Disease risk higher in highly polluted areas – COVID-19 risk greater?

With the COVID-19 pandemic, one thing we notice is the higher fatality rate for elderly patients, or for those with impaired health, or for those who are smokers. It seems that those with weaker immune systems have a harder time fighting off COVID-19, and therefore are more likely to result in death. The question is whether polluted air results in a weakened immune system and a greater likelihood of death from COVID-19.

Doesn’t that sound like a likely result? That humans living in areas with more pollution will tend to be sicker, and perhaps have a weaker immune system?

If there is a correlation – that folks living in polluted areas are more likely to get sick and die from diseases – that would put yesterday’s decision EPA decision in a bad light. Yesterday, the US Environmental Protection Agency rolled back the tighter CAFE standards enacted by the Obama Administration. While that move does a disservice to efforts to stop Climate Change, it might also have an impact on our collective health.

Yesterday, the Huffington Post posted an article examining this question. China, for example, has extremely polluted air, and suffered greatly with SARS and COVID-19 both. The powers-that-be identified China as the source of this disease, specifically pointing to the practice of eating unsafe animals and a resulting cross-species disease transmission. But what if the polluted air played a role?

Back in 2003, subsequent to the SARS epidemic, a scientific paper (Cui, Y., Zhang, Z., Froines, J. et al. Air pollution and case fatality of SARS in the People’s Republic of China: an ecologic study. Environ Health2, 15 (2003). https://doi.org/10.1186/1476-069X-2-15) studied the correlation between pollution and SARS mortality.

Unsurprisingly that paper found a strong correlation between higher mortality rates and higher pollution.

However that was a small study, so it may not be possible to draw a significant conclusion. But that’s hardly the only relevant research.

About 10 years ago I read a research paper published by the California Air Resources Board about the correlation between cardiovascular disease and high air pollution. In that study they rigged a van with a chamber where passengers could sit, and the researchers could control whether the chamber gets clean air from an oxygen tank, or dirty air from the highway. The van was driven in areas of Los Angeles with horrid air, such as near the shipyards. The study showed a clear correlation between cardiovascular problems and breathing the dirty polluted air.

It’s useful to note that COVID-19 impacts the lungs, and those who die of it generally have a severe pneumonia.

That isn’t the only research of that sort. There is enough research on the connection between air pollution and disease that the Huffington Post article has a supporting quote from Aaron Bernstein, interim director of the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health. He said that Air Pollution “… stifles the immune response to infections, it actually directly can damage immune cells. It also tends to be inflammatory in the lung, and that inflammation can interfere with mechanisms that clear pathogens (including viruses) from our respiratory tracts.”

Again, COVID-19 is a lung disease. Therefore we should expect COVID-19 mortality rates to be higher in areas with high air pollution.

As the Huffington Post article points out, Iran is an area with a massive COVID-19 problem, and which is heavily polluted. Likewise, while New York’s air is cleaner than it used to be, it too is a heavily polluted area, with a huge COVID-19 problem.

The European Public Health Alliance issued a press release on March 16, 2020: Coronavirus threat greater for polluted cities. It references the 2003 study from China, and then has this quote:

Dr Sara De Matteis, Associate Professor in Occupational and Environmental Medicine at Cagliari University, Italy, and member of the ERS Environmental Health Committee said: “Urban air quality has improved in the last half century, but petrol and especially diesel vehicle fumes remain a serious problem. Even the latest diesel engines emit dangerous levels of pollution. Patients with chronic lung and heart conditions caused or worsened by long-term exposure to air pollution are less able to fight off lung infections and more likely to die. This is likely also the case for Covid-19. By lowering air pollution levels we can help the most vulnerable in their fight against this and any possible future pandemics.’’

Clearly the correlation isn’t that simple, because there are biological reasons for the spread of COVID-19. In New York, an infected person went to some gatherings in New Rochelle, he spread the infection to others at the gatherings, who spread it further, causing a severe cluster that is now spinning out of control. Likewise the infection cluster in Iran, South Korea, Italy, and Louisiana were due to gatherings attended by infected people.

The Trump Administration has repeatedly acted to relax environmental regulations. It is again safe to dump toxic waste in rivers, for instance. Yesterday the decision was made to gut the CAFE standard regulations enacted by the Obama Administration, replacing it with a weaker standard. The result will be greater levels of air pollution from cars and trucks, that will not only increase the impact of climate change, but probably negatively impact our health.

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About David Herron

David Herron is a writer and software engineer living in Silicon Valley. He primarily writes about electric vehicles, clean energy systems, climate change, peak oil and related issues. When not writing he indulges in software projects and is sometimes employed as a software engineer. David has written for sites like PlugInCars and TorqueNews, and worked for companies like Sun Microsystems and Yahoo.