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Int J Environ Res Public Health . Population Response to Air Pollution and the Risk of Coronavirus Disease in Chinese Cities during the Early Pandem

tetano

Editor, Senior Moderator
Int J Environ Res Public Health


. 2021 Feb 24;18(5):2248.
doi: 10.3390/ijerph18052248.
Population Response to Air Pollution and the Risk of Coronavirus Disease in Chinese Cities during the Early Pandemic Period


Miryoung Yoon[SUP] 1 [/SUP], Jong-Hun Kim[SUP] 1 [/SUP], Jisun Sung[SUP] 1 [/SUP], Ah-Young Lim[SUP] 1 [/SUP], Myung-Jae Hwang[SUP] 1 [/SUP], Eun-Hye Kim[SUP] 1 [/SUP], Hae-Kwan Cheong[SUP] 1 [/SUP]



Affiliations
Free article

Abstract

Health behavior is a critical measure in controlling the coronavirus disease 2019 (COVID-19) pandemic. We estimated the effect of health behaviors against air pollution on reducing the risk of COVID-19 during the initial phase of the pandemic. The attack rates of COVID-19 in 159 mainland Chinese cities during the first 2 weeks after the closure of major cities was estimated; air pollution level as a surrogate indicator of the mask-wearing rate. Data on air pollution levels and meteorologic factors 2 weeks prior to the closure were obtained. The attack rate was compared with the level of air pollution using a generalized linear model after adjusting for confounders. When fine particulates (PM[SUB]2.5[/SUB]) and nitrogen dioxide (NO[SUB]2[/SUB]) levels increased by one unit of air quality index (AQI), the infection risk decreased by 0.7% and 3.4%, respectively. When PM[SUB]2.5[/SUB] levels exceeded 150 (level 4), the infection risk decreased (relative risk, RR = 0.635, 95% confidence interval, CI: 0.442 to 0.912 for level 4; RR = 0.529, 95% CI: 0.337 to 0.830 for level 5; respectively). After controlling for the number of high-speed railway routes, when PM[SUB]2.5[/SUB] and NO[SUB]2[/SUB] levels increased by one AQI, relative risk for PM[SUB]2.5[/SUB] and NO[SUB]2[/SUB] was 0.990 (95% CI, 0.984 to 0.997) and 0.946 (95% CI, 0.911 to 0.982), respectively, demonstrating a consistently negative association. It is postulated that, during the early phase of the pandemic, the cities with higher air pollution levels may represent the higher practice of mask-wearing to protect from air pollution, which could have acted as a barrier to the transmission of the virus. This study highlights the importance of health behaviors, including mask-wearing for preventing infections.

Keywords: air pollution; environmental epidemiology; health behavior; mask-wearing; personal protective equipment.
 
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