Incidence of COVID-19 and Connections with Air Pollution Exposure: Evidence from the Netherlands

Bo Pieter Johannes Andree

Research output: Working paper / PreprintWorking paperProfessional


The fast spread of severe acute respiratory syndrome coronavirus 2 has resulted in the emergence of several hot-spots around the world. Several of these are located in areas associated with high levels of air pollution. This study investigates the relationship between exposure to particulate matter and COVID-19 incidence in 355 municipalities in the Netherlands. The results show that atmospheric particulate matter with diameter less than 2.5 is a highly significant predictor of the number of confirmed COVID-19 cases and related hospital admissions. The estimates suggest that expected COVID-19 cases increase by nearly 100 percent when pollution concentrations increase by 20 percent. The association between air pollution and case incidence is robust in the presence of data on health-related preconditions, proxies for symptom severity, and demographic control variables. The results are obtained with ground-measurements and satellite-derived measures of atmospheric particulate matter as well as COVID-19 data from alternative dates. The findings call for further investigation into the association between air pollution and SARS-CoV-2 infection risk. If particulate matter plays a significant role in COVID-19 incidence, it has strong implications for the mitigation strategies required to prevent spreading.
Original languageEnglish
Place of PublicationWashington, D.C.
PublisherThe World Bank
Number of pages30
Publication statusPublished - 24 Apr 2020

Publication series

NamePolicy Research Working Papers
PublisherThe World Bank

Bibliographical note

This paper is a product of the Fragility, Conflict and Violence Global Theme. It is part of a larger effort by the World Bank to provide open access to its research and make a contribution to development policy discussions around the world. Policy
Research Working Papers are also posted on the Web at The author may be contacted at


  • COVID-19
  • coronavirus
  • SARS-CoV-2
  • Pollution
  • particulate matter 2.5

VU Research Profile

  • Human Health and Life Sciences
  • Science for Sustainability


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