Excess Mortality Associated with High Ozone Exposure: A National Cohort Study in China

Overview

Journal Environ Sci Ecotechnol

Date 2023 Feb 10

PMID 36761466

Authors

Yang Yuan

Kai Wang

Haitong Zhe Sun

Yu Zhan

Zhiming Yang

Kejia Hu

Yunquan Zhang

Affiliations

Soon will be listed here.

Abstract

Emerging epidemiological studies suggest that long-term ozone (O) exposure may increase the risk of mortality, while pre-existing evidence is mixed and has been generated predominantly in North America and Europe. In this study, we investigated the impact of long-term O exposure on all-cause mortality in a national cohort in China. A dynamic cohort of 20882 participants aged ≥40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study. A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season (April-September) O exposure. The annual average level of participant exposure to warm-season O concentrations was 100 μg m (range: 61-142 μg m). An increase of 10 μg m in O was associated with a hazard ratio (HR) of 1.18 (95% confidence interval [CI]: 1.13-1.23) for all-cause mortality. Compared with the first exposure quartile of O, HRs of mortality associated with the second, third, and highest exposure quartiles were 1.09 (95% CI: 0.95-1.25), 1.02 (95% CI: 0.88-1.19), and 1.56 (95% CI: 1.34-1.82), respectively. A J-shaped concentration-response association was observed, revealing a non-significant increase in risk below a concentration of approximately 110 μg m. Low-temperature-exposure residents had a higher risk of mortality associated with long-term O exposure. This study expands current epidemiological evidence from China and reveals that high-concentration O exposure curtails the long-term survival of middle-aged and older adults.

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