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Environmental factors in COVID-19 susceptibility and recovery

Department of Health Sciences

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Prof A Hansell No more applications being accepted Funded PhD Project (European/UK Students Only)
Leicester United Kingdom Epidemiology Nursing & Health Social Work

About the Project

The COVID-19 pandemic has resulted in >100,000 deaths and >4m confirmed cases in the UK alone. Potentially 1 in 10 of cases have long-term symptoms (‘long COVID’) and slow recovery. As part of the Longitudinal Health and Wellbeing programme in the UK government funded COVID-19 Core Studies (, there is a focus on bringing together and enhancing UK cohort studies to enable research into COVID-19. The Centre for Environmental Health and Sustainability at the University of Leicester is leading on environmental enhancements in the Longitudinal Linkage Collaboration. This will provide new air pollution, noise and green space exposure data at place of residence that will be integrated into existing UK cohorts, and also be available for new studies set up to follow COVID-19 survivors such as the PHOSP-COVID (, which is led from University of Leicester.

National cohorts have excellent information about individual characteristics and pre-existing health conditions and have also been collecting information on COVID-19 infections. Additionally, over 2020-21, national cohorts including the Leicester-based EXCEED study ( have sent out questionnaires to cohort members about COVID-19 symptoms as well as social aspects of the pandemic. The same questionnaires have been used across multiple cohorts e.g. using the Wellcome Trust COVID-19 questionnaire In the EXCEED study in Leicester, we have been able to include additional environmental questions in the 2021 follow-up questionnaire being sent out after Easter 2021.

COVID-19 severity and mortality has been linked to exposure to air pollutants such as PM2.5 and NO2 1 2, but there are no individual level studies to date. A potential mechanism is that air pollution increases the risk of chronic cardiovascular and respiratory disease, and presence of chronic disease increases the risk of severe COVID-19. UK data from the first wave of COVID-19 in 2020 suggested that COPD results in ~60% increased risk of death from COVID-193. Post-COVID-19 infection, individuals may experience multi-system symptoms including breathlessness, high heart rate, anxiety and fatigue. It is possible that environmental exposures may influence recovery from COVID-19, as studies pre-COVID-19 have found associations between these symptoms and various environmental exposures. Air pollution exposure is associated with respiratory symptoms4. There is now a substantive body of evidence on impacts of environmental noise on cardiovascular disease and sleep disturbance, as set out in the 2018 WHO noise guidelines for the European Region5. Greenspace exposure has been linked with improved health outcomes for cardiovascular disease and mental health6

Aim of PhD:

The aim of this PhD is to conduct epidemiological analyses to make inferences about the role of environmental factors on COVID-19 severity and recovery.

Outline of PhD research:

The student will first start to explore and document environmental and health data availability in the EXCEED, PHOSP-COVID, UK Biobank and other UK cohort studies. They will then review literature on environmental factors in relation to COVID-19 and other relevant respiratory diseases. Research questions include: Are there associations between greenspace, environmental noise and air pollution exposures and COVID-19 susceptibility and recovery? Are there associations between green space availability and mental health during the pandemic period? Detailed research questions will be developed according to available data and emerging evidence.

What the PhD student will gain:

The studentship will involve training and development of a range of skillsets and excellent experience in interdisciplinary working. In particular, it will involve statistical analysis, exposure science and epidemiology to provide information that could potentially be translated into healthcare management and public health policy. The student will be expected to lead on developing research questions and analysis, present work at national and international conferences and write up papers for publication. They will also have opportunities to develop a personal network with academic researchers and make links with policy makers and clinicians.

Training environment:

The PhD student will join a growing multi-disciplinary team in the Centre for Environmental Health and Sustainability (CEHS) at the University of Leicester, currently with 15 researchers. They will also be affiliated with our new National Institutes of Health Research (NIHR) Health Protection Research Unit (HPRU) in Environmental Exposures and Health, which gives access to a wider group of researchers across the University and externally and to our HPRU training initiatives. The HPRU is a partnership with Public Health England (from April 2021, the National Institute of Health Protection) and the Health and Safety Executive.  CEHS has good links with the Leicester NIHR Biomedical Research Centre hosted by the University Hospitals of Leicester NHS Trust. 

Entry requirements:

Applicants are required to hold/or expect to obtain a UK Bachelor Degree 2:1 or better in a relevant subject. 

A Master’s degree in a relevant subject including epidemiology, public health (with good quantitative statistical skills component) or medical statistics.

The University of Leicester English language requirements apply where applicable.


How to apply:

To apply, please follow the guidance at:

Project / Funding Enquiries: Professor Anna Hansell ([Email Address Removed])

Application enquiries to [Email Address Removed]

Closing date for applications: Friday 9 April 2021

Funding Notes

This 3-year PhD studentship provides:
• UK/EU tuition fee waiver
• Annual stipend at UKRI rates (£15,609 for 2021/22)


1. Wu X, Nethery RC, Sabath MB, et al. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. Science Advances 2020;6(45):eabd4049. doi: 10.1126/sciadv.abd4049
2. Liang D, Shi L, Zhao J, et al. Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States. Innovation (N Y) 2020;1(3):100047. doi: 10.1016/j.xinn.2020.100047 [published Online First: 2020/09/29]
3. Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584(7821):430-36. doi: 10.1038/s41586-020-2521-4
4. Doiron D, Hoogh Kd, Probst-Hensch N, et al. Residential Air Pollution and Associations with Wheeze and Shortness of Breath in Adults: A Combined Analysis of Cross-Sectional Data from Two Large European Cohorts. Environmental Health Perspectives 2017;125(9):097025. doi: doi:10.1289/EHP1353
5. World Health Organization. Environmental Noise Guidelines for the European Region. Copenhagen, Denmark: WHO Regional Office for Europe 2018.
6. Sarkar C, Webster C, Gallacher J. Residential greenness and prevalence of major depressive disorders: a cross-sectional, observational, associational study of 94 879 adult UK Biobank participants. The Lancet Planetary Health 2018;2(4):e162-e73. doi: 10.1016/S2542-5196(18)30051-2

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