High ozone exposure linked to increased mortality: new insights from a comprehensive Chinese National Cohort study
In a new study published in Volume 15 of the journal Environmental Science and Ecotechnology, researchers from Wuhan University of Science and Technology revealed that even a modest increase of 10 μg m−3 in O3 concentration was associated with a hazard ratio of 1.18 for all-cause mortality, indicating an 18% higher risk of death. The investigation encompassed a robust cohort of 20,882 participants nationwide and spanned a comprehensive seven-year period from 2011 to 2018. An intriguing aspect of this study is its particular focus on warm-season O3 exposure, which, despite the implementation of the Air Pollution Prevention and Control Action Plan in 2013, remains a significant concern in China. Furthermore, the relationship between long-term O3 exposure and mortality risk exhibited a J-shaped pattern, implying a non-linear association with a potential threshold of O3 concentration. A crucial discovery highlights that people in colder climates face heightened mortality risks due to long-term O3 exposure. This underscores the necessity of considering geographical and climate factors when assessing the health impacts of air pollution. The study also revealed a notable regional discrepancy, with China exhibiting higher risk estimates than recent estimates from Europe and North America. These variations could be attributed to variances in exposure metrics, population susceptibility, and generally lower O3 concentrations in developed nations.
Highlights
•A national cohort study on O3 exposure and all-cause mortality is conceived in China.
•Long-term O3 exposure is associated with increased mortality risk.
•A J-shaped O3-mortality relationship is identified in middle-aged and older adults.
However, it is essential to note that despite the significant findings, the study had certain limitations. The assessment of O3 exposure was based on data at the city level rather than individual-level exposure Furthermore, the study did not consider factors such as indoor O3 exposure and potential unmeasured confounders (e.g., traffic noise or other climatic factors). Additionally, the lack of clinical diagnoses regarding the cause of death restricts the exploration of associations between O3 exposure and cause-specific mortality.
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References
Funding information
Youth Fund Project of Humanities and Social Sciences Research of the Ministry of Education (21YJCZH229).
DOI
About Environmental Science and Ecotechnology
Environmental Science and Ecotechnology (ISSN 2666-4984) is an international, peer-reviewed, and open-access journal published by Elsevier. The journal publishes significant views and research across the full spectrum of ecology and environmental sciences, such as climate change, sustainability, biodiversity conservation, environment & health, green catalysis/processing for pollution control, and AI-driven environmental engineering. ESE received its latest impact factor of 12.6, according to the Journal Citation ReportTM 2022.
The C–R curve for O3 and all-cause mortality was fitted using a natural cubic spline. A nonlinear association between long-term O3 exposure and mortality risk (P for nonlinearity < 0.001) was observed at 60.7–142.4 μg m−3. Intuitively, we observed a J-shaped relationship, revealing a relatively flat curve as O3 levels fell below approximately 110 μg m−3, while the slope (i.e., increase in mortality risk) was steeper at higher concentrations.
CREDIT
Environmental Science and Ecotechnology
JOURNAL
Environmental Science and Ecotechnology
SUBJECT OF RESEARCH
Not applicable
ARTICLE TITLE
Excess mortality associated with high ozone exposure: A national cohort study in China
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