Observational studies generate misleading results about the health effects of air pollution: Evidence from chronic air pollution and COVID-19 outcomes

PLoS One. 2024 Jan 2;19(1):e0296154. doi: 10.1371/journal.pone.0296154. eCollection 2024.

Abstract

Several observational studies from locations around the globe have documented a positive correlation between air pollution and the severity of COVID-19 disease. Observational studies cannot identify the causal link between air quality and the severity of COVID-19 outcomes, and these studies face three key identification challenges: 1) air pollution is not randomly distributed across geographies; 2) air-quality monitoring networks are sparse spatially; and 3) defensive behaviors to mediate exposure to air pollution and COVID-19 are not equally available to all, leading to large measurement error bias when using rate-based COVID-19 outcome measures (e.g., incidence rate or mortality rate). Using a quasi-experimental design, we explore whether traffic-related air pollutants cause people with COVID-19 to suffer more extreme health outcomes in New York City (NYC). When we address the previously overlooked challenges to identification, we do not detect causal impacts of increased chronic concentrations of traffic-related air pollutants on COVID-19 death or hospitalization counts in NYC census tracts.

MeSH terms

  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • COVID-19* / epidemiology
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Humans
  • Particulate Matter / analysis
  • Vehicle Emissions / analysis

Substances

  • Air Pollutants
  • Vehicle Emissions
  • Particulate Matter

Grants and funding

The authors received no specific funding for this work.