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Exposure to Perfluoroalkyl Substances and Mortality for COVID-19: A Spatial Ecological Analysis in the Veneto Region (Italy)

Author

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  • Dolores Catelan

    (Department of Statistics, Computer Science, Applications ‘G. Parenti’ (DiSIA), University of Florence, 50134 Firenze, Italy)

  • Annibale Biggeri

    (Department of Statistics, Computer Science, Applications ‘G. Parenti’ (DiSIA), University of Florence, 50134 Firenze, Italy)

  • Francesca Russo

    (Regional Directorate of Prevention, Food Safety, Veterinary Public Health, Regione del Veneto, 30123 Venice, Italy)

  • Dario Gregori

    (Unit of Biostatistics, Epidemiology and Public Health, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy)

  • Gisella Pitter

    (Screening and Health Impact Assessment Unit, Azienda Zero, Regione del Veneto, 35131 Padova, Italy)

  • Filippo Da Re

    (Regional Directorate of Prevention, Food Safety, Veterinary Public Health, Regione del Veneto, 30123 Venice, Italy)

  • Tony Fletcher

    (Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK)

  • Cristina Canova

    (Unit of Biostatistics, Epidemiology and Public Health, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy)

Abstract

Background: In the context of the COVID-19 pandemic, there is interest in assessing if per- and polyfluoroalkyl substances (PFAS) exposures are associated with any increased risk of COVID-19 or its severity, given the evidence of immunosuppression by some PFAS. The objective of this paper is to evaluate at the ecological level if a large area (Red Zone) of the Veneto Region, where residents were exposed for decades to drinking water contaminated by PFAS, showed higher mortality for COVID-19 than the rest of the region. Methods: We fitted a Bayesian ecological regression model with spatially and not spatially structured random components on COVID-19 mortality at the municipality level (period between 21 February and 15 April 2020). The model included education score, background all-cause mortality (for the years 2015–2019), and an indicator for the Red Zone. The two random components are intended to adjust for potential hidden confounders. Results: The COVID-19 crude mortality rate ratio for the Red Zone was 1.55 (90% Confidence Interval 1.25; 1.92). From the Bayesian ecological regression model adjusted for education level and baseline all-cause mortality, the rate ratio for the Red Zone was 1.60 (90% Credibility Interval 0.94; 2.51). Conclusion: In conclusion, we observed a higher mortality risk for COVID-19 in a population heavily exposed to PFAS, which was possibly explained by PFAS immunosuppression, bioaccumulation in lung tissue, or pre-existing disease being related to PFAS.

Suggested Citation

  • Dolores Catelan & Annibale Biggeri & Francesca Russo & Dario Gregori & Gisella Pitter & Filippo Da Re & Tony Fletcher & Cristina Canova, 2021. "Exposure to Perfluoroalkyl Substances and Mortality for COVID-19: A Spatial Ecological Analysis in the Veneto Region (Italy)," IJERPH, MDPI, vol. 18(5), pages 1-11, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2734-:d:512884
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    References listed on IDEAS

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    1. Julian Besag & Jeremy York & Annie Mollié, 1991. "Bayesian image restoration, with two applications in spatial statistics," Annals of the Institute of Statistical Mathematics, Springer;The Institute of Statistical Mathematics, vol. 43(1), pages 1-20, March.
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    Cited by:

    1. Christel Nielsen & Anna Jöud, 2021. "Susceptibility to COVID-19 after High Exposure to Perfluoroalkyl Substances from Contaminated Drinking Water: An Ecological Study from Ronneby, Sweden," IJERPH, MDPI, vol. 18(20), pages 1-8, October.
    2. Zygmunt F. Dembek & Robert A. Lordo, 2022. "Influence of Perfluoroalkyl Substances on Occurrence of Coronavirus Disease 2019," IJERPH, MDPI, vol. 19(9), pages 1-12, April.
    3. Francesco Jacopo Pintus, 2023. "Valuing drinking water quality after a PFAS contamination event: results from a meta-analysis benefit transfer," "Marco Fanno" Working Papers 0308, Dipartimento di Scienze Economiche "Marco Fanno".
    4. Marialuisa Menegatto & Adriano Zamperini, 2024. "Contamination of Perfluoroalkyl Substances and Environmental Fight for Safe and Health: The MammeNoPfas Movement as Epistemic Community," Social Sciences, MDPI, vol. 13(10), pages 1-25, September.

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