Journal
SCIENCE ADVANCES
Volume 6, Issue 45, Pages -Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/sciadv.abd4049
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Funding
- NIH [R01 ES024332-01A1, P50MD010428, RO1 ES026217, RO1 ES028033, R01 ES030616, R01 AG066793-01, R01 MD012769]
- Health Effects Institute grant (HEI) [4953-RFA14-3/16-4]
- US EPA grant [83587201-0]
- EPA [R-83467701]
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Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.
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