Indoor Air Nicotine, Nitrogen Dioxide Exposure, and COVID-19 Outcomes in a Great Plains Tribal Community.

Authors

Anna Tillery, Rae O'Leary, Nora Pisanic, Brittany Youpee, Angela Aherrera, Kate Krucynski, Jaylynn Farlee, Megan Wilks, Erena S Hovhannisyan Romero, Miranda Cajero, Jacob Duran, Christopher Heaney, Ana M Rule, Esther Erdei

Published in

Indoor air. Volume 2026. Epub Mar 31, 2026.

Abstract

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.
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).
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.
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.
Indoor air exposures to AN and NO₂ increased the odds of having COVID-19 infection and long COVID-19 outcomes. The combination of toxic chemical exposures, increased prevalence of existing chronic diseases, and structural social problems placed Indigenous communities at increased risk of having COVID-19 infections. High exposures to household AN and NO₂ and the occurrence of COVID-19 disease highlight the importance of consistently including exposure assessments to design targeted interventions in Tribal communities.

PMID:
42569680
Bibliographic data and abstract were imported from PubMed on 09 Aug 2026.

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