Health Effects Of Ozone Research Articles

Study on O3-NOx-VOCscombined air pollution and ozone health effects in the Hexi Corridor.

In order to study the ecological and atmospheric recovery of the Hexi Corridor region, this paper analyzes the migration changes of land use characteristics and utilizes multivariate data and BenMAP-CE software to study the pollution characteristics of ozone and its precursors and the impact on human health in the Hexi Corridor region. The results showed that the increase of cultivated land area in the Hexi Corridor mainly originated from grassland. The MDA8-O3 concentrations met the primary and secondary standards of the Ambient Air Quality Standards on 43% and 99% of the days, respectively. NO2 showed a negative weekend effect with O3, and HCHO was opposite to it. Temperature, barometric pressure, and vegetation were highly correlated with O3-NO2-HCHO. Ozone pollution in the study area caused about 60% of all-cause premature deaths due to cardiovascular diseases. The study suggests that controlling exogenous transport in Wuwei City during the high ozone period (except August) is mainly dominated by the west and northwest, and that synergistic management of VOCs and NOx emissions can reduce O3 pollution and, consequently, reduce the risk to human health.

Research on the spatial and temporal patterns of ozone concentration and population health effects in the Central Plains Urban Agglomeration from 2017 to 2020.

Fine particulate matter (PM2.5) and near-surface ozone (O3) are the main atmospheric pollutants in China. Long-term exposure to high ozone concentrations adversely affects human health. It is of great significance to systematically analyze the spatiotemporal evolution mechanism and health effects of ozone pollution. Based on the ozone data of 91 monitoring stations in the Central Plains Urban Agglomeration from 2017 to 2020, the research used Kriging method and spatial autocorrelation analysis to investigate the spatiotemporal variations of ozone concentration. Additionally, the study assessed the health effects of ozone on the population using the population exposure risk model and exposure-response relationship model. The results indicated that: (1) The number of premature deaths caused by ozone pollution in the warm season were 37,053 at 95% confidence interval (95% CI: 28,190-45,930) in 2017, 37,685 (95% CI: 28,669-46,713) in 2018, and 37,655 (95% CI: 28,647-46,676) in 2019. (2) The ozone concentration of the Central Plains urban agglomeration showed a decreasing trend throughout the year and during the warm season from 2017 to 2020, there are two peaks monthly, one is June, and the other is September. (3) In the warm season, the high-risk areas of population exposure to ozone in the Central Plains Urban Agglomeration were mainly concentrated in urban areas. In general, the population exposure risk of the south is lower than that of the north. The number of premature deaths attributed to ozone concentration during the warm season has decreased, but some southern cities such as Xinyang and Zhumadian have also seen an increase in premature deaths. China has achieved significant results in air pollution control, but in areas with high ozone concentrations and high population density, the health burden caused by air pollution remains heavy, and stricter air pollution control policies need to be implemented.

Влияние поллютантов атмосферного воздуха на здоровье человека (обзор)

One of modern humanity’s global scourges is air pollution on account not only of its influence on climate change but also its significant impact on public health. A review of current data on the effects of priority atmospheric air pollutants on human health was carried out. The search was performed using eLIBRARY.RU, Web of Science, Scopus and PubMed, in a time span of 2017–2022. Particulate matter (with a diameter of 2.5 μm (PM2.5) or less and 10 μm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the context of health effects. Recently, however, there has been growing interest in the health effects of ozone. Despite the fact that most of the works were devoted to the study of the influence of pollutants on the respiratory and cardiovascular systems, recently the vector of scientific interests shifted to determine the possible role of pollutants in the formation of mental disorders, pathologies of central nervous and endocrine systems, reproductive function. Data on the association of prolonged exposure to nitrogen dioxide, PM2.5, carbon monoxide and ozone with increased morbidity and mortality from SARS-CoV-2 were provided. Prolonged exposure to concentrations well below current standards has been found to have a significant negative impact on the health of both adults and children. Further research in this area is needed to address the possible correction of modern air quality standards.

Ozone Loss: A Surrogate for the Indoor Concentration of Ozone-Derived Products.

