Indoor Air Nicotine, Nitrogen Dioxide Exposure, and COVID-19 Outcomes in a Great Plains Tribal Community
Abstract
Introduction: Indigenous communities in the United States have disproportionately high tobacco use and reliance on propane for heating and cooking fuel compared to other demographic groups. Of concern is exposure to air nicotine (AN) and NO2 in indoor environments and their potential impact on respiratory infections.
Objective: The objective of this study is to assess indoor air pollution and COVID-19 infection outcomes in multigenerational households within the Cheyenne River Sioux Tribe (CRST).
Methods: The COVID-19 Wayakta He? ("Are you on guard against COVID-19?") Study recruited 290 multigenerational households with two adults at least 9 years apart. All participants responded to a questionnaire on COVID-19 outcomes, housing conditions, and environmental health factors. Households deployed passive AN and NO2 air monitors in their homes for 1 week. Each participant provided saliva samples for COVID-19 serological testing.
Results: The geometric mean AN concentration was 0.052 μg/m3 (range: 0.017-5.35); 40.1% of households had AN detected. The geometric mean NO2 concentration was 10.5 ppb (range: 0.65-138). The odds of previous COVID-19 infection were 1.21 (95% CI: 1.01, 1.51) times higher for those exposed to AN; the odds of self-reported long COVID-19 disease were 3.69 (95% CI: 1.11, 16.6) times higher for those exposed to NO2.
Conclusion: Indoor air exposures to AN and NO2 increased the odds of having COVID-19 infection and long COVID-19 outcomes. The combination of…
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