Elsevier

Environmental Pollution

Volume 308, 1 September 2022, 119686
Environmental Pollution

Associations of air pollution with COVID-19 positivity, hospitalisations, and mortality: Observational evidence from UK Biobank

https://doi.org/10.1016/j.envpol.2022.119686Get rights and content
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open access

Highlights

  • We assessed the associations of air pollution with COVID-19 outcomes in UK Biobank.

  • Long-term exposure to PM2.5 and NO2 was associated with COVID-19 positive test result.

  • Pre-existing chronic diseases did not fully explain associations.

  • Air pollution was not associated with COVID-19 hospitalisations or deaths.

Abstract

Individual-level studies with adjustment for important COVID-19 risk factors suggest positive associations of long-term air pollution exposure (particulate matter and nitrogen dioxide) with COVID-19 infection, hospitalisations and mortality. The evidence, however, remains limited and mechanisms unclear. We aimed to investigate these associations within UK Biobank, and to examine the role of underlying chronic disease as a potential mechanism. UK Biobank COVID-19 positive laboratory test results were ascertained via Public Health England and general practitioner record linkage, COVID-19 hospitalisations via Hospital Episode Statistics, and COVID-19 mortality via Office for National Statistics mortality records from March–December 2020. We used annual average outdoor air pollution modelled at 2010 residential addresses of UK Biobank participants who resided in England (n = 424,721). We obtained important COVID-19 risk factors from baseline UK Biobank questionnaire responses (2006–2010) and general practitioner record linkage. We used logistic regression models to assess associations of air pollution with COVID-19 outcomes, adjusted for relevant confounders, and conducted sensitivity analyses. We found positive associations of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) with COVID-19 positive test result after adjustment for confounders and COVID-19 risk factors, with odds ratios of 1.05 (95% confidence intervals (CI) = 1.02, 1.08), and 1.05 (95% CI = 1.01, 1.08), respectively. PM 2.5 and NO 2 were positively associated with COVID-19 hospitalisations and deaths in minimally adjusted models, but not in fully adjusted models. No associations for PM10 were found. In analyses with additional adjustment for pre-existing chronic disease, effect estimates were not substantially attenuated, indicating that underlying chronic disease may not fully explain associations. We found some evidence that long-term exposure to PM2.5 and NO2 was associated with a COVID-19 positive test result in UK Biobank, though not with COVID-19 hospitalisations or deaths.

Keywords

Air pollution
Particulate matter
PM2.5
Nitrogen dioxide
NO2
COVID-19
Coronavirus
SARS-CoV-2
Cohort study

Data availability

The authors do not have permission to share data.

Cited by (0)

This paper has been recommended for acceptance by Da Chen.