Department of Epidemiology, Fielding School of Public Health, University of California at Los Angeles (UCLA), Los Angeles, CA 90095, USA.
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY 14214, USA.
Int J Environ Res Public Health. 2021 Jun 10;18(12):6274. doi: 10.3390/ijerph18126274.
Long-term PM exposure might predispose populations to SARS-CoV-2 infection and intervention policies might interrupt SARS-CoV-2 transmission and reduce the risk of COVID-19. We conducted an ecologic study across the United States, using county-level COVID-19 incidence up to 12 September 2020, to represent the first two surges in the U.S., annual average of PM between 2000 and 2016 and state-level facemask mandates and stay home orders. We fit negative binomial models to assess COVID-19 incidence in association with PM and policies. Stratified analyses by facemask policy and stay home policy were also performed. Each 1-µg/m increase in annual average concentration of PM exposure was associated with 7.56% (95% CI: 3.76%, 11.49%) increase in COVID-19 risk. Facemask mandates and stay home policies were inversely associated with COVID-19 with adjusted RRs of 0.8466 (95% CI: 0.7598, 0.9432) and 0.9193 (95% CI: 0.8021, 1.0537), respectively. The associations between PM and COVID-19 were consistent among counties with or without preventive policies. Our study added evidence that long-term PM exposure increased the risk of COVID-19 during each surge and cumulatively as of 12 September 2020, in the United States. Although both state-level implementation of facemask mandates and stay home orders were effective in preventing the spread of COVID-19, no clear effect modification was observed regarding long-term exposure to PM on the risk of COVID-19.
长期 PM 暴露可能使人群易感染 SARS-CoV-2，干预政策可能会中断 SARS-CoV-2 的传播并降低 COVID-19 的风险。我们在美国进行了一项生态学研究，使用截至 2020 年 9 月 12 日的县一级 COVID-19 发病率来代表美国的前两次疫情高峰，使用 2000 年至 2016 年的年度平均 PM 浓度和州一级的口罩强制令和居家令。我们使用负二项式模型评估 PM 和政策与 COVID-19 发病率的关系。还进行了按口罩政策和居家政策分层的分析。每年平均 PM 暴露浓度增加 1μg/m，与 COVID-19 风险增加 7.56%（95%CI：3.76%，11.49%）相关。口罩强制令和居家令与 COVID-19 呈负相关，调整后的 RR 分别为 0.8466（95%CI：0.7598，0.9432）和 0.9193（95%CI：0.8021，1.0537）。在有或没有预防政策的县，PM 与 COVID-19 之间的关系是一致的。我们的研究结果表明，在美国的每一次疫情高峰期间和截至 2020 年 9 月 12 日的累计期间，长期 PM 暴露增加了 COVID-19 的风险。尽管州一级实施口罩强制令和居家令在防止 COVID-19 传播方面都很有效，但在长期暴露于 PM 对 COVID-19 风险的影响方面，没有观察到明显的效应修饰。
