The relevance and feasibility of a study on the role of ambient air pollution in the incidence and/or severity of COVID-19 in France

The objective of this review is to analyze, from a public health and methodological perspective, the relevance and feasibility of conducting an epidemiological study on the link between ambient air pollution (AAP) and the COVID-19 pandemic in France. To this end, 21 literature reviews and critical analyses, as well as 77 original articles, were identified and analyzed from a methodological perspective between January 2020 and September 2021. Additionally, the availability in France of the exposure and health indicators identified in the literature was examined. Studies on pathophysiological mechanisms and epidemiological studies addressing the link between PA and COVID-19 generally support this link. They highlight the need for further studies to better assess this association, particularly in terms of disease severity. The role of long-term exposure in this worsening of the disease appears to be the most plausible mechanism of action for PA. However, while the question of PA’s influence on COVID-19 seems relevant and is justified from a pathophysiological standpoint, it appears that the actual effect is likely weaker than that of already known individual or contextual factors strongly associated with severe cases in particular. Thus, it will surely be difficult to establish a link, even with high-quality methodology and data. Therefore, only a large-scale multicenter study (European or international), preferably at the individual level, employing innovative and tailored methods to study the association between exposure to PA and a pandemic viral infection that spreads through person-to-person transmission and evolves so rapidly over time and space, would allow for a reliable quantification of the role of PA in the progression of COVID-19. Furthermore, the relevance of studies specifically investigating the link between air pollution and COVID-19 must be evaluated more broadly in light of the analysis of other contextual and individual cofactors that may more significantly influence the dynamics of the epidemic. It should be noted that if more comprehensive epidemiological studies were conducted, the "ambient air pollution" parameter should be analyzed on the same footing as other cofactors. That said, it appears clear that air pollution leads to comorbidities that make populations more vulnerable to infections, including COVID-19. Exposure to air pollution also leads to a decrease in life expectancy and, in the most severe cases, results in death, as shown by the latest estimates from Santé publique France for the period 2016 to 2019 (nearly 40,000 deaths attributable each year to PM2.5 fine particulate matter). This research once again underscores the importance of continuing efforts to reduce air pollution by addressing all sources of pollution. Finally, the COVID-19 pandemic underscores the close interconnection between issues related to climate change, air pollution, and emerging infectious diseases, reinforcing the importance of developing assessment and action policies through an integrated approach to public health and environmental health.

Author(s): Medina Sylvia, Wagner Vérène, Adélaïde Lucie, de Crouy Chanel Perrine, Durou Amélie, Corso Magali

Publishing year: 2022

Pages: 65 p.

Collection: Studies and Surveys

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