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Long-term exposure to ambient ozone and mortality: a quantitative systematic review and meta-analysis of evidence from cohort studies.

Atkinson, RW; Butland, BK; Dimitroulopoulou, C; Heal, MR; Stedman, JR; Carslaw, N; Jarvis, D; Heaviside, C; Vardoulakis, S; Walton, H; et al. Atkinson, RW; Butland, BK; Dimitroulopoulou, C; Heal, MR; Stedman, JR; Carslaw, N; Jarvis, D; Heaviside, C; Vardoulakis, S; Walton, H; Anderson, HR (2016) Long-term exposure to ambient ozone and mortality: a quantitative systematic review and meta-analysis of evidence from cohort studies. BMJ Open, 6 (2). ISSN 2044-6055 https://doi.org/10.1136/bmjopen-2015-009493
SGUL Authors: Anderson, Hugh Ross Atkinson, Richard William Butland, Barbara Karen

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Abstract

OBJECTIVES: While there is good evidence for associations between short-term exposure to ozone and a range of adverse health outcomes, the evidence from narrative reviews for long-term exposure is suggestive of associations with respiratory mortality only. We conducted a systematic, quantitative evaluation of the evidence from cohort studies, reporting associations between long-term exposure to ozone and mortality. METHODS: Cohort studies published in peer-reviewed journals indexed in EMBASE and MEDLINE to September 2015 and PubMed to October 2015 and cited in reviews/key publications were identified via search strings using terms relating to study design, pollutant and health outcome. Study details and estimate information were extracted and used to calculate standardised effect estimates expressed as HRs per 10 ppb increment in long-term ozone concentrations. RESULTS: 14 publications from 8 cohorts presented results for ozone and all-cause and cause-specific mortality. We found no evidence of associations between long-term annual O3 concentrations and the risk of death from all causes, cardiovascular or respiratory diseases, or lung cancer. 4 cohorts assessed ozone concentrations measured during the warm season. Summary HRs for cardiovascular and respiratory causes of death derived from 3 cohorts were 1.01 (95% CI 1.00 to 1.02) and 1.03 (95% CI 1.01 to 1.05) per 10 ppb, respectively. CONCLUSIONS: Our quantitative review revealed a paucity of independent studies regarding the associations between long-term exposure to ozone and mortality. The potential impact of climate change and increasing anthropogenic emissions of ozone precursors on ozone levels worldwide suggests further studies of the long-term effects of exposure to high ozone levels are warranted.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Keywords: Air Pollution, EPIDEMIOLOGY, Mortality, Ozone, PUBLIC HEALTH, Systematic review
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMJ Open
Article Number: e009493
ISSN: 2044-6055
Language: eng
Dates:
DateEvent
23 February 2016Published
10 December 2015Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 26908518
Web of Science ID: WOS:000381514500052
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107623
Publisher's version: https://doi.org/10.1136/bmjopen-2015-009493

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