Next Article in Journal
Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress
Previous Article in Journal
Assessment of Hygienic Practices in Beef Cattle Slaughterhouses and Retail Shops in Bishoftu, Ethiopia: Implications for Public Health
Article

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

1
Department of Statistics, Computer Science, Applications ‘G. Parenti’ (DiSIA), University of Florence, 50134 Firenze, Italy
2
Regional Directorate of Prevention, Food Safety, Veterinary Public Health, Regione del Veneto, 30123 Venice, Italy
3
Unit of Biostatistics, Epidemiology and Public Health, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy
4
Screening and Health Impact Assessment Unit, Azienda Zero, Regione del Veneto, 35131 Padova, Italy
5
Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Dudley E. Shallcross
Int. J. Environ. Res. Public Health 2021, 18(5), 2734; https://doi.org/10.3390/ijerph18052734
Received: 29 December 2020 / Revised: 8 February 2021 / Accepted: 1 March 2021 / Published: 8 March 2021
(This article belongs to the Section Environmental Health)
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. View Full-Text
Keywords: PFAS; COVID-19 mortality; ecological analysis; epidemiological surveillance; hierarchical Bayesian models PFAS; COVID-19 mortality; ecological analysis; epidemiological surveillance; hierarchical Bayesian models
Show Figures

Figure 1

MDPI and ACS Style

Catelan, D.; Biggeri, A.; Russo, F.; Gregori, D.; Pitter, G.; Da Re, F.; Fletcher, T.; Canova, C. Exposure to Perfluoroalkyl Substances and Mortality for COVID-19: A Spatial Ecological Analysis in the Veneto Region (Italy). Int. J. Environ. Res. Public Health 2021, 18, 2734. https://doi.org/10.3390/ijerph18052734

AMA Style

Catelan D, Biggeri A, Russo F, Gregori D, Pitter G, Da Re F, Fletcher T, Canova C. Exposure to Perfluoroalkyl Substances and Mortality for COVID-19: A Spatial Ecological Analysis in the Veneto Region (Italy). International Journal of Environmental Research and Public Health. 2021; 18(5):2734. https://doi.org/10.3390/ijerph18052734

Chicago/Turabian Style

Catelan, Dolores, Annibale Biggeri, Francesca Russo, Dario Gregori, Gisella Pitter, Filippo Da Re, Tony Fletcher, and Cristina Canova. 2021. "Exposure to Perfluoroalkyl Substances and Mortality for COVID-19: A Spatial Ecological Analysis in the Veneto Region (Italy)" International Journal of Environmental Research and Public Health 18, no. 5: 2734. https://doi.org/10.3390/ijerph18052734

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop