Cohort-based long-term ozone exposure-associated mortality risks with adjusted metrics: A systematic review and meta-analysis.

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cam.issuedOnline2022-04-20
dc.contributor.authorSun, Haitong Zhe
dc.contributor.authorYu, Pei
dc.contributor.authorLan, Changxin
dc.contributor.authorWan, Michelle WL
dc.contributor.authorHickman, Sebastian
dc.contributor.authorMurulitharan, Jayaprakash
dc.contributor.authorShen, Huizhong
dc.contributor.authorYuan, Le
dc.contributor.authorGuo, Yuming
dc.contributor.authorArchibald, Alexander T
dc.contributor.orcidYuan, Le [0000-0002-4282-0459]
dc.date.accessioned2022-06-07T08:16:57Z
dc.date.available2022-06-07T08:16:57Z
dc.date.issued2022-05-10
dc.date.updated2022-06-07T08:16:56Z
dc.descriptionFunder: Natural Environment Research Council
dc.description.abstractLong-term ozone (O3) exposure may lead to non-communicable diseases and increase mortality risk. However, cohort-based studies are relatively rare, and inconsistent exposure metrics impair the credibility of epidemiological evidence synthetization. To provide more accurate meta-estimations, this study updates existing systematic reviews by including recent studies and summarizing the quantitative associations between O3 exposure and cause-specific mortality risks, based on unified exposure metrics. Cross-metric conversion factors were estimated linearly by decadal observations during 1990-2019. The Hunter-Schmidt random-effects estimator was applied to pool the relative risks. A total of 25 studies involving 226,453,067 participants (14 unique cohorts covering 99,855,611 participants) were included in the systematic review. After linearly unifying the inconsistent O3 exposure metrics , the pooled relative risks associated with every 10 nmol mol-1 (ppbV) incremental O3 exposure, by mean of the warm-season daily maximum 8-h average metric, were as follows: 1.014 with 95% confidence interval (CI) ranging 1.009-1.019 for all-cause mortality; 1.025 (95% CI: 1.010-1.040) for respiratory mortality; 1.056 (95% CI: 1.029-1.084) for COPD mortality; 1.019 (95% CI: 1.004-1.035) for cardiovascular mortality; and 1.074 (95% CI: 1.054-1.093) for congestive heart failure mortality. Insignificant mortality risk associations were found for ischemic heart disease, cerebrovascular diseases, and lung cancer. Adjustment for exposure metrics laid a solid foundation for multi-study meta-analysis, and widening coverage of surface O3 observations is expected to strengthen the cross-metric conversion in the future. Ever-growing numbers of epidemiological studies supported the evidence for considerable cardiopulmonary hazards and all-cause mortality risks from long-term O3 exposure. However, evidence of long-term O3 exposure-associated health effects was still scarce, so more relevant studies are needed to cover more populations with regional diversity.
dc.identifier.doi10.17863/CAM.85251
dc.identifier.eissn2666-6758
dc.identifier.issn2666-6758
dc.identifier.other35519514
dc.identifier.otherPMC9065904
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337842
dc.languageeng
dc.publisherElsevier BV
dc.publisher.urlhttp://dx.doi.org/10.1016/j.xinn.2022.100246
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourcenlmid: 101771342
dc.sourceessn: 2666-6758
dc.subject4202 Epidemiology
dc.subject4206 Public Health
dc.subject42 Health Sciences
dc.subjectLung
dc.subjectRespiratory
dc.subjectCardiovascular
dc.subject3 Good Health and Well Being
dc.titleCohort-based long-term ozone exposure-associated mortality risks with adjusted metrics: A systematic review and meta-analysis.
dc.typeArticle
dcterms.dateAccepted2022-04-16
prism.issueIdentifier3
prism.publicationNameInnovation (Camb)
prism.volume3
pubs.funder-project-idNatural Environment Research Council (NE/P016383/1)
pubs.funder-project-idEngineering and Physical Sciences Research Council (EP/S022961/1)
pubs.funder-project-idEPSRC (2413435)
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1016/j.xinn.2022.100246
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