Is the risk of dying from COVID-19, a disease caused by the coronavirus SARS-CoV-2, increased when breathing polluted air for a long time? Such a connection is obvious, but cannot be measured directly, reports the Max Planck Institute for Chemistry in a recent report. In a study, the proportion of COVID-19 deaths that could be attributable to air pollution by particulate matter has now been determined for the first time on a country-specific basis.
Already in spring, the journal “Science of the Total Environment” reported that there are significantly more COVID-19 deaths in regions with high air pollution. A new study has now also come to the conclusion that a large proportion of corona deaths could be attributable to polluted air.
Experts agree that polluted air is harmful to health and increases the risk of cardiovascular and respiratory disease. And air pollution is an important co-factor in COVID-19 deaths, researchers now report.
Coronavirus: Air pollution often the cause of fatal outcome
The study, published in the scientific journal Cardiovascular Research, estimates that about 15 percent of global COVID-19 deaths could be due to long-term exposure to air pollution.
According to the authors from the Max Planck Institute for Chemistry, the Harvard T.H. Chan School of Public Health, the London Centre for Climate Change and Planetary Health, Berlin Charité and Universitätsmedizin Mainz, the proportion of air pollution-related COVID-19 deaths is 19 percent in Europe, 17 percent in North America and 27 percent in East Asia.
According to the data, the figures are an estimate of the proportion of COVID-19 deaths that could have been avoided if the population had been exposed to less air pollution with no emissions from fossil fuel use and other anthropogenic, i.e. man-made, sources.
Dr. Andrea Pozzer from the Max Planck Institute for Chemistry in Mainz emphasizes that the attributable contribution does not prove a direct link between air pollution and COVID-19 mortality, but rather an indirect effect, which is why he and his colleagues also give relative figures: “Our estimates show the importance of air pollution on comorbidities, i.e. health factors that can exacerbate each other and thus trigger deadly health consequences of viral infection,” says the atmospheric researcher and first author of the study.
The proportion is lower, for example, in Italy (15 percent) or Brazil (12 percent). The figures for Israel (six percent), Australia (three percent) and New Zealand (one percent) are in single figures. In their publication, the researchers also state the statistical confidence intervals of their calculations, which range from five to 33 percent worldwide.
Estimates of COVID-19 deaths related to air pollution show a very different picture for the individual countries: the proportion is comparatively high in the Czech Republic with 29 percent, in China with 27 percent and in Germany with 26 percent.
“Although our results show uncertainties, the contribution of air pollution to COVID-19 mortality is clearly evident. However, actual mortality is influenced by many factors, such as the country’s healthcare system,” explains Pozzer, who is also a researcher at the International Center for Theoretical Physics in Trieste, Italy.
“When people inhale polluted air, the very small health-endangering fine dust particles migrate from the lungs into the blood and blood vessels,” explains Univ. Professor Dr. Thomas Münzel from the University Hospital in Mainz, Germany, explaining the effect of air pollution on our bodies. “There they cause inflammation and severe oxidative stress, disrupting the balance between free radicals and the oxidizing agents that normally repair cell damage,” explains the director at the Center for Cardiology at the University Hospital Mainz and co-author of the study.
This in turn damages the inner arterial layer, the endothelium, and leads to narrowing and stiffening of the arteries. The coronavirus also enters the body via the lungs and causes similar damage to the blood vessels. It is therefore also considered an endothelial disease.
“However, in the UK, for example, around 44,000 people have died from COVID-19 between the beginning of the pandemic and mid-June, and we estimate that the proportion of air pollution-related deaths was 14%, which corresponds to almost 6,000 deaths. In the United States, 220,000 COVID deaths with a share of 18% led to almost 40,000 deaths that can be attributed to air pollution,” he said.
“As the number of COVID-19 deaths continues to increase, it is not possible to provide definitive figures for deaths per country that can be attributed to air pollution,” said Jos Lelieveld, director at the Max Planck Institute for Chemistry and professor at the Cyprus Institute in Nicosia, Cyprus.
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