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Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study
Open accessAbstract
The "Air Pollution and Health: A Combined European and North American Approach" (APHENA) project is a collaborative analysis of multi-city time-series data on the association between air pollution and adverse health outcomes. The main objective of APHENA was to examine the coherence of findings of time-series studies relating short-term fluctuations in air pollution levels to mortality and morbidity in 125 cities in Europe, the US, and Canada. Multi-city time-series analysis was conducted using a two-stage approach. We used Poisson regression models controlling for overdispersion with either penalized or natural splines to adjust for seasonality. Hierarchical models were used to obtain an overall estimate of excess mortality associated with ozone and to assess potential effect modification. Potential effect modifiers were city-level characteristics related to exposure to other ambient air pollutants, weather, socioeconomic status, and the vulnerability of the population. Regionally pooled risk estimates from Europe and the US were similar; those from Canada were substantially higher. The pooled estimated excess relative risk associated with a 10 µg/m 3 increase in 1 h daily maximum O 3 was 0.26 % (95 % CI, 0.15 %, 0.37 %). Across regions, there was little consistent indication of effect modification by age or other effect modifiers considered in the analysis. The findings from APHENA on the effects of O 3 on mortality in the general population were comparable with previously reported results and relatively robust to the method of data analysis. Overall, there was no indication of strong effect modification by age or ecologic variables considered in the analysis.
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TL;DR
The APHENA study pooled multi-city time-series data from Europe, the US, and Canada and found that short-term ambient ozone exposure was associated with increased all-cause mortality. Pooled risk estimates were similar for Europe and the US but substantially higher for Canada, with little consistent evidence of effect modification by age or other city-level factors.
Key findings
- The pooled estimated excess relative risk associated with a 10 µg/m³ increase in 1 h daily maximum O₃ was 0.26% (95% CI, 0.15%, 0.37%) using natural splines with 8 df per year.
- Warm-season effects were higher than annual effects: for all-cause non-accidental mortality, all ages, per 10 µg/m³ increase in average lags 0–1 O₃, excess risks were 0.25% (95% CI, 0.10%, 0.40%) in Europe, 0.95% (95% CI, 0.65%, 1.2%) in Canada, and 0.57% (95% CI, 0.35%, 0.79%) in the US.
- There was little consistent effect modification by age or other modifiers. In the US, temperature had a strong negative modifying effect, with the percent increase in mortality per 10 µg/m³ O₃ ranging from 0.27% to 0.00% between the 25th and 75th percentiles of temperature.
- The exposure–response analysis did not support a threshold for O₃ and total mortality in any of the three centers.
Methods
- Two-stage multi-city time-series analysis: first-stage city-specific log-linear Poisson regression models with overdispersion, controlling for seasonality using natural splines or penalized splines with 3, 8, or 12 df per year, temperature smooths, day-of-week, and holiday effects.
- Main year-round O₃ analysis included 23 European cities, 50 US cities, and 12 Canadian cities; warm-season analysis used all 86 US cities. Exposure was daily 1 h maximum O₃; outcomes included all-cause mortality excluding external causes, overall and by age (<75 and ≥75 years).
- Second-stage Bayesian hierarchical models pooled city-specific effects and assessed effect modification by city-level variables; threshold analyses used a grid from 0 to 75 µg/m³ in 5 µg/m³ increments and compared AIC values.
Limitations
- Stated: data came from multiple countries and had not been collected under a uniform protocol across Europe and North America; European data came from 24 countries with varying collection methods, and a fully harmonized database was not possible, leaving differing measurement error structures as potential contributors to heterogeneity.
- Stated: effect-modification analyses were limited by the restricted number of variables measured with sufficient commonality; the only socioeconomic indicator available across the full dataset was unemployment rate, and data were unavailable on health status, diabetes, housing characteristics, or air pollution source mix.
