The Effects of Air Pollution on COVID-19 Related Mortality in Northern Italy
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The Effects of Air Pollution on COVID‑19 Related Mortality in Northern Italy Eric S. Coker1 · Laura Cavalli2 · Enrico Fabrizi3 · Gianni Guastella2,4 · Enrico Lippo2 · Maria Laura Parisi5 · Nicola Pontarollo5 · Massimiliano Rizzati2 · Alessandro Varacca6 · Sergio Vergalli2,5 Accepted: 13 July 2020 © The Author(s) 2020
Abstract Long-term exposure to ambient air pollutant concentrations is known to cause chronic lung inflammation, a condition that may promote increased severity of COVID-19 syndrome caused by the novel coronavirus (SARS-CoV-2). In this paper, we empirically investigate the ecologic association between long-term concentrations of area-level fine particulate matter (PM2.5) and excess deaths in the first quarter of 2020 in municipalities of Northern Italy. The study accounts for potentially spatial confounding factors related to urbanization that may have influenced the spreading of SARS-CoV-2 and related COVID-19 mortality. Our epidemiological analysis uses geographical information (e.g., municipalities) and negative binomial regression to assess whether both ambient PM2.5 concentration and excess mortality have a similar spatial distribution. Our analysis suggests a positive association of ambient PM2.5 concentration on excess mortality in Northern Italy related to the COVID19 epidemic. Our estimates suggest that a one-unit increase in P M2.5 concentration (µg/m3) is associated with a 9% (95% confidence interval: 6–12%) increase in COVID-19 related mortality. Keywords COVID-19 · Mortality · Pollution · Italy · Municipalities JEL Classification Q53 · I18 · J11
* Gianni Guastella [email protected] 1
College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
2
Fondazione Eni Enrico Mattei, Milan, Italy
3
Department of Economics and Social Sciences, Università Cattolica del Sacro Cuore, Piacenza, Italy
4
Department of Mathematics and Physics, Università Cattolica del Sacro Cuore, Brescia, Italy
5
Department of Economics and Management, Università degli Studi di Brescia, Brescia, Italy
6
Department of Agricultural Economics, Università Cattolica del Sacro Cuore, Piacenza, Italy
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E. S. Coker et al.
1 Introduction With more than twelve million confirmed COVID-19 cases and more than 550 thousand related deaths globally as of the beginning of July 2020,1 the novel coronavirus pandemic has unquestionably caused dramatic health and economic impacts. Despite the public health benefits of the consequent COVID-19 mitigation measures adopted by the central and the regional governments in Italy, one of the most heavily impacted countries, there are adverse socioeconomic effects of the lockdown on top of what are already dramatic public health impacts. Official morbidity statistics, although complicated by the public health interventions and the emergency status, reveal a strong spatial clustering phenomenon across administrative regions in Italy and provinces and municipalities within each region. Such a geographical c
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