{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:25:44Z","timestamp":1780071944640,"version":"3.54.0"},"reference-count":40,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2021,12,9]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Citizens of Varese aged \u226518 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM<jats:sub>2.5<\/jats:sub>, PM<jats:sub>10<\/jats:sub>, NO<jats:sub>2<\/jats:sub>, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1\u2009\u00b5g\/m<jats:sup>3<\/jats:sup>increase in air pollutants from single- and bi-pollutant Poisson regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 62 848 residents generated 4408 cases. Yearly average PM<jats:sub>2.5<\/jats:sub>exposure was 12.5\u2009\u00b5g\/m<jats:sup>3<\/jats:sup>. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM<jats:sub>2.5<\/jats:sub>was associated with a 5.1% increase in the rate of COVID-19 (95%\u2009CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM<jats:sub>10<\/jats:sub>, NO<jats:sub>2<\/jats:sub>and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long-term exposure to low levels of air pollutants, especially PM<jats:sub>2.5<\/jats:sub>, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2021-107833","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T01:00:11Z","timestamp":1641862811000},"page":"192-199","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":51,"title":["Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy"],"prefix":"10.1136","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4119-6615","authenticated-orcid":false,"given":"Giovanni","family":"Veronesi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8256-2661","authenticated-orcid":false,"given":"Sara","family":"De Matteis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Calori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pepe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2741-7124","authenticated-orcid":false,"given":"Marco M","family":"Ferrario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"2024110805101650000_79.3.192.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30120-1"},{"key":"2024110805101650000_79.3.192.2","first-page":"1775","article-title":"Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy","volume":"323","author":"Onder","year":"2020","journal-title":"JAMA"},{"key":"2024110805101650000_79.3.192.3","unstructured":"European Environmental Agency . 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