Alternative ozone metrics and daily mortality in Suzhou: the China Air Pollution and Health Effects Study (CAPES)
Abstract
Controversy remains regarding the relationship between various metrics of ozone (O(3)) and mortality. In China, the largest developing country, there have been few studies investigating the acute effect of O(3) on death. We used three exposure metrics of O(3) (1-hour maximum, maximum 8-hour average and 24-hour average) to examine its short-term association with daily mortality in Suzhou, China. We used a Generalized Additive Model (GAM) with penalized splines to analyze the mortality, O(3), and covariate data. We examined the association by season, age group, sex and educational level. We found that the current level of O(3) in Suzhou is associated with death rates from all causes and cardiovascular diseases. Among various metrics of O(3), maximum 8-hour average and 1-hour maximum concentrations seem to be more strongly associated with increased mortality rate compared to 24-hour average concentrations. Using maximum 8-hour average, an inter-quartile range increase of 2-day average O(3) (lag 01) corresponds to 2.15% (95%CI, 0.36 to 3.93), 4.47% (95%CI, 1.43 to 7.51), -1.85% (95%CI, -6.91 to 3.22) increase in all-cause, cardiovascular, and respiratory mortality, respectively. The associations between O(3) and daily mortality appeared to be more evident in the cool season than in the warm season. In conclusion, maximum 8-hour average and 1-hour maximum concentrations of O(3) are associated with daily mortality in Suzhou. Our analyses strengthen the rationale for further limiting levels of O(3) pollution in the city.
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Previous studies also supported the linear association between ozone and mortality in Chinese cities.
“In accordance with our finding, previous studies also supported the linear association between ozone and mortality in Chinese cities (Wong et al., 2008; Yang et al., 2012).”
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 Yang et al., 2012
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- Authors
- Yang, C., Yang, H., Guo, S., Wang, Z., Xu, X., Duan, X., & Kan, H.
- Affiliations
- Fudan University (CN)
- Ministry of Ecology and Environment (CN)
- University of Florida Health (US)
- Chinese Research Academy of Environmental Sciences (CN)
- Corresponding author
- Guo, Shu
- Kan, Haidong
- Venue
- Science of The Total Environment
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 426
- Pages
- 83-89
- ISSN
- 0048-9697 (ISSN-L)
- OpenAlex
- W2037393815
- Cited by
- 161
- References
- 31
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 7 · 2023: 11 · 2022: 28 · 2021: 13 · 2020: 17 · 2019: 9 · 2018: 11 · 2017: 10 · 2016: 7 · 2015: 7 · 2014: 6 · 2013: 14 · 2012: 2
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Science of The Total Environment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Key Research and Development Program of China
- 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, daily mortality, short-term air pollution effects, cardiovascular mortality, respiratory mortality, all-cause mortality, seasonal variation, Suzhou
- MeSH terms
- Adolescent, Adult, Aged, Air Pollutants, Air Pollution, Cardiovascular Diseases, Child, Child, Preschool, China, Environmental Monitoring, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mortality, Ozone, Respiratory Tract Diseases, Young Adult, Epidemiological Monitoring
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