Ozone concentrations tend to be substantially lower indoors than outdoors, largely because of ozone reactions with indoor surfaces. When there are no indoor sources of ozone, a common condition, the net concentration of gaseous products derived from indoor ozone chemistry scales linearly with the difference between outdoor and indoor ozone concentrations, termed "ozone loss." As such, ozone loss is a metric that might be used by epidemiologists to disentangle the adverse health effects of ozone's oxidation products from those of exposure to ozone itself. The present paper examines the characteristics, potential utility, and limitations of the ozone loss concept. We show that for commonly occurring indoor conditions, the ozone loss concentration is directly proportional to the total rate constant for ozone removal on surfaces (ksum) and inversely proportional to the net removal of ozone by air exchange (λ) plus surface reactions (ksum). It follows that the ratio of indoor ozone to ozone loss is equal to the ratio of λ to ksum. Ozone loss is a promising metric for probing potential adverse health effects resulting from exposures to products of indoor ozone chemistry. Notwithstanding its virtues, practitioners using it should be mindful of the limitations discussed in this paper.

Evaluating test method of air cleaning devices for ozone removal (ASHRAE RP-1579)

As awareness of the adverse health effects of ozone and its byproducts increases, a dedicated filtration system that removes ozone from ambient air has become a required or preferred component of building ventilation systems. A test method that can provide accurate information on the performance and service life of ozone removal devices is key to their wide application. This study investigates the temporal change of ozone removal efficiency of air cleaning devices that use activated carbon and proposes a prolonged test protocol called “Ozone Stress Test”; it compares this new test protocol to the protocol described in ANSI/ASHRAE Standard 145.2-2016. Results show that activated carbon-based devices had a high degradation rate at the beginning of exposure to ozone or exposure to significantly increased ozone, so a short test (i.e., 1-h initial efficiency test and 4-h capacity test in Standard 145.2) overestimated filter performance. Filter capacity at 95% breakthrough could not be measured using the Standard 145.2 method or the prolonged test method because the filters had exceedingly low degradation rates after few hours’ exposure to ozone. However, the average degradation rate during the capacity test can serve as an indicator of filter capacity.

Ozone exposure and blood transcriptome: A randomized, controlled, crossover trial among healthy adults

RationaleTranscriptome-wide analysis is powerful in studying systemic RNA changes following environmental exposures. However, impacts of ozone inhalation on circulating transcriptome have not yet been examined. ObjectivesTo explore the impact of acute ozone exposure on circulating transcriptome using RNA sequencing (RNA-seq). MethodsWe recruited 32 healthy young adults in a randomized, crossover, controlled exposure trial. Each participant completed two 2-h exposure sessions of ozone (200 ppb) and clean air, respectively. Blood samples were collected at the end of each session and were used for RNA-seq. The differentially expressed genes associated with ozone exposure were assessed using Bayesian adjusted statistics from linear models in the limma R package. ResultsA total of 29 participants finished this trial and donated their blood samples for transcriptome analysis. The average concentration of ozone was 7.8 ± 2.6 ppb under clean air and 201.1 ± 1.7 ppb under ozone exposure session. A total of 1899 genes were significantly changed (1067 up-regulated and 832 down-regulated) by ozone exposure at a false discovery rate < 0.05, in which 403 genes had a fold change of > 1.2 or < 0.8. The top 10 terms of biological processes showed that most of the differentially expressed genes were related to various functions, such as neutrophil degranulation, immune response, and neutrophil activation. Pathway enrichment analysis showed dozens of pathways were dysregulated after ozone exposure, including mitochondrial dysfunction, and glucocorticoid receptor signaling. ConclusionFor the first time this trial characterized the genome-wide changes of mRNA in response to ozone exposure. We identified a range of differentially expressed genes that were involved in dozens of biological processes and pathways, providing novel biological insights into the systemic health effects of ozone.

Associations between short-term ambient ozone exposure and cause-specific mortality in rural and urban areas of Jiangsu, China

Most previous studies on the acute health effects of ozone are limited to urban areas, largely due to the paucity of air pollutant measurements in rural areas. We here estimated the county-specific daily maximum 8-h average ozone concentration in Jiangsu Province, China during 2015–2018, using a recently developed spatiotemporal machine learning model at a spatial resolution of 0.1° × 0.1° (∼11 × 11 km). Counties were equally divided into urban and rural groups based on the median of the percentage of urban residents across Jiangsu counties obtained from the National Population Census in 2010. We first conducted time-series analyses to estimate the county-specific effect of ozone using generalized linear models, then pooled the effect estimates by random-effects modeling. A 10 μg/m3 increase in the 4-day moving average (lag 0–3) of ambient ozone exposure was associated with increases of 0.66% (95% confidence interval [CI] 0.36%–0.95%) in daily nonaccidental mortality in rural areas and 0.42% in urban areas (95% CI, 0.27%–0.56%). Short-term ambient ozone exposure was associated with an increased risk of mortality caused by chronic obstructive pulmonary disease, hypertension, ischemic heart disease, and stroke. Our finding suggests that both urban and rural residents suffer adverse health effects from short-term ozone exposure.

