Impacts of changes in environmental exposures and health behaviours due to the COVID-19 pandemic on cardiovascular and mental health: A comparison of Barcelona, Vienna, and Stockholm.
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Authors
Koch, Sarah
Khomenko, Sasha
Cirach, Marta
Ubalde-Lopez, Mònica
Baclet, Sacha
Daher, Carolyn
Hidalgo, Laura
Lõhmus, Mare
Rizzuto, Debora
Rumpler, Romain
Susilo, Yusak
Venkataraman, Siddharth
Wegener, Sandra
Wellenius, Gregory A
Nieuwenhuijsen, Mark
Publication Date
2022-03-29Journal Title
Environmental Pollution
ISSN
0269-7491
Publisher
Elsevier
Volume
304
Number
119124
Pages
119124
Type
Article
This Version
VoR
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Koch, S., Khomenko, S., Cirach, M., Ubalde-Lopez, M., Baclet, S., Daher, C., Hidalgo, L., et al. (2022). Impacts of changes in environmental exposures and health behaviours due to the COVID-19 pandemic on cardiovascular and mental health: A comparison of Barcelona, Vienna, and Stockholm.. Environmental Pollution, 304 (119124), 119124. https://doi.org/10.1016/j.envpol.2022.119124
Abstract
Responses to COVID-19 altered environmental exposures and health behaviours associated with non-communicable diseases. We aimed to (1) quantify changes in nitrogen dioxide (NO2), noise, physical activity, and greenspace visits associated with COVID-19 policies in the spring of 2020 in Barcelona (Spain), Vienna (Austria), and Stockholm (Sweden), and (2) estimated the number of additional and prevented diagnoses of myocardial infarction (MI), stroke, depression, and anxiety based on these changes. We calculated differences in NO2, noise, physical activity, and greenspace visits between pre-pandemic (baseline) and pandemic (counterfactual) levels. With two counterfactual scenarios, we distinguished between Acute Period (March 15th - April 26th, 2020) and Deconfinement Period (May 2nd - June 30th, 2020) assuming counterfactual scenarios were extended for 12 months. Relative risks for each exposure difference were estimated with exposure-risk functions. In the Acute Period, reductions in NO2 (range of change from -16.9 μg/m3 to -1.1 μg/m3), noise (from -5 dB(A) to -2 dB(A)), physical activity (from -659 MET*min/wk to -183 MET*min/wk) and greenspace visits (from -20.2 h/m to 1.1 h/m) were largest in Barcelona and smallest in Stockholm. In the Deconfinement Period, NO2 (from -13.9 μg/m3 to -3.1 μg/m3), noise (from -3 dB(A) to -1 dB(A)), and physical activity levels (from -524 MET*min/wk to -83 MET*min/wk) remained below pre-pandemic levels in all cities. Greatest impacts were caused by physical activity reductions. If physical activity levels in Barcelona remained at Acute Period levels, increases in annual diagnoses for MI (mean: 572 (95% CI: 224, 943)), stroke (585 (6, 1156)), depression (7903 (5202, 10,936)), and anxiety (16,677 (926, 27,002)) would be anticipated. To decrease cardiovascular and mental health impacts, reductions in NO2 and noise from the first COVID-19 surge should be sustained, but without reducing physical activity. Focusing on cities' connectivity that promotes active transportation and reduces motor vehicle use assists in achieving this goal.
Keywords
Air pollution, Cardiovascular disease, Greenspace, Mental disorders, Noise, Physical activity
Sponsorship
European Commission Horizon 2020 (H2020) ERC (817754)
Identifiers
External DOI: https://doi.org/10.1016/j.envpol.2022.119124
This record's URL: https://www.repository.cam.ac.uk/handle/1810/336632
Rights
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/
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