- Stated: identifying a threshold is exceedingly difficult because the O₃–mortality association is inherently small and would likely require far more data than APHENA could assemble. Evident from the text: Canadian estimates were based on smaller cities with wider confidence intervals, Canadian O₃ concentrations were lowest and covered the narrowest range, and Canadian PM₁₀ was measured only every sixth day, making two-pollutant estimates not directly comparable.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The annual estimated effects of O3 on cardiovascular mortality for those above or below 75 years of age (data not shown) were generally slightly higher than those for total mortality.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the US, temperature had a strong negative modifying effect, with the percent increase in mortality for a 10 µg/m3 increase in O3 estimated to range from 0.27 % to 0.00 % between the 25th and 75th percentiles of temperature.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was a statistically significant effect of O3 on total mortality for all ages in all three centers.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The highest effect of O3 in Europe was observed on cardiovascular mortality among those <75 years using the average of 2 days exposure (0.35 %, 95 % CI, 0.12 %, 0.58 %).”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Across regions, there was little consistent indication of effect modification by age or other effect modifiers considered in the analysis.”
- Also stated in: § Discussion · plain
“There was no consistent pattern of effect modification for the association between O3 and mortality.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The US effect estimates were not statistically significant.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The highest effects on cardiovascular mortality in Canada were seen among the elderly using DL models (1.20 %, 95% CI, 0.18%, 2.30%).”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled estimated excess relative risk associated with a 10 µg/m3 increase in 1 h daily maximum O3 was 0.26 % (95 % CI, 0.15 %, 0.37 %).”
- Also stated in: § Results · plain
“Across all three regions, the pooled estimated excess relative risk associated with a 10 µg/m3 increase in 1 h daily maximum O3 was 0.26 % (95 % CI, 0.15 %, 0.37 %) for the model using natural splines and 8 df per year.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Correlations between PM10 and O3 were generally modest ranging from −0.40 to 0.55 across all three regions.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In general, there were no strong patterns of effect modification by these characteristics either within or across regions.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
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- It may state two separate claims as one. 24
- Probably not a substantial claim. 4
- The quote only partly states this claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Regionally pooled risk estimates from Europe and the US were similar; those from Canada were substantially higher.”
- Also stated in: § Results · plain
“The effects for Canada are generally larger but with wider confidence intervals due to the smaller sizes of the Canadian cities. With the exception of estimates based on 3 df per year, the estimates for Europe and the US are comparable.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In Canada and the US, the largest effect of annual O3 was observed in the older age group; in Europe, the largest effect was seen among those <75 years of age.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All O3 effects were statistically significant during the warm period and higher than the annual effects.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Using these warm months only, the percent increase in all-cause non-accidental mortality for all ages associated with at 10 µg/m3 increase in the average of lags 0–1 O3 was 0.25 % (95 % CI, 0.10 %, 0.40 %) for Europe, 0.95 % (95 % CI, 0.65 %, 1.2 %) for Canada, and 0.57 % (95 % CI, 0.35 %, 0.79 %) for the US.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In Europe and the US, the largest effects were observed when we took into account the exposure over 3 days for all the health outcomes analyzed, whereas the highest effects in Canada were observed when we took into account the average of lags 0–1.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The summer-only O3 effect estimates for cause-specific mortality were positive (except for cardiovascular mortality among those <75 years of age in Canada) and in most cases statistically significant.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In Canada, the highest effects of summertime O3 were observed for respiratory mortality for all ages under all lag structures considered while, in Europe and the US, the same was true only using lag 1 O3 exposure.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The results for respiratory mortality were less consistent and not statistically significant in any case.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
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In the paper
“There was some indication of confounding by PM10 in the Canadian results, but the estimates with and without PM10 in the models are not directly comparable for Canada, since PM10 measurements were only measured every sixth day.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Mortality risk estimates for O3 tended to decrease with increasing df in the smooth function of time and were generally higher for the average of lags 0 and 1 compared with lag 1 O3 concentration alone.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For O3 and mortality, there was some variation in findings by whether results were considered for the full year or only for the summer months, pointing to higher effects when only the warm period was considered.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The coefficient of variation for O3 was associated with mortality in both the US and Europe, but not in Canada.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We note that O3 concentrations were lowest in the Canadian data and also covered the narrowest range.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
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In the paper
“Although there was some evidence that the mean SO2 level and the percent of the population over age 75 years modified the O3 effect, the evidence was not consistent across the US, Canada, and Europe.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Results
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings from APHENA on the effects of O3 on mortality in the general population were comparable with previously reported results and relatively robust to the method of data analysis.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Abstract
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In the paper
“These functions remove long-term trends and seasonal patterns from the data to guard against confounding by smoothly varying unmeasured temporal confounders.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Materials and methods > Methods
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- The authors state this as an assumption: The smooth function of time serves as a proxy for any time-dependent outcome predictors or confounders with long-term trends and seasonal patterns not explicitly included in the model.
