Influence of air quality on the expected burden on the health care system in the event of pandemics

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Human health is determined by the interaction of internal (e.g. genetic disposition) and external (e.g. pathogens, environment) influences. Thus, air pollutants can both reduce the natural defense mechanisms of the human lung and, in the long term, lead to chronic diseases. Both increase the susceptibility to respiratory diseases such as SARS-CoV-2 and influenza. The strict initial restrictions applied in the context of the SARS-CoV-2 pandemic in spring 2020 led to a short-term reduction in traffic emissions. Depending on the weather situation, this may reduce the exposure of human health to air pollutants, thus having a positive effect on health. Negative effects of the strict initial restrictions are to be expected due to a lack of exercise and the avoidance of visits to the doctor, e.g. for cancer screening. The interrelationships are complex and targeted analyses are needed to determine the effectiveness and impact of administrative interventions.Three questions are addressed in this project:1. what influence does air quality have on the spread of virus-transmitted infections (SARS-CoV 2, influenza), which can lead to pandemics? 2. what impact do measures such as lockdown have on the spread of other (non-viral) respiratory and cardiovascular diseases?3. what measures are recommended locally to reduce the spread of virus-transmitted infections?In addition, the burden on the health care system from the diseases addressed under 1 and 2 is estimated. This will perspectively contribute to the management of future pandemics; the vulnerability of the population to pandemics can thus be assessed more precisely with regard to the additional impact of air pollution.As a database for this project, health data (certificates of incapacity to work, data on outpatient GP-centered care and regular care, outpatient and inpatient hospital data) of the AOK Baden-Württemberg are already available today and later also the nationwide time series on mortality and hospital admissions of the Research Data Center of the Federal and State Governments. Air quality data is provided daily by the German Aerospace Center. The proposed project is an interdisciplinary initiative (medicine, physics, mathematics, biostatistics and epidemiology) of the University of Augsburg, the Ludwig-Maximilians-University Munich and the German Aerospace Center.