Invisible enemy: The health impact of ozone

China has exerted great efforts in the past decades to fight against particulate matters and has achieved initial results, but ozone pollution has increased significantly. Using a unique diagnostic data of a peninsula city in China, this study evaluates the health effect of ozone pollution on emergency room admission and medical expenditure. We present strong evidence that ozone has a significant negative impact on health. Specifically, one standard deviation increase in ozone pollution will result in an additional 3.30, 2.25, and 4.94 weekly emergency room admissions in respiratory, ophthalmology, and internal medicine. Our analysis of medical expenditure implies that one standard deviation increase of ozone pollution generates a 5.89 million yuan increase of annual medical expenditure for a representative city. We further show that land wind, sunny weather, and dense roads significantly moderate the adverse health effects of ozone. Our findings offer a timely reminder for policymakers to pay attention to “invisible” ozone pollution while managing particulate pollution.

Associations between short-term ambient ozone exposure and cause-specific mortality in the rural and urban areas of Jiangsu, China

BACKGROUND AND AIM: Ambient ozone pollution has been worsening in China. However, current understanding on the acute health effects of ozone is limited to urban areas, partly due to the paucity of air pollutant measurements in rural areas. We here applied modeled ambient ozone exposure covering both rural and urban areas to evaluate the associations between short-term ozone exposure and cause-specific mortality in Jiangsu Province, China, 2015-2018. METHODS: We divided a total of 86 Jiangsu counties equally into urban and rural based on the median value of the percentage of urban residents across Jiangsu counties. We estimate the county-specific daily maximum 8-hour average ozone concentration using a recently developed spatiotemporal machine learning model in China at a resolution of 0.1° × 0.1°. We first estimated county-specific effect of ozone using generalized linear models, adjusting for long-term and seasonal trend, day of week, temperature, and humidity. We then pooled the overall urban and rural area estimates by random-effects meta-analysis. RESULTS:Short-term ambient ozone exposure was associated with mortality of non-accidental cause in rural areas (percentage increase in mortality per 10 μg/m³, 0.45%; 95% confidence interval [CI], 0.29%-0.61%) and urban areas (0.36%; 95% CI, 0.23%-0.49%). The association was significant for mortality caused by respiratory disease or cardiovascular disease in both areas. Our results remain similar after additional adjustments for PM₂.₅ and alternative methods of controlling temperature. CONCLUSIONS:Short-term ambient ozone exposure was associated with increased risk of cause-specific mortality, and the effect size of ozone in rural areas was similar to that in urban areas in Jiangsu Province. This finding suggests that residents in rural areas also suffer adverse health effects from short-term ozone exposure. KEYWORDS: Air pollution, Ozone, Short-term exposure, Mortality

Air quality and synergistic health effects of ozone and nitrogen oxides in response to China’s integrated air quality control policies during 2015–2019

O3 pollution had been worsening in mainland China in the past decade, posing significant human health challenges. The NOx control would trigger increasing O3 concentrations in response to a series of released China emission reduction policies. This study used sensitivity analysis methodology to explore the effectiveness of integrated sectoral emission control policies that have been expanded throughout China. Air quality and synergistic health effects of O3 and NO2 were investigated to obtain an in-depth understanding of the O3 control, especially under a VOC-limited regime. The findings demonstrated that although the NOx-titration effect triggered an increase in O3, the combined health effects of two pollutants tended to improve in most regions of China under a VOC-limited regime. The region-based annual average NO2 concentrations exhibited a larger reduction in Hong Kong (HK) than in the Pearl River Delta Economic Zone (PRD EZ). The short-term measures led to substantial health benefits for Shenzhen and HK. The sectoral emission controls demonstrated a considerable health improvement for the major PRD EZ cities. Joint national control efforts confined the domain-wide health risks below the safety line in China. National cooperative efforts in China could avoid more than 1.5–2% of the emergency hospital admissions for cardiovascular and respiratory diseases attributed to NO2 and O3 exposure. The observed O3 increases due to the NOx-titration effect for calculating the integral health effects of emission control on concentration reduction called for simultaneously strengthened controls on both NOx and VOC in areas subject to a VOC-limited regime.

