COVID-19による大気汚染と健康負荷の関連性。方法論的課題と機会

Linkages Between Air Pollution and the Health Burden from COVID-19: Methodological Challenges and Opportunities.

• Tarik Benmarhnia

抄録

COVID-19パンデミックは、既存の社会的・経済的な健康格差を明らかにし、悪化させた。そのため、標的を絞った対応の情報提供に役立つ潜在的な脆弱性の要因を特定するために、実用的な疫学的証拠が必要である。本解説では、大気汚染とCOVID-19との関連性に関する方法論的課題と機会について、次の点に焦点を当てて論じている：i）集団間での大気汚染への差動曝露の役割と、流行の広がりとその結果としての死亡率の時空間的変動を説明する。最初に、大気汚染への曝露とCOVID-19との間の潜在的なメカニズムと、標的試験の枠組みを通じて関心のある因果関係の問題を明確に定式化する機会について論じる。次に、対照群の選択や共通ショック仮定の違反の可能性など、COVID-19政策の時期の違いを利用した疑似実験計画の使用に関する課題について論じる。最後に、この多頭飼いの危機の環境正義への影響について論じる。

The COVID-19 pandemic revealed and exacerbated existing social and economic health disparities and actionable epidemiological evidence is needed to identify potential vulnerability factors to help inform targeted responses. In this commentary, methodological challenges and opportunities regarding the links between air pollution and COVID-19 are discussed with a focus on: i) the role of differential exposure to air pollution across populations and explain spatio-temporal variability of the epidemic spread and resultant mortality; ii) the indirect impacts of interventions treated as natural experiments to control COVID-19 person-to-person spread on air pollution and population health. I first discuss the potential mechanisms between exposure to air pollution and COVID-19 and the opportunity to clearly formulate causal questions of interest through the target trial framework. Then, I discuss challenges regarding the use of quasi-experimental designs that capitalize on the differential timing of COVID-19 policies including the selection of control groups and potential violations of the common shock assumption. Finally, I discuss environmental justice implications of this many-headed beast of a crisis.

© The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.