclusions: A small increase in long-term exposure to PM2.5 leads to a large increase in the COVID-19 death rate. Despite the inherent limitations of the ecological study design, our results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. The data and code are publicly available so our analyses can be updated routinely.
has issue date	2020-04-07(xsd:dateTime)
bibo:doi	10.1101/2020.04.05.20054502
bibo:pmid	32511651
has license	medrxiv
sha1sum (hex)	9aa462d97c0fda4cd26f4804a3c5a9825870eb26
schema:url	https://doi.org/10.1101/2020.04.05.20054502
resource representing a document's title	Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study
has PubMed identifier	32511651
schema:publication	medRxiv : the preprint server for health sciences
resource representing a document's body	covid:9aa462d97c0fda4cd26f4804a3c5a9825870eb26#body_text
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