Health Effects of Ozone on Respiratory Diseases.

Ozone is known to cause bronchial inflammation and airway hyper-responsiveness via oxidative injury and inflammation. While other ambient air pollutants such as particulate matter (PM) and nitrogen dioxide showed decreasing trends in mean annual concentrations, ozone concentrations have not declined recently in most countries across the world. Short-term exposure to high concentrations of ozone has been associated with increased mortality and cardiovascular and respiratory morbidity in many regions of the world. However, the long-term effects of ozone have been less investigated than the short-term exposure due to the difficulty in modeling ozone exposure and linking between individual exposures and health outcome data. A recently developed model of ozone exposure enabled the investigation of long-term ozone effects on health outcomes. Recent findings suggested that long-term exposure to ozone was associated with an increased risk of cardiovascular and respiratory mortality. Longitudinal studies using large cohorts also revealed that long-term exposure to ozone was associated with a greater decline in lung function and the progression of emphysema. The development of long-term standards for ozone as well as PM should be considered to protect the respiratory health of the general population and people with chronic respiratory diseases.

Spatial variation in the joint effect of heat waves and ozone on respiratory hospitalizations in California, 2004 to 2013

Extreme heat and ozone are co-occurring exposures that have been shown to independently and synergistically increase risk of respiratory disease. While some studies have quantified the joint effects of temperature and ozone, none assessed its fine spatial variation. We propose the use of a spatial analysis to examine the potential heterogeneity (on the additive scale) in joint effects between heat and ozone at a small geographical scale. Temperature data was downloaded from the National Ocean and Atmosphere Administration Cooperative Observer stations across the United States and ozone data was estimated at the daily level using 24-hour daily means sampled and analyzed by the US EPA Air Quality System. A spatial extension of the case-crossover design was applied to study this association at the zip code level; spatially varying relative risk due to interaction (RERI) was quantified to consider joint effects. A total of 3,858,196 unscheduled respiratory hospitalizations occurred in California from 2004 to 2013 in the May-September period, and mean thresholds for heat waves ranged from 37.75ºC to 39.57ºC. For ozone, average concentrations ranged from 61.66 ppb to 79.90 for the different thresholds considered. When considering the overall joint effect in all of California, the RERIs revealed no additive interaction. However, when considering the joint-effects at the zip code level, some areas show a strong joint-effect and other areas indicate negative interaction. Results indicate unspecific patterns of heterogeneity, but by considering spatial differences in these impacts variation in the effect of ozone, heat waves and joint-effects is apparent throughout California. Results indicate the importance of going beyond average measures to consider spatial variation in the health effects of ozone and heat. This information can be used to inform hybrid early warning systems to protect populations from the deleterious effects of both ozone and heat.

Analysis of wintertime O3 variability using a random forest model and high-frequency observations in Zhangjiakou—an area with background pollution level of the North China Plain

The short-term health effects of ozone (O3) have highlighted the need for high-temporal-resolution O3 observations to accurately assess human exposure to O3. Here, we performed 20-s resolution observations of O3 precursors and meteorological factors to train a random forest model capable of accurately predicting O3 concentrations. Our model performed well with an average validated R2 of 0.997. Unlike in typical linear model frameworks, variable dependencies are not clearly modelled by random forest model. Thus, we conducted additional studies to provide insight into the photochemical and atmospheric dynamic processes driving variations in O3 concentrations. At nitrogen oxides (NOx) concentrations of 10–20 ppb, all the other O3 precursors were in states that increased the production of O3. Over a short timescale, nitrogen dioxide (NO2) can almost track each high-frequency variation in O3. Meteorological factors play a more important role than O3 precursors do in predicting O3 concentrations at a high temporal resolution; however, individual meteorological factors are not sufficient to track every high-frequency change in O3. Nevertheless, the sharp variations in O3 related to flow dynamics are often accompanied by steep temperature changes. Our results suggest that high-temporal-resolution observations, both ground-based and vertical profiles, are necessary for the accurate assessment of human exposure to O3 and the success and accountability of the emission control strategies for improving air quality.

Air pollutants and daily number of admissions to psychiatric emergency services: evidence for detrimental mental health effects of ozone.