In the paper
“However, identifying a threshold in time-series models is exceedingly difficult, and numerous simulation studies bear this out (Katsouyanni et al. 2009).”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
What the sources say
- Not checked yetcites Katsouyanni et al. 2009
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In the paper
“In previously reported analyses, the European and North American risk estimates were quite similar, whereas the estimates based on the Canadian data were somewhat higher (Health Effects Institute 2003).”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
What the sources say
- Not checked yetcites Health Effects Institute 2003
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Canadian, APHEA, and NMMAPS data sets have now been extensively analyzed, and, while the quantitative risk estimates have varied across the three data sets, these data sets consistently demonstrate an acute effect of O3 on mortality.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
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In the paper
“In the United States and Canada, nationwide reference methods for air pollution data collection are in place, and deaths are captured and coded uniformly.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Consequently, differences in the time-series data, as well as the possibility of differing measurement error structures across the three sets of data, remain as potential contributors to heterogeneity.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one. The quote only partly states this claim.
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In the paper
“The data came from multiple countries and had not been collected according to a uniform protocol across Europe and North America; however, all data had been edited and had undergone a quality assessment audit as part of the APHENA project.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The data can be analyzed with multiple models, so as to assess sensitivity of findings to model specification, and effect modification can be assessed using risk estimates coming from a common analytic approach.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Well-documented approaches were used to develop air pollution concentration values that would be as complete and uniform as possible.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
Strength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Coordinated multi-city studies in four major Asian cities and 14 UK conurbations reported 0.38 % and 0.30 % increases in all-natural cause mortality, respectively, associated with a 10 µg/m3 increase in an 8-h average ozone (Health Effects Institute 2010; Pattenden et al. 2010).”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
What the sources say
- Not checked yetcites Health Effects Institute 2010
- Not checked yetcites Pattenden et al. 2010 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The European data came from 24 countries and methods for their collection varied among the countries, although they were assembled and edited with a common protocol.”
§ Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The authors state this as an assumption.
In the second-stage model, city-specific effects βc are normally distributed around an overall effect and are independent observations with variances equal to the between-cities variance and the squared standard error of βc.
“For the second stage of the analysis, we assumed the city-specific effects βc to be normally distributed around an overall effect.”
“These models assumed that city-specific effects βc were a sample of independent observations from a normal distribution with the same mean and with variances equal to the between-cities variance and the squared standard error of βc.”
The authors state this as an assumption.
The smooth function of time serves as a proxy for any time-dependent outcome predictors or confounders with long-term trends and seasonal patterns not explicitly included in the model.
“The smooth function of time serves as a proxy for any time-dependent outcome predictors or confounders with long-term trends and seasonal patterns not explicitly included in the model.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“This indicates lack of support for the presence of a threshold (Peng et al., 2013).”
