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Abstract
Little is known about the acute effects of ozone on morbidity risk in China. We conducted a time-series study to examine the association between ozone and daily emergency room visits (ERVs) in Beijing, China. We identified 7,088,309 ERVs between January 1, 2014 and December 31, 2015. A generalized additive model with Poisson regression incorporating penalized spline functions was employed to analyze ERVs in association with daily 8-h maximum ozone concentrations. An increase of 10 μg/m3 of same-day ozone concentration was significantly associated with a 0.24% (95% CI, 0.21%–0.26%), 0.31% (95% CI, 0.27%–0.35%), and 0.43% (95% CI, 0.36%–0.50%) increase in daily ERVs for the whole study period, days when the daily 8-h maximum ozone met the Chinese Ambient Air Quality Standards (CAAQS) Grade II standard, and days that met the CAAQS Grade I standard, respectively. These results were robust when considering the potential confounding effects of PM2.5, PM10, NO2, SO2, and CO. In conclusion, our findings suggested significant effects of ozone exposure on daily ERVs in Beijing. Improving air quality with even lower ozone level than the current CAAQS could yield important public health.
Highlights
China, the largest developing country, may have the severest ambient ozone pollution in the world[13]
8-h maximum ozone levels were weakly correlated with NO2, SO2, and carbon monoxide (CO) concentrations, while were highly positively correlated with temperature (r = 0.84) (Table 3)
Evidence gained in this analysis indicated that the current level of ozone in Beijing was significantly associated with increased daily emergency room visits (ERVs), even at ozone levels below the current Chinese Ambient Air Quality Standards (CAAQS)
Summary
The largest developing country, may have the severest ambient ozone pollution in the world[13]. ERV can better test the temporal association between clinical presentation of disease and exposure to air pollution[18]. ERV is a good indicator in evaluating the health effects associated with air pollution. A key scientific issue in evaluating the ozone-associated health effects is whether a threshold concentration exists below which no adverse impacts are expected[1]. No study has evaluated the health effects of ozone on morbidity risk at levels below the current CAAQS. We aimed to test the relationship between short-term exposure to ozone and daily ERVs, and to explore whether ozone at levels below the current CAAQS has adverse effects on morbidity risk in Beijing, the capital of China
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