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. 2022;34(1):39.
doi: 10.1186/s12302-022-00617-z. Epub 2022 Apr 26.

Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health

Dante R Culqui Lévano  1 , Julio Díaz  1 , Alejandro Blanco  1 , José A Lopez  1 , Miguel A Navas  1 , Gerardo Sánchez-Martínez  2 , M Yolanda Luna  3 , Beatriz Hervella  3 , Fernando Belda  3 , Cristina Linares  1
Affiliations

Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health

Dante R Culqui Lévano et al. Environ Sci Eur. 2022.

Abstract

Background: The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could influence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 ℃ in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health.

Results: Statistically significant associations were found between PM10, NO2 and the CM. These associations had a positive value. In the case of temperature and humidity, the associations had a negative value. PM10 being the variable that showed greater association, with the CM followed of NO2 in the majority of provinces. Anyone of the health determinants considered, could explain the differential geographic behavior.

Conclusions: The role of PM10 is worth highlighting, as the chemical air pollutant for which there was a greater number of provinces in which it was associated with CM. The role of the meteorological variables-temperature and HA-was much less compared to that of the air pollutants. None of the social determinants we proposed could explain the heterogeneous geographical distribution identified in this study.

Supplementary information: The online version contains supplementary material available at 10.1186/s12302-022-00617-z.

Keywords: Air pollution; COVID-19 mortality; Determinants of health; Humidity; Temperature.

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Conflict of interest statement

Competing interestsThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Risks of air pollutants and atmospheric variables associated with the COVID-19 mortality rate (CM) in provinces in Spain (*) from Feb. 1, to May 31, 2020. a Risk map COVID-19 mortality rate (CM) vs PM10 in Spain February–May 2020-tertiles in natural break; b risk map COVID-19 mortality rate (CM) vs NO2 in Spain February–May 2020-tertiles in natural break; c risk map COVID-19 mortality rate (CM) vs Tmax in Spain February–May 2020-tertiles in natural break; d risk map COVID-19 mortality rate (CM) vs HA in Spain February–May 2020-tertiles in natural break
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