Aim of the current study is to investigate the associations between daily levels of air pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide) and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy). We collected data about daily admissions to psychiatric emergency services of two general hospitals, air pollutants' levels and meteorological data for the time period 1 January 2015 until 31 December 2016. We assessed the impact of an increase in air pollutants on the number of daily admissions using a time-series econometric framework. A total of 1860 emergency department admissions for mental disorders were identified. We observed a statistically significant impact of ozone levels on daily admissions. The estimated coefficient of O3 is statistically significant at the 1% level. All other pollutants were not significantly associated with the number of daily admissions. Short-term exposure to ozone may be associated with increased psychiatric emergency services admissions. Findings add to previous literature on existing evidence for air pollution to have an impact on mental health. Ozone may be considered a potential environmental risk factor for impaired mental health.

Health effects of ozone and particulate matter pollution in China: a province-level CGE analysis

In this study, we estimate the cost of PM2.5 and O3 pollution in China and explore how it differs by province. For the analysis, we extend the China Regional Energy Model—a computable general equilibrium model of the Chinese economy—to explicitly represent the pollution-health linkage within a larger economic system. Our results show that health damage from air pollution in China is substantially large. For each year between 2010 and 2030, China’s welfare loss from excess pollution is estimated to be 3.2–5.1% of the baseline level when welfare is measured as the sum of consumption and leisure. The PM2.5 share of the costs was > 13 times as large as the O3 share, and premature deaths from chronic exposure to PM2.5 were the single most important health endpoint, accounting for ≤ 56% of the total costs. Cross-regional heterogeneity is substantial, and populous and wealthy Eastern China is subject to particularly large health damage. When the size of provincial economies is controlled for, however, the dominance of the eastern region is less obvious and several inland provinces (e.g., Henan, Shanxi, and Chongqing) also suffer high pollution-health costs, due to low air quality and fast productivity growth. Finally, broader economic loss from inefficient resource allocation and its cumulative effects, which is often neglected in static analysis, accounts for > 29% of the total costs. Overlooking this cost component will, in particular, lead to substantial underestimation for China’s central and western regions, whose economies are growing fast.

The acute health effects of ozone and PM2.5 on daily cardiovascular disease mortality: A multi-center time series study in China

To explore the acute health effects of ozone(O3) and PM2.5 on daily cardiovascular disease mortality in all the cities of Jiangsu province, China. Daily average concentrations of ozone (maximum 8-h average), fine particle matter (PM2.5), meteorological data (including temperature and relative humidity) and daily cardiovascular diseases mortality data were collected from January 1, 2015, to December 31, 2017, in all the 13 cities of Jiangsu Province in China. The time-series model linked with Poisson distribution was used to estimate the correlation between O3 and daily cardiovascular diseases mortality, after adjusting for PM2.5 and other pollutants. Firstly, we evaluated the acute effects of O3 on cardiovascular mortality in each city in Jiangsu province, and then we combined the effects of O3 on cardiovascular disease mortality by meta-analysis. The single-pollutant model indicated that the acute health effects of O3 in different cities were quite different. After combined the effects of 13 cities, the mortality of cardiovascular diseases increased by 0.983%（95%CI：0.588–1.377%）for every 10 μg/m3 increases of O3. O3 showed the strongest effect on 3-day moving average concentration (Lag 0–3). After adjusting PM2.5，NO2, SO2, and CO, the results were still statistically significant at the multi-city level. The study found that O3 had a greater effect on women; the elderly population was susceptible and high-education groups were more vulnerable to O3, although the differences between different subgroups were insignificant. The dose-response curve showed that the mortality of cardiovascular disease increased with the increase of O3. The increase in O3 concentration of atmospheric can increase the daily mortality of cardiovascular diseases in Jiangsu, China.

