Outdoor PM2.5 concentration and rate of change in COVID-19 infection in provincial capital cities in China.
Lam, Jacqueline CK
Li, Victor OK
Springer Science and Business Media LLC
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Han, Y., Lam, J. C., Li, V. O., Crowcroft, J., Fu, J., Downey, J., Gozes, I., et al. (2021). Outdoor PM2.5 concentration and rate of change in COVID-19 infection in provincial capital cities in China.. Sci Rep, 11 (1) https://doi.org/10.1038/s41598-021-02523-5
This study investigates thoroughly whether acute exposure to outdoor PM2.5 concentration, P, modifies the rate of change in the daily number of COVID-19 infections (R) across 18 high infection provincial capitals in China, including Wuhan. A best-fit multiple linear regression model was constructed to model the relationship between P and R, from 1 January to 20 March 2020, after accounting for meteorology, net move-in mobility (NM), time trend (T), co-morbidity (CM), and the time-lag effects. Regression analysis shows that P (β = 0.4309, p < 0.001) is the most significant determinant of R. In addition, T (β = -0.3870, p < 0.001), absolute humidity (AH) (β = 0.2476, p = 0.002), P × AH (β = -0.2237, p < 0.001), and NM (β = 0.1383, p = 0.003) are more significant determinants of R, as compared to GDP per capita (β = 0.1115, p = 0.015) and CM (Asthma) (β = 0.1273, p = 0.005). A matching technique was adopted to demonstrate a possible causal relationship between P and R across 18 provincial capital cities. A 10 µg/m3 increase in P gives a 1.5% increase in R (p < 0.001). Interaction analysis also reveals that P × AH and R are negatively correlated (β = -0.2237, p < 0.001). Given that P exacerbates R, we recommend the installation of air purifiers and improved air ventilation to reduce the effect of P on R. Given the increasing observation that COVID-19 is airborne, measures that reduce P, plus mandatory masking that reduces the risks of COVID-19 associated with viral-particulate transmission, are strongly recommended. Our study is distinguished by the focus on the rate of change instead of the individual cases of COVID-19 when modelling the statistical relationship between R and P in China; causal instead of correlation analysis via the matching analysis, while taking into account the key confounders, and the individual plus the interaction effects of P and AH on R.
Article, /692/699/255, /704/172/4081, /692/499, article
Research Grants Council, University Grants Committee (T41-709/17-N)
External DOI: https://doi.org/10.1038/s41598-021-02523-5
This record's URL: https://www.repository.cam.ac.uk/handle/1810/331497