From Acute effect of ozone exposure on daily mortality in seven cities of Jiangsu Province, China: no clear evidence for threshold (2017) · cites this paper as Peng et al., 2013
In the citing paper
“Our estimate was slightly higher than results from studies in the U.S. and Europe (Bell et al., 2004; Pascal et al., 2012; Peng et al., 2013), where the mean estimates ranges from 0.18% to 0.39% increase of total mortality per 10 μg/m3 increase in MDA8 ozone concentrations.”
From Acute effect of ozone exposure on daily mortality in seven cities of Jiangsu Province, China: no clear evidence for threshold (2017) · cites this paper as Peng et al., 2013
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
European city count is smaller than the reported country count
MinorThe paper says the European data came from 24 countries, but it reports only 23 European cities in the analysis. Twenty-three cities cannot represent 24 countries.
“The European data came from 24 countries and methods for their collection varied among the countries”
“23 European cities in the APHEA project (that provided full time-series data)”
UK conurbation count differs from the cited study title
MinorThe discussion attributes a result to a study of 14 UK conurbations, but the cited Pattenden et al. reference identifies its study as covering 15 British conurbations.
“Coordinated multi-city studies in four major Asian cities and 14 UK conurbations reported 0.38 % and 0.30 % increases in all-natural cause mortality, respectively”
“Pattenden S Armstrong B Milojevic A Heal MR Chalabi Z Doherty R Barratt B Kovats RS Wilkinson P Ozone, heat and mortality: acute effects in 15 British conurbations”
Citations
Cites
Stable and Efficient Multiple Smoothing Parameter Estimation for Generalized Additive Models
Wood, S. (2004) · Journal of the American Statistical Association · doi:10.1198/016214504000000980 · Cited by 2,046
Ozone and short-term mortality in 95 US urban communities, 1987–2000
Bell, M. L. (2004) · JAMA · doi:10.1001/jama.292.19.2372 · Cited by 1,202
Kernel Smoothing in Partial Linear Models
Speckman, P. (1988) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1988.tb01738.x · Cited by 986
Model Choice in Time Series Studies of Air Pollution and Mortality
Peng, R. D., Dominici, F., & Louis, T. A. (2006) · Journal of the Royal Statistical Society Series A: Statistics in Society · doi:10.1111/j.1467-985x.2006.00410.x · Cited by 583
Self-citationBell, M. L., Peng, R. D., & Dominici, F. (2006) · Environmental Health Perspectives · doi:10.1289/ehp.8816 · Cited by 481 · cited 1×
“The results presented here are consistent with previous findings in the US (Bell et al. 2006).”
Self-citationAcute Effects of Ozone on Mortality from the “Air Pollution and Health
Gryparis, A., Forsberg, B., Katsouyanni, K., Analitis, A., Touloumi, G., Schwartz, J., Samoli, E., Medina, S., Anderson, H. R., Niciu, E. M., et al. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200403-333oc · Cited by 449
Self-citationSamoli, E., Peng, R. D., Ramsay, T., Pipikou, M., Touloumi, G., Dominici, F., Burnett, R. T., Cohen, A., Krewski, D. R., Samet, J. M., et al. (2008) · Environmental Health Perspectives · doi:10.1289/ehp.11345 · Cited by 440
Self-citationAssociations between Short-Term Changes in Nitrogen Dioxide and Mortality in Canadian Cities
Burnett, R. T., Stieb, D. M., Brook, J. R., Cakmak, S., Dales, R., Raizenne, M. E., Vincent, R., & Dann, T. F. (2004) · Archives of Environmental Health An International Journal · doi:10.3200/aeoh.59.5.228-236 · Cited by 202
Self-citationAir pollution and health: a European and North American approach (APHENA).
