Publication: A Breath of Fresh Air? How COVID-19 Lockdowns Impacted Air Pollution and Asthma Prevalence in Urban, East Coast United States Cities
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Abstract
The following study investigated temporary declines in air pollution observed during the COVID-19 lockdown and potential changes in adult asthma prevalence across four urban U.S. East Coast cities: Boston, Massachusetts; Baltimore, Maryland; New York City, New York; and Washington, D.C. Leveraging the COVID-19 lockdown as a natural experiment, this research combined annual air pollutant data from the U.S. Environmental Protection Agency (EPA) with asthma prevalence data from the Center of Disease Control’s Behavioral Risk Factor Surveillance System from the years 2013 to 2023 and conducted multiple statistical analyses to determine associations between air pollutants and asthma prevalence. Regression and mediation models were utilized to assess the effects of nitrogen dioxide (NO2) and fine particulate matter (PM2.5) on asthma prevalence. Results showed that NO2 concentrations significantly declined during the COVID-19 period and were modestly associated with reduced asthma prevalence. Mediation analysis suggested that NO2 partially mediated the relationship between the COVID-19 period and observed decreases in asthma prevalence. PM2.5 did not demonstrate a significant mediating effect. Although asthma prevalence declined during the COVID-19 lockdown period, the decrease was not statistically significant. Additionally, the rebound in asthma prevalence after COVID-19 may reflect diagnostic delays or other non-environmental factors impacting the data. Nonetheless, these findings reinforce and inform previous research regarding the impact of air pollution on respiratory health outcomes and asthma prevalence. Furthermore, the results of this study support tactics to reduce NO2 emissions as a strategy to improve public health in urban environments.