2021
Author(s): Li M, Dong H, Wang B, Zhao W, Zare Sakhvidi MJ, Li L, Lin G, Yang J
Ambient ozone (O(3)) has emerged as an important public health issue worldwide. Previous studies found an association between O(3) and cardiorespiratory mortality. However, evidence was limited regarding the risk of O(3) on mortality from other diseases. In this study, we aimed to estimate the association between O(3) and mortality from a broad spectrum of diseases in Guangzhou, China, which has experienced a rapid increase in O(3) concentration over the past decades. Daily data were obtained on cause-specific mortality, air pollutant concentrations and weather conditions during 2013-2018. A generalized additive model with quasi-Poisson regression was applied to examine the association between O(3) and mortality from 10 broad causes and 26 refined subcategories, with adjustment of long-term and seasonal trends, weather conditions, public holidays and days of the week. We found that the threshold concentrations of O(3) were 40 μg/m(3) for all-cause, non-accidental, cardiovascular and respiratory mortality. Mortality risk increased monotonically with O(3) concentrations above the threshold. Per 10 μg/m(3) increase of O(3) at lag 0-3 days was associated with 0.54% (95%CI: 0.34-0.74%), 0.56% (95%CI: 0.36-0.76%), 0.59% (95%CI: 0.30-0.88%), 0.78% (95%CI: 0.33-1.24%) and 0.52% (95%CI: 0.21-0.83%) elevated risk of death from all causes, non-accidental causes, cardiovascular diseases, respiratory diseases and neoplasms, respectively. Among the subcategories, the largest effect estimate was observed in people with chronic obstructive pulmonary disease. The elderly suffered from a higher mortality risk from O(3). Stringent emission control strategies and multi-sectoral collaborations are needed to reduce the detrimental impact of O(3) on vulnerable populations.
DOI: https://dx.doi.org/10.1016/j.scitotenv.2020.142110