Long-term exposure to ambient ozone and mortality: a quantitative systematic review and meta-analysis of evidence from cohort studies.
Long-term exposure to ambient ozone and mortality: a quantitative systematic review and meta-analysis of evidence from cohort studies.
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DOI：
10.1136/bmjopen-2015-009493
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发表时间：
2016-02-23
期刊：
影响因子：
2.9
通讯作者：
Anderson HR
中科院分区：
文献类型：
--
作者：
Atkinson RW;Butland BK;Dimitroulopoulou C;Heal MR;Stedman JR;Carslaw N;Jarvis D;Heaviside C;Vardoulakis S;Walton H;Anderson HR
虽然有很好的证据表明短期接触臭氧与一系列不良健康结果之间存在关联，但长期接触的叙述性审查证据表明仅与呼吸死亡率相关。我们对来自队列研究的证据进行了系统的定量评估，报告了长期暴露于臭氧和死亡率之间的关联。使用与研究设计、污染物和健康结局相关的术语，通过检索字符串识别在EMBASE和MEDLINE（截至2015年9月）和PubMed（截至2015年10月）中索引的同行评审期刊中发表的队列研究，并在综述/关键出版物中引用。提取了研究细节和估计信息，并用于计算标准化效应估计值，表示为长期臭氧浓度每10 ppb增量的HR。 来自8个群组的14份出版物介绍了臭氧与全因和特定原因死亡率的结果。我们没有发现长期的年度O3浓度与所有原因，心血管或呼吸系统疾病或肺癌死亡风险之间存在关联的证据。4个队列评估了暖季期间测量的臭氧浓度。来自3个队列的心血管和呼吸系统死亡原因的总结HR分别为1.01（95% CI 1.00 - 1.02）和1.03（95% CI 1.01 - 1.05）/10 ppb。 我们的定量审查显示，缺乏关于长期暴露于臭氧和死亡率之间的关联的独立研究。气候变化和臭氧前体人为排放量的增加对全世界臭氧水平的潜在影响表明，有必要进一步研究接触高臭氧水平的长期影响。
While there is good evidence for associations between short-term exposure to ozone and a range of adverse health outcomes, the evidence from narrative reviews for long-term exposure is suggestive of associations with respiratory mortality only. We conducted a systematic, quantitative evaluation of the evidence from cohort studies, reporting associations between long-term exposure to ozone and mortality. Cohort studies published in peer-reviewed journals indexed in EMBASE and MEDLINE to September 2015 and PubMed to October 2015 and cited in reviews/key publications were identified via search strings using terms relating to study design, pollutant and health outcome. Study details and estimate information were extracted and used to calculate standardised effect estimates expressed as HRs per 10 ppb increment in long-term ozone concentrations. 14 publications from 8 cohorts presented results for ozone and all-cause and cause-specific mortality. We found no evidence of associations between long-term annual O3 concentrations and the risk of death from all causes, cardiovascular or respiratory diseases, or lung cancer. 4 cohorts assessed ozone concentrations measured during the warm season. Summary HRs for cardiovascular and respiratory causes of death derived from 3 cohorts were 1.01 (95% CI 1.00 to 1.02) and 1.03 (95% CI 1.01 to 1.05) per 10 ppb, respectively. Our quantitative review revealed a paucity of independent studies regarding the associations between long-term exposure to ozone and mortality. The potential impact of climate change and increasing anthropogenic emissions of ozone precursors on ozone levels worldwide suggests further studies of the long-term effects of exposure to high ozone levels are warranted.