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The temporal pattern of mortality responses to ambient ozone in the APHEA project


Background: The temporal pattern of effects of summertime ozone (O3) in total, cardiovascular and respiratory mortality were investigated in 21 European cities participating in the APHEA-2 (Air Pollution and Health: a European Approach) project, which is fundamental in determining the importance of the effect in terms of life loss.

Methods: Data from each city were analysed separately using distributed lag models with up to 21 lags. City-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity.

Results: Stronger effects on respiratory mortality that extend to a period of 2 weeks were found. A 10 μg/m3 increase in O3 was associated with a 0.36% (95% CI −0.21% to 0.94%) increase in respiratory deaths for lag 0 and with 3.35% (95% CI 1.90% to 4.83%) for lags 0–20. Significant adverse health effects were found of summer O3 (June–August) on total and cardiovascular mortality that persist up to a week, but are counterbalanced by negative effects thereafter.

Conclusions: The results indicate that studies on acute health effects of O3 using single-day exposures may have overestimated the effects on total and cardiovascular mortality, but underestimated the effects on respiratory mortality.

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