Short-term Effect of Ambient Ozone on Daily Emergency Room Visits in Beijing, China

Abstract

Little is known about the acute effects of ozone on morbidity risk in China. We conducted a time-series study to examine the association between ozone and daily emergency room visits (ERVs) in Beijing, China. We identified 7,088,309 ERVs between January 1, 2014 and December 31, 2015. A generalized additive model with Poisson regression incorporating penalized spline functions was employed to analyze ERVs in association with daily 8-h maximum ozone concentrations. An increase of 10 μg/m3 of same-day ozone concentration was significantly associated with a 0.24% (95% CI, 0.21%–0.26%), 0.31% (95% CI, 0.27%–0.35%), and 0.43% (95% CI, 0.36%–0.50%) increase in daily ERVs for the whole study period, days when the daily 8-h maximum ozone met the Chinese Ambient Air Quality Standards (CAAQS) Grade II standard, and days that met the CAAQS Grade I standard, respectively. These results were robust when considering the potential confounding effects of PM2.5, PM10, NO2, SO2, and CO. In conclusion, our findings suggested significant effects of ozone exposure on daily ERVs in Beijing. Improving air quality with even lower ozone level than the current CAAQS could yield important public health.

Effects of ambient air pollution on emergency room visits of children for acute respiratory symptoms

“…This observation is in line with that reported in western countries (Jaakkola et al, 1991; M. Lin et al, 2003; Segala et al, 1998) in children with pre-existing chronic conditions leading to an increase in respiratory symptoms and deterioration of lung function (Jaakkola et al, 1991; Mansourian et al, 2010; Segala et al, 1998). O 3 showed an independent negative association with acute respiratory ER on the same day as reported in earlier study (Tian et al, 2018). This lower effect of O 3 during higher O 3 levels could be attributed to the scavenging effects of O 3 by the production of nitric oxide by roadside traffic (Bono et al, 2016), thereby leading to the reduced effect of O 3 than that of PM 10 and NO 2 (R. Chen et al, 2017).…”

“…This lower effect of O 3 during higher O 3 levels could be attributed to the scavenging effects of O 3 by the production of nitric oxide by roadside traffic (Bono et al, 2016), thereby leading to the reduced effect of O 3 than that of PM 10 and NO 2 (R. Chen et al, 2017). Alternatively, the individuals predisposed to O 3 might develop respiratory symptoms at lower concentrations and reaches the hospital before O 3 levels reach higher levels leading to the high effect of O 3 at lower concentration (Tian et al, 2018).…”

Short-term effects of ambient fine particulate matter pollution on hospital visits for chronic obstructive pulmonary disease in Beijing, China

“…We further explored potential effect modification of COPD risk by sex, age (18-64 years and ≥65 years), and season (warm: April to September; cool: October to March) using concurrent day PM 2.5 concentration. A penalized spline function of calendar time on warm or cool season was used to accommodate the long-term trend in hospital visits for COPD [30,31]. The statistical significance of subgroup differences were tested using the Z-test [32].…”

Continuous increases of surface ozone and associated premature mortality growth in China during 2015–2019

“…Both long-and short-term O 3 exposure causes adverse human health effects. Most of the studies in China have so far focused on health impacts attributed to long-term exposure, but short-term O 3 exposure at high concentrations in the summer season also significantly impacts on human health, so cannot be overlooked (Bell et al, 2014;Tian et al, 2018;Raza et al, 2018). The short-term premature mortality attributed to high 4DMA8 O 3 is thought to have significantly contributed to the total mortality in China (Liang et al, 2019), as the number of people exposed above the 4DMA8 O 3 threshold was very high (Zhan et al, 2018).…”