Development of a large-scale computer-controlled ozone inhalation exposure system for rodents

Objective: Complete systems for laboratory-based inhalation toxicology studies are typically not commercially available; therefore, inhalation toxicologists utilize custom-made exposure systems. Here we report on the design, construction, testing, operation and maintenance of a newly developed in vivo rodent ozone inhalation exposure system.Materials and methods: Key design requirements for the system included large-capacity exposure chambers to facilitate studies with large sample sizes, automatic and precise control of chamber ozone concentrations, as well as automated data collection on airflow and environmental conditions. The exposure system contains two Hazelton H-1000 stainless steel and glass exposure chambers, each providing capacity for up to 180 mice or 96 rats. We developed an empirically tuned proportional-integral-derivative control loop that provides stable ozone concentrations throughout the exposure period (typically 3h), after a short ramp time (∼8 min), and across a tested concentration range of 0.2–2 ppm. Specific details on the combination of analog and digital input/output system for environmental data acquisition, control and safety systems are provided, and we outline the steps involved in maintenance and calibration of the system.Results: We show that the exposure system produces consistent ozone exposures both within and across experiments, as evidenced by low coefficients of variation in chamber ozone concentration and consistent biological responses (airway inflammation) in mice, respectively.Conclusion: Thus, we have created a large and robust ozone exposure system, facilitating future studies on the health effects of ozone in rodents.

Blood pressure and pulmonary health effects of ozone and black carbon exposure in young adult runners

Physical activity has been shown to promote health and well-being, however, exercising in environments with high level of air pollution might increase the risk of cardio-respiratory impairments. In this crossover study, we constructed linear mixed models to investigate the impact of short-term exposure to black carbon (BC) and ozone on blood pressure and pulmonary functions among 30 healthy adult runners after 30-minute run on a clean and polluted route on separate days in August 2015 in Hong Kong. Runners were on average 20.6 years old, with mean body mass index of 20.3 kg/m2. Air pollution concentrations were higher in the polluted route than in the clean route, with the highest difference in BC (5.4 μg/m3 versus 1.3 μg/m3). In single-pollutant models, no significant association was found between air pollution and changes in blood pressures, forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow and fractional exhaled nitric oxide, after adjusting for gender, type of route, temperature and relative humidity. When further adjusting for both BC and ozone simultaneously, increment in BC became statistically significantly associated with increase in systolic blood pressure (relative risk = 3.18; 95% CI: 0.24, 6.13) after running exercise. Stratified analysis further shows that the significant adverse association between systolic blood pressure and BC was only observed in the polluted route (e.g., relative risk = 4.51, 95% CI: 0.75, 8.27 in two-pollutant). Our finding of BC is consistent with existing literature, while further studies with greater sample size and longer exposure time are needed to investigate the effects of ozone to cardio-respiratory functions in runners. Given that exercise has clear health benefits, one should consider ways to minimize the air pollution exposure.

A Multi-Country Study on Ozone-Related Mortality

Back&amp;aim: Many studies have characterized the short-term association between ozone and mortality in different settings, but mostly across limited geographical areas and using different methodological approaches. In this study, we aimed at comprehensively assessing short-term ozone-related mortality associations in a multi-country analysis.Method: We collected daily mortality and air pollution data (ozone, O3, and particulate matter, PM10) from 245 locations in 16 countries (Australia, Brazil, Canada, Chile, Columbia, France, Japan, South Korea, Mexico, Portugal, Spain, Sweden, Switzerland, Taiwan, Thailand, and United States), included in the Multi-City Multi-Country Collaborative Research Network. We applied a two-stage time-series design. First, we modelled mortality-ozone associations across 21 days of lag using quasi-Poisson regression and distributed lag linear models (DLMs). Second, we performed a multilevel multivariate meta-regression to obtain pooled associations across locations nested within country. Best linear unbiased predictions (BLUPs) were derived at both location and country levels. We estimated season-specific ozone-related mortality through time-varying interaction DLMs.Results: On average, an increase in 10 &amp;#956;g/m3 in ozone was associated with a 0.6% increase in mortality risk [95%CI: 0.3 to 0.8%]. The positive association was lagged and persisted during the following 7 days. Country-specific BLUPs ranged between 0.2%[-0.05 to 0.5] in Brazil to 0.8%[0.5 to 1.2] in the US. The ozone-related mortality association was significantly larger in winter [0.8%, 0.5 to 1.0] vs summer [0.5%, 0.4 to 0.7]. Results were robust to sensitivity analyses, such as multi-pollutant models.Conclusion: This represents the largest epidemiological study on health effects of ozone. By using a common advanced statistical framework, we provide robust evidence on the association with all-cause mortality in different locations across the globe.On behalf of the MCC Network

Metabolic and Pulmonary Health Effects of Ozone and Black Carbon Exposure in Young Adult Runners

Metabolic and Pulmonary Health Effects of Ozone and Black Carbon Exposure in Young Adult Runners