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Article

Assessing the Country-Level Excess All-Cause Mortality and the Impacts of Air Pollution and Human Activity during the COVID-19 Epidemic

by 1, 1,2,*, 3,4, 5,6,7 and 1
1
Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong
2
Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hong Kong
3
School of Geography, South China Normal University, Guangzhou 510000, China
4
College of Geography and Environment, Shandong Normal University, Jinan 250000, China
5
Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong
6
Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong
7
Department of Human Geography and Spatial Planning, Utrecht University, 3584 CB Utrecht, The Netherlands
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(13), 6883; https://doi.org/10.3390/ijerph18136883
Received: 17 May 2021 / Revised: 22 June 2021 / Accepted: 23 June 2021 / Published: 26 June 2021
The impact of Coronavirus Disease 2019 (COVID-19) on cause-specific mortality has been investigated on a global scale. However, less is known about the excess all-cause mortality and air pollution-human activity responses. This study estimated the weekly excess all-cause mortality during COVID-19 and evaluated the impacts of air pollution and human activities on mortality variations during the 10th to 52nd weeks of 2020 among sixteen countries. A SARIMA model was adopted to estimate the mortality benchmark based on short-term mortality during 2015–2019 and calculate excess mortality. A quasi-likelihood Poisson-based GAM model was further applied for air pollution/human activity response evaluation, namely ground-level NO2 and PM2.5 and the visit frequencies of parks and workplaces. The findings showed that, compared with COVID-19 mortality (i.e., cause-specific mortality), excess all-cause mortality changed from −26.52% to 373.60% during the 10th to 52nd weeks across the sixteen countries examined, revealing higher excess all-cause mortality than COVID-19 mortality in most countries. For the impact of air pollution and human activities, the average country-level relative risk showed that one unit increase in weekly NO2, PM2.5, park visits and workplace visits was associated with approximately 1.54% increase and 0.19%, 0.23%, and 0.23% decrease in excess all-cause mortality, respectively. Moreover, compared with the impact on COVID-19 mortality, the relative risks of weekly NO2 and PM2.5 were lower, and the relative risks of weekly park and workplace visits were higher for excess all-cause mortality. These results suggest that the estimation based on excess all-cause mortality reduced the potential impact of air pollution and enhanced the influence of human activities compared with the estimation based on COVID-19 mortality. View Full-Text
Keywords: excess mortality; air pollution; human activities; COVID-19 mortality; NO2; PM2.5 excess mortality; air pollution; human activities; COVID-19 mortality; NO2; PM2.5
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MDPI and ACS Style

Meng, Y.; Wong, M.S.; Xing, H.; Kwan, M.-P.; Zhu, R. Assessing the Country-Level Excess All-Cause Mortality and the Impacts of Air Pollution and Human Activity during the COVID-19 Epidemic. Int. J. Environ. Res. Public Health 2021, 18, 6883. https://doi.org/10.3390/ijerph18136883

AMA Style

Meng Y, Wong MS, Xing H, Kwan M-P, Zhu R. Assessing the Country-Level Excess All-Cause Mortality and the Impacts of Air Pollution and Human Activity during the COVID-19 Epidemic. International Journal of Environmental Research and Public Health. 2021; 18(13):6883. https://doi.org/10.3390/ijerph18136883

Chicago/Turabian Style

Meng, Yuan, Man S. Wong, Hanfa Xing, Mei-Po Kwan, and Rui Zhu. 2021. "Assessing the Country-Level Excess All-Cause Mortality and the Impacts of Air Pollution and Human Activity during the COVID-19 Epidemic" International Journal of Environmental Research and Public Health 18, no. 13: 6883. https://doi.org/10.3390/ijerph18136883

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