Associations between ozone and daily mortality: analysis and meta-analysis.
BACKGROUND
There is ample evidence that short-term ozone exposure is associated with transient decrements in lung functions and increased respiratory symptoms, but the short-term mortality effect of such exposures has not been established.


METHODS
We conducted a review and meta-analysis of short-term ozone mortality studies, identified unresolved issues, and conducted an additional time-series analysis for 7 U.S. cities (Chicago, Detroit, Houston, Minneapolis-St. Paul, New York City, Philadelphia, and St. Louis).


RESULTS
Our review found a combined estimate of 0.39% (95% confidence interval = 0.26-0.51%) per 10-ppb increase in 1-hour daily maximum ozone for the all-age nonaccidental cause/single pollutant model (43 studies). Adjusting for the funnel plot asymmetry resulted in a slightly reduced estimate (0.35%; 0.23-0.47%). In a subset for which particulate matter (PM) data were available (15 studies), the corresponding estimates were 0.40% (0.27-0.53%) for ozone alone and 0.37% (0.20-0.54%) with PM in model. The estimates for warm seasons were generally larger than those for cold seasons. Our additional time-series analysis found that including PM in the model did not substantially reduce the ozone risk estimates. However, the difference in the weather adjustment model could result in a 2-fold difference in risk estimates (eg, 0.24% to 0.49% in multicity combined estimates across alternative weather models for the ozone-only all-year case).


CONCLUSIONS
Overall, the results suggest short-term associations between ozone and daily mortality in the majority of the cities, although the estimates appear to be heterogeneous across cities.
Ito
Kazuhiko
K
Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo Park, NY, USA. kaz@env.med.nyu.edu
De Leon
Samantha F
SF
Lippmann
Morton
M
D000393:Air Pollutants / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015233:Models, Statistical; D009026:Mortality; D010126:Ozone / Q000633:toxicity*; D010316:Particle Size; D018570:Risk Assessment / Q000379:methods; D012621:Seasons; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
D000393:Air Pollutants; D010126:Ozone