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Ambient Air Pollution and COVID-19 in California
1Department of Civil and Environmental Engineering, University of California, Davis, USA.
Research Report (Health Effects Institute)
|April 14, 2026
Summary
Exposure to common air pollutants like ozone and particulate matter is linked to increased COVID-19 incidence, mortality, and long COVID. Addressing air pollution is crucial for mitigating COVID-19
Area of Science:
- Environmental health
- Epidemiology
- Public health
Background:
- COVID-19 has caused millions of deaths globally and significant long-term health issues (long COVID).
- Preliminary evidence suggested air pollution worsens COVID-19 outcomes, but studies lacked robust exposure models.
- COVID-19 continues to pose substantial health risks, with ongoing hospitalizations and deaths.
Purpose of the Study:
- To investigate the relationship between ambient air pollution and COVID-19 outcomes.
- To assess the impact of various air pollutants on COVID-19 incidence, severity, mortality, and long COVID.
- To identify modifiable environmental risk factors for COVID-19 and its sequelae.
Main Methods:
- Utilized advanced models to estimate daily air pollution exposures (ozone, NO2, PM2.5, PM0.1) in Southern California.
- Analyzed administrative COVID-19 data and patient cohorts from a large health system.
- Employed negative binomial regression, Cox proportional hazards models, and multistate survival models to assess associations.
Main Results:
- PM0.1, O3, NO2, and PM2.5 elemental carbon were risk factors for COVID-19 incidence and mortality.
- Air pollution exposure was significantly associated with increased mortality in hospitalized patients.
- Ozone, PM0.1, and PM2.5 nitrate were linked to several long COVID conditions, including cardiac and pulmonary issues.
Conclusions:
- Common air pollutants are associated with increased COVID-19 incidence, mortality, and progression to severe illness, including long COVID.
- Air pollution is a modifiable risk factor that can be targeted to improve COVID-19 prognosis and prevent long COVID.
- Addressing air pollution is critical for reducing the public health burden of COVID-19 and future coronavirus outbreaks.
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