Long-term exposure to ozone and cardiovascular mortality in a large Chinese cohort

Liu, Shudan; Zhang, Yi; Ma, Runmei; Liu, Xiaofei; Liang, Jingyuan; Lin, Hongbo; Shen, Peng; Zhang, Jingyi; Lü, Ping; Tang, Xun; Li, Tiantian; Gao, Pei

doi:10.1016/j.envint.2022.107280

Cited by 38 publications

(36 citation statements)

References 33 publications

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“…First, our findings provide a national epidemiologic evidence for the association between long-term O 3 exposure and all-cause mortality among middle-aged and older adults in Chinese Mainland. Cohort studies exploring the long-term effects of air pollution exposure on the Chinese population remain rare [ 33 , 36 ]; therefore, our findings appropriately fill the literature gap. Second, our analyses included extensive confounders, including individual lifestyles, and evaluated the C–R relationship in a wide range (60.7–142.4 μg m −3 ) of O 3 exposure.…”

Section: Discussionmentioning

confidence: 52%

“…Consistent with findings from prior publications [ 11 , 12 ], we observed a positive association between long-term O 3 exposure and mortality risk, with an HR of 1.197 (95% CI: 1.171–1.223) for every 10-μg m −3 increase in annual warm-season O 3 at a wide exposure range of 60.7–142.4 μg m −3 . The magnitude of the effect size in this study was between the estimated risk for cardiovascular disease mortality (HR = 1.09, 95% CI: 1.05–1.14) from a national cohort study [ 36 ] and that (HR = 1.22, 95% CI: 1.13–1.33) from a regional longitudinal study in China [ 33 ], although the magnitude we observed was considerably higher than estimates (HRs range:1.01–1.05) from recent cohort studies in Europe [ 37 ] and North America [ 12 , 38 ]. Such regional heterogeneity could be partly attributed to the use of differing O 3 exposure metrics (e.g., 6mDMA8, 6mDA24, and ADMA8) and differential population susceptibility [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…To be specific, (1) the 6-month warm-season mean of 24-h daily average (6mDA24), (2) the annual mean of daily maximum 8-h average (ADMA8), (3) the annual mean of 24-h daily average (ADA24), (4) the annual mean of daily maximum 1-h average (ADMA1), and (5) the 6-month warm-season mean of daily maximum 1-h average (6mDMA1)—according to cross-metric conversion coefficients [ 10 ] and re-estimated the association between O 3 exposure and mortality ( Table S1 ). To investigate the C–R relationship between O 3 and all-cause mortality, O 3 exposure was fitted as a smoothing term using a natural cubic spline function [ 16 , 33 ] with three knots, following the Akaike Information Guidelines in the fully adjusted model. Participants were categorized by O 3 concentration quartiles: quartile 1, ≤89.7 μg m −3 ; quartile 2, >89.7 and ≤ 100.5 μg m −3 ; quartile 3, >100.5 and ≤ 110.5 μg m −3 ; and quartile 4, >110.5 μg m −3 .…”

Section: Methodsmentioning

confidence: 99%

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Excess mortality associated with high ozone exposure: A national cohort study in China

Yang

Wang

Sun

et al. 2023

Environmental Science and Ecotechnology

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Excess mortality associated with high ozone exposure: A national cohort study in China

Yang

Wang

Sun

et al. 2023

Environmental Science and Ecotechnology

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“…Most of the prior studies are in line with our assessment. Liu et al, in a time-series analysis in 272 cities in China, found significant associations between short-term exposure to ambient carbon monoxide and cardiovascular disease mortality in China [ 36 ]. An increase in percentage mortality due to CVD was also assessed in another time-series study in China [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Low-Level Air Pollution and Cardiovascular Incidence in Gdansk, Poland: Time-Series Cross-Sectional Analysis

Czernych

Badyda

Kozera

et al. 2023

JCM

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(1) Background: More than 1.8 million people in the European Union die every year as a result of CVD, accounting for 36% of all deaths with a large proportion being premature (before the age of 65). There are more than 300 different risk factors of CVD, known and air pollution is one of them. The aim of this study was to investigate whether daily cardiovascular mortality was associated with air pollutants and meteorological conditions in an urban environment with a low level of air pollution. (2) Methods: Data on daily incidence of strokes and myocardial infarctions in the city of Gdansk were obtained from the National Health Fund (NHF) and covered the period from 1 January 2014 to 31 December 2018. Data on the level of pollution, i.e., SO2, NO, NO2, NOx, CO, PM10, PM2.5, CO2, O3 and meteorological conditions came from the foundation: Agency of Regional Air Quality Monitoring in the Gdańsk metropolitan area (ARMAG). Using these data, we calculated mean values with standard deviation (SD) and derived the minimum and maximum values and interquartile range (IQR). Time series regression with Poisson distribution was used in statistical analysis. (4) Results: Stroke incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.019 (95%CI: 1.001–1.036), 1.036 (95%CI: 1.008–1.064) and 1.017 (95%CI: 1.000–1.034) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Similarly, myocardial infarction incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.030 (95%CI: 1.011–1.048), 1.053 (95%CI: 1.024–1.082) and 1.027 (95%CI: 1.010–1.045) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Both PM10 and PM2.5 were positively associated with myocardial infarction incidence. (5) Conclusions: In this time-series cross-sectional study, we found strong evidence that support the hypothesis that transient elevations in ambient PM2.5, PM10, NO2, SO2 and CO are associated with higher relative risk of ischemic stroke and myocardial infarction incidents.

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“…Atmospheric ozone pollution is due to anthropogenic emissions of pollutants of many precursors including VOCs and NO x through photochemical reactions [ 9 ]. There is a positive and independent association between long-term O 3 exposure and cause-specific cardiovascular mortality [ 10 ]. Nearly 18% of respiratory mortality in Shanghai from 2013 to 2019 was attributed to O 3 exposure [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Air Pollutants Emission and Its Impacts on Public Health of Chengdu, Western China

Wang

et al. 2022

IJERPH

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Pollution caused by PM2.5 and O3 are common environmental problems which can easily affect human health. Chengdu is a major central city in Western China, and there is little research on the regional emissions and health effects of air pollution in Chengdu. According to the Multi-resolution Emissions Inventory of the Chinese Model, 2017 (MEIC v1.3), this study compiled the air pollutant emission inventory of Chengdu. The results show that the pollutant emission of Chengdu is generally higher in winter than in summer. The southeast area of Chengdu is the key area where emissions of residential and industrial sectors are dominant. Through air quality simulation with a Weather Research and Forecasting model, coupled with the Community Multiscale Air Quality (WRF-CMAQ), the health effects of PM2.5 and O3 in winter and summer in Chengdu of 2017 were investigated. The primary pollutant in winter is PM2.5 and O3 in summer. PM2.5 pollution accounted for 351 deaths in January and July 2017, and O3 pollution accounted for 328 deaths in the same period. There were 276 deaths in rural areas and 413 in urban areas. In January and July 2017, the health economic loss caused by PM2.5 accounted for 0.0974% of the gross regional product (GDP) of Chengdu in 2017, and the health economic loss caused by O3 accounted for 0.0910%.

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Long-term exposure to ozone and cardiovascular mortality in a large Chinese cohort

Cited by 38 publications

References 33 publications

Excess mortality associated with high ozone exposure: A national cohort study in China

Excess mortality associated with high ozone exposure: A national cohort study in China

Assessment of Low-Level Air Pollution and Cardiovascular Incidence in Gdansk, Poland: Time-Series Cross-Sectional Analysis

Characteristics of Air Pollutants Emission and Its Impacts on Public Health of Chengdu, Western China

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