Abstract
BackgroundOzone effects on lung function are particularly important to understand in the context of the air pollution-health outcomes epidemiologic literature, given the complex relationships between ozone and other air pollutants with known lung function effects.Research QuestionWhat has been learned about the association between ozone exposures and lung function from epidemiology studies published from 2013 through 2020?Study Design and MethodsOn March 18, 2018, and September 8, 2020, PubMed was searched using the terms health AND ozone, filtering to articles in English and about humans, from 2013 or later. An additional focused review searching for ozone AND (lung function OR FEV1OR FVC) was performed June 26, 2021. Articles were selected for this review if they reported a specific relationship between a lung function outcome and ozone exposure.ResultsOf 3,271 articles screened, 53 ultimately met criteria for inclusion. A systematic review with assessment of potential for bias was conducted, but a meta-analysis was not carried out because of differences in exposure duration and outcome quantification. Consistent evidence exists of small decreases in children’s lung function, even associated with very low levels of short-term ozone exposure. The effects on adult lung function from exposure to low-level, short-term ozone are less clear, although ozone-associated decrements may occur in the elderly. Finally, long-term ozone exposure decreases both lung function and lung function growth in children, although few new studies have examined long-term ozone and lung function in adults.InterpretationMuch of this literature involves concentrations below the current US Environmental Protection Agency’s National Ambient Air Quality Standard of 70 parts per billion over an 8-h averaging time, suggesting that this current standard may not protect children adequately from ozone-related decrements in lung function.
Highlights
RESEARCH QUESTION: Much of this literature involves concentrations below the current USEnvironmental Protection Agency’s National Ambient Air Quality Standard of 70 parts per billion over an 8-h averaging time, suggesting that this current standard may not protect children adequately from ozone-related decrements in lung function
New research continues to suggest small decrements in lung function associated with short-term exposures, including to relatively low levels of ozone
Nine of the 11 new studies that assessed the relationship between short-term ozone exposures and FEV1 in children demonstrated small decreases associated with increases of 10 ppb of ozone over times ranging from 1 day to 2 weeks
Summary
RESEARCH QUESTION: Much of this literature involves concentrations below the current US. Environmental Protection Agency’s National Ambient Air Quality Standard of 70 parts per billion over an 8-h averaging time, suggesting that this current standard may not protect children adequately from ozone-related decrements in lung function. Consistent evidence exists of small decreases in children’s lung function, even associated with very low levels of short-term ozone exposure. The effects on adult lung function from exposure to low-level, short-term ozone are less clear, ozone-associated decrements may occur in the elderly. Articles were selected for this review if they reported a specific relationship between a lung function outcome and ozone exposure. M. Holm), the Division of Environmental Health Sciences Balmes), University of California, San Francisco, and the Division of Occupational and Environmental Medicine
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