A meta-analysis of time-series studies of ozone and mortality with comparison to the national morbidity, mortality, and air pollution study

School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, United States
Epidemiology (Impact Factor: 6.18). 08/2005; 16(4):436-45. DOI: 10.1097/01.ede.0000165817.40152.85
Source: PubMed

ABSTRACT Although many time-series studies of ozone and mortality have identified positive associations, others have yielded null or inconclusive results, making the results of these studies difficult to interpret.
We performed a meta-analysis of 144 effect estimates from 39 time-series studies, and estimated pooled effects by lags, age groups, cause-specific mortality, and concentration metrics. We compared results with pooled estimates from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS), a time-series study of 95 large U.S. urban centers from 1987 to 2000.
Both meta-analysis and NMMAPS results provided strong evidence of a short-term association between ozone and mortality, with larger effects for cardiovascular and respiratory mortality, the elderly, and current-day ozone exposure. In both analyses, results were insensitive to adjustment for particulate matter and model specifications. In the meta-analysis, a 10-ppb increase in daily ozone at single-day or 2-day average of lags 0, 1, or 2 days was associated with an 0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%), whereas the lag 0 NMMAPS estimate is 0.25% (0.12% to 0.39%). Several findings indicate possible publication bias: meta-analysis results were consistently larger than those from NMMAPS; meta-analysis pooled estimates at lags 0 or 1 were larger when only a single lag was reported than when estimates for multiple lags were reported; and heterogeneity of city-specific estimates in the meta-analysis were larger than with NMMAPS.
This study provides evidence of short-term associations between ozone and mortality as well as evidence of publication bias.

1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A field performance evaluation of Maxxam passive samplers was carried out for ambient concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2) and ground-level ozone (O3). Monthly passive and hourly continuous air monitoring data from four regional air monitoring networks in Alberta, Canada were evaluated over a 5-year period (2006–2010). Monthly concentrations were relatively low, ranging from 0.1 to 3.9 ppb, 0.2 to 18.1 ppb and 10.1 to 56.1 ppb for SO2, NO2 and O3, respectively. From duplicate passive sampling, geometric mean precision values were 17.9%, 14.8% and 4.7% for SO2, NO2 and O3, respectively. Geometric mean of the relative error (as a measure of accuracy) was 30% (median = 33%, interquartile range, IQR 15–63%) for SO2 and 32% (median = 33%, IQR = 25–64%) for NO2. O3 measurements had a better measure of accuracy with a geometic mean relative error of 12% (median = 17%, IQR = 9–30%) and met the acceptable level recommended by United States National Institute of Safety and Health (NIOSH) and the European Union (EU) Directive (±25%). From reduced major axis (RMA) analysis, bias (systematic error) is apparent in the Maxxam passive samplers in the field resulting in overestimation of ambient SO2 and O3 concentrations and underestimation of NO2 concentrations relative to continuous analyzers. Seasonal influences were observed for accuracy of passive SO2 and O3 measurements. A poor association was found between passive versus continuous concentrations for SO2 and O3 during the winter and the summer, respectively.
    Atmospheric Environment 05/2015; 114:39–47. · 3.06 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper evaluates the PM2.5- and ozone-related mortality at present (2000s) and in the future (2050s) over the continental United States by using the Environmental Benefits Mapping and Analysis Program (BenMAP-CE). Atmospheric chemical fields are simulated by WRF/CMAQ (horizontal resolution: 12 × 12km), applying the dynamical downscaling technique from global climate-chemistry model under the Representative Concentration Pathways scenario (RCP 8.5). Future air quality results predict that the annual mean PM2.5 concentration in continental U.S. decreases nationwide, especially in the Eastern U.S. and west coast. However, the ozone concentration is projected to decrease in the Eastern U.S. but increase in the Western U.S. Future mortality is evaluated under two scenarios (1) holding future population and baseline incidence rate at the present level and (2) using the projected baseline incidence rate and population in 2050. For PM2.5, the entire continental U.S. presents a decreasing trend of PM2.5-related mortality by the 2050s in Scenario (1), primarily resulting from the emissions reduction. While in Scenario (2), almost half of the continental states show a rising tendency of PM2.5-related mortality, due to the dominant influence of population growth. In particular, the highest PM2.5-related deaths and the biggest discrepancy between present and future PM2.5-related deaths both occur in California in 2050s. For the ozone-related premature mortality, the simulation shows nation-wide rising tendency in 2050s under both scenarios, mainly due to the increase of ozone concentration and population in the future. Furthermore, the uncertainty analysis shows that the confidence interval of all causes mortality is much larger than that for specific causes, probably due to the accumulated uncertainty of generating datasets and sample size. The confidence interval of ozone-related all cause premature mortality is narrower than the PM2.5-related all cause mortality, due to its smaller standard deviation of the concentration-mortality response factor. The health impact of PM2.5 is more linearly proportional to the emission reductions than ozone. The reduction of anthropogenic PM2.5 precursor emissions is likely to lead to the decrease of PM2.5 concentrations and PM2.5 related mortality. However, the future ozone concentrations could increase due to increase of the greenhouse gas emissions of methane. Thus, to reduce the impact of ozone related mortality, anthropogenic emissions including criteria pollutant and greenhouse gas (i.e. methane) need to be controlled.
    Journal of the Air & Waste Management Association (1995) 02/2015; 65(5):611-623. DOI:10.1080/10962247.2015.1033068 · 1.17 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In this United States-focused analysis we use outputs from two general circulation models (GCMs) driven by different greenhouse gas forcing scenarios as inputs to regional climate and chemical transport models to investigate potential changes in near-term U.S. air quality due to climate change. We conduct multiyear simulations to account for interannual variability and characterize the near-term influence of a changing climate on tropospheric ozone-related health impacts near the year 2030, which is a policy-relevant time frame that is subject to fewer uncertainties than other approaches employed in the literature. We adopt a 2030 emissions inventory that accounts for fully implementing anthropogenic emissions controls required by federal, state, and/or local policies, which is projected to strongly influence future ozone levels. We quantify a comprehensive suite of ozone-related mortality and morbidity impacts including emergency department visits, hospital admissions, acute respiratory symptoms, and lost school days, and estimate the economic value of these impacts. Both GCMs project average daily maximum temperature to increase by 1-4°C and 1-5 ppb increases in daily 8-hr maximum ozone at 2030, though each climate scenario produces ozone levels that vary greatly over space and time. We estimate tens to thousands of additional ozone-related premature deaths and illnesses per year for these two scenarios and calculate an economic burden of these health outcomes of hundreds of millions to tens of billions of U.S. dollars (2010$).
    Journal of the Air & Waste Management Association 12/2014; 65(5). DOI:10.1080/10962247.2014.996270 · 1.67 Impact Factor


Available from