Determining the threshold effect of ozone on daily mortality: an analysis of ozone and mortality in Seoul, Korea, 1995–1999
Abstract
Many studies have shown a positive association between ambient ozone levels and mortality. Typically, these findings are based on models that assume a linear relationship between log mortality and ozone level. In this study, we adapted generalized additive models in which ozone effects are presumed to occur in three different ways: as a simple linear term, as a cubic natural spline term, and as a combination of two linear terms (a threshold model). We applied these models to daily time-series data for Seoul, Korea for the years 1995-1999 and found that the threshold model always fits best among the three. A 2.6% (95% CI: 1.7-3.5) increase of estimated relative risk (RR) in the total mortality associated with a 21.5 ppb increase of daily 1-h maximum ozone lagged by 1 day was observed by linear Poisson's regression. However, a 3.4% (95% CI: 2.3-4.4) increase in the estimated RR was observed using the threshold model. Adjustments for other ambient pollutants caused little changes to these results; 2.4-2.5% in the linear models and 3.2-3.4% in the threshold models. In addition, the largest difference in the estimated RRs of the linear and threshold models was observed in the summer: 1.9% (95% CI: 0.5-3.3) by the linear model and 3.8% (95% CI: 2.0-5.7) by the threshold model. These findings indicate that the conventional time-series Poisson regression model, which dose not take threshold into consideration, could underestimate the true risk of the ozone effect on daily mortality.
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Kim et al. (2004) found that a spline model indicated a threshold around 20-30 ppb for the daily 1-hr maximum, approximately equal to 8-12 ppb for the 24-hr average, using 5 years of data for Seoul, Korea.
“Consistent with the results obtained under our spline approach, Kim et al. (2004) found that a spline model indicated a threshold around 20–30 ppb for the daily 1-hr maximum, which is approximately equal to 8–12 ppb for the 24-hr average, using 5 years of data for Seoul, Korea.”
From The Exposure–Response Curve for Ozone and Risk of Mortality and the Adequacy of Current Ozone Regulations (2006) · cites this paper as Kim et al. (2004)
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Self-citation
- Authors
- Kim, S.-Y., Lee, J.-T., Hong, Y.-C., Ahn, K.-J., & Kim, H.
- Affiliations
- Seoul National University (KR)
- Ewha Womans University (KR)
- Inha University (KR)
- Korea Institute of Science and Technology (KR)
- Corresponding author
- Kim, Ho
- Venue
- Environmental Research
- Publisher
- Elsevier BV
- Published
- 2004-02
- Volume
- 94
- Issue
- 2
- Pages
- 113-119
- ISSN
- 0013-9351 (ISSN-L)
- OpenAlex
- W2061995361
- Cited by
- 79
- References
- 23
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Environmental Research (publishedVersion)
- PubMed (publishedVersion)
- 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, air pollution, daily mortality, threshold effects, relative risk, summer mortality, Poisson regression, generalized additive models, Seoul
- MeSH terms
- Adolescent, Adult, Aged, Air Pollutants, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Korea, Male, Middle Aged, Models, Theoretical, Mortality, Oxidants, Photochemical, Ozone
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