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Aims The available literature on morbidity risk of cardiovascular diseases associated with ambient ozone pollution is still limited. This study examined the potential acute effects of exposure to ambient ozone pollution on hospital admissions of cardiovascular events in China. Methods and results A two-stage multi-city time-series study approach was used to explore the associations of exposure to ambient ozone with daily hospital admissions (n = 6 444 441) for cardiovascular events in 70 Chinese cities of prefecture-level or above during 2015–17. A 10 μg/m3 increment in 2-day average daily 8 h maximum ozone concentrations was associated with admission risk increases of 0.46% [95% confidence interval (CI): 0.28%, 0.64%] in coronary heart disease, 0.45% (95% CI: 0.13%, 0.77%) in angina pectoris, 0.75% (95% CI: 0.38%, 1.13%) in acute myocardial infarction (AMI), 0.70% (95% CI: 0.41%, 1.00%) in acute coronary syndrome, 0.50% (95% CI: 0.24%, 0.77%) in heart failure, 0.40% (95% CI: 0.23%, 0.58%) in stroke and 0.41% (95% CI: 0.22%, 0.60%) in ischemic stroke, respectively. The excess admission risks for these cardiovascular events associated with high ozone pollution days (with 2-day average 8-h maximum concentrations ≥100 µg/m3 vs. < 70 µg/m3) ranged from 3.38% (95% CI: 1.73%, 5.06%) for stroke to 6.52% (95% CI: 2.92%, 10.24%) for AMI. Conclusion Ambient ozone was associated with increased hospital admission risk for cardiovascular events. Greater admission risks for cardiovascular events were observed under high ozone pollution days. These results provide evidence for the harmful cardiovascular effects of ambient ozone and call for special attention on the control of high ozone pollution.

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Groundwater quality degradation has raised widespread concerns about water supplies and ecological crises in China. In this study, hydrogeochemistry, environmental stable isotopes (δ18O, δD), and principal component analysis were conducted together to reveal the mechanism’s response to the hydrogeochemical and quality degradation of groundwater in Yuncheng Basin, Northern China, so that reasonable water resource management strategies can be developed. The study reveals that groundwater faces a tremendous risk of quality decrease during the past decade: (1) the hydrochemical facies of groundwater shows that the bicarbonate and chloride type water was replaced with sulfate type water and the occupying area of SO4·Cl-Na, SO4·HCO3-Na type water expanded dramatically in shallow and intermediate-deep aquifers. (2) Major ion chemistry and hydrogen and oxygen isotope compositions indicate that the major hydrogeochemical processes responsible for groundwater quality deterioration include the dissolution of evaporates (i.e., halite, gypsum, and mirabilite), ion exchange, and evaporation process. Additionally, (3) anthropogenic activities (overutilization of fertilizer) have resulted in nitrate contamination, and have thereby led to groundwater quality degradation.