Katsouyanni, K., Samet, J. M., Anderson, H. R., Atkinson, R. W., Tertre, A. L., Médina, S., Samoli, E., Touloumi, G., Rt, B., Krewski, D. R., et al. (2009) · PubMed · Cited by 169
Self-citationThe Effect of the Urban Ambient Air Pollution Mix on Daily Mortality Rates in 11 Canadian Cities
Burnett, R. T., Cakmak, S., & Brook, J. R. (1998) · Canadian Journal of Public Health · doi:10.1007/bf03404464 · Cited by 163
Self-citation
Flagged first, then by citations
Research works printed but not linked: 3
- Health Effects Institute (2003) Revised analyses of time-series studies of air pollution and health. Health Effects Institute, Cambridge
- Health Effects Institute (2010) Public Health and Air Pollution in Asia (PAPA): coordinated studies of short-term exposure to air pollution and daily mortality in four cities. HEI research report 154. Health Effects Institute, Boston
- World Health Organization (2006) Air quality guidelines: global ppdate 2005—particulate matter, ozone, nitrogen dioxide and sulfur dioxide. World Health Organization, Copenhagen
Cited by
Sorted by citations
Items 101–110 of 110
Evaluating the effects of atmospheric environment on children’s health in Hanoi, Vietnam
Luong, L. M. T. (2019) · The University of Queensland · doi:10.14264/uql.2019.823
P, V. K. S., Roshan Kumar., M., & Kumar, V. (2021) · GLOBAL JOURNAL FOR RESEARCH ANALYSIS · doi:10.36106/gjra/9209247
Zhang, Z., Yao, M., Wu, W., Zhao, X., & Zhang, J. (2020) · doi:10.21203/rs.3.rs-32364/v2
Zafeiratou, S., Samoli, E., Analitis, A., Dimakopoulou, K., Giannakopoulos, C., Varotsos, K. V., Schneider, A., Stafoggia, M., Aunan, K., & Katsouyanni, K. (2024) · Figshare · doi:10.6084/m9.figshare.26672322
Self-citationAnenberg, S. C., Haines, S., Wang, E., Nassikas, N., & Kinney, P. L. (2020) · Figshare · doi:10.6084/m9.figshare.13346431
Hess, J. W., & Chan, W. (2026) · International Journal of Environmental Health Research · doi:10.1080/09603123.2025.2612008
Tropospheric Ozone Assessment Report II: Changing health impacts of global ozone exposure
Kerr, G. H., Amegah, A. K., Chen, L., Crooks, J., Shindell, D. T., Akritidis, D., Vohra, K. G., Anenberg, S. C., Carlsten, C., Lacey, F. G., et al. (2026) · Philosophical Transactions of the Royal Society A Mathematical Physical and Engineering Sciences · doi:10.1098/rsta.2025.0268
Metadata
- Authors
- Peng, R. D., Samoli, E., Pham, L., Dominici, F., Touloumi, G., Ramsay, T., Burnett, R. T., Krewski, D., Le Tertre, A., Cohen, A., Atkinson, R. W., Anderson, H. R., Katsouyanni, K., & Samet, J. M.
- Affiliations
- Johns Hopkins University (US)
- National and Kapodistrian University of Athens (GR)
- Harvard University (US)
- University of Ottawa (CA)
- Health Canada (CA)
- Health Effects Institute (US)
- St George's, University of London (GB)
- University of Southern California (US)
- Corresponding author
- Peng, Roger D.
- ORCID
- Venue
- Air Quality, Atmosphere & Health
- Published
- 2012-08-15
- Volume
- 6
- Issue
- 2
- Pages
- 445-453
- ISSN
- 1873-9318 (ISSN-L)
- 1873-9326
- PMC
- PMC3668792
- OpenAlex
- W2002527279
- Cited by
- 110
- References
- 16
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 8 · 2021: 10 · 2020: 16 · 2019: 9 · 2018: 10 · 2017: 15 · 2016: 8 · 2015: 8 · 2014: 6 · 2013: 3
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Air Quality Atmosphere & Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute of Environmental Health Sciences (R21ES022585, R01ES019560)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- ozone, ambient air pollution, mortality, excess relative risk, effect modification, air pollution and health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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