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Ozone and cause-specific cardiorespiratory morbidity and mortality
  1. Jaana I Halonen1,
  2. Timo Lanki1,
  3. Pekka Tiittanen1,
  4. Jarkko V Niemi2,
  5. Miranda Loh1,
  6. Juha Pekkanen1,3
  1. 1Environmental Epidemiology Unit, National Institute for Health and Welfare (former National Public Health Institute), Kuopio, Finland
  2. 2Helsinki Metropolitan Area Council (YTV), Helsinki, Finland
  3. 3School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland
  1. Correspondence to Timo Lanki, National Institute for Health and Welfare, Environmental Epidemiology Unit, P O Box 95, FI-70701 Kuopio, Finland; timo.lanki{at}


Background Health effects of ozone have been observed in numerous studies. However, analyses of more cause-specific morbidity or mortality outcomes have rarely been performed. A study was undertaken to determine the short-term associations of ozone with cause-specific cardiorespiratory mortality and morbidity by age groups.

Methods Daily levels of ozone were measured at a background measurement station in 1998–2004 in Helsinki, Finland. All analyses were a priori restricted to the warm season. Daily cause-specific cardiorespiratory mortality and hospital admissions were studied in elderly people (≥65 years) and adults (15–64 years) and associations between ozone and asthma emergency room visits in children (<15 years) were analysed. All models were adjusted for PM2.5 and Poisson regression was used for the analyses.

Results There was a positive association between ozone and admissions for asthma-chronic obstructive pulmonary disease (COPD) in elderly people (9.6%; 95% CI 2.0% to 17.8% at 0-day lag for 25 μg/m3 increase in ozone). Consistent associations were also found between ozone and asthma emergency room visits in children (12.6%; 95% CI 0.8% to 25.1%, 0-day lag). There was a suggestion of an association between ozone and admissions for arrhythmia among elderly people (6.4%; 95% CI 0.63% to 12.5%, 1-day lag), which was slightly confounded by PM2.5.

Conclusions Positive associations were found for ambient ozone with asthma visits among children and with pooled asthma/COPD admissions among elderly people. The evidence for a positive association between ozone and cardiovascular health was weaker.

  • Ozone
  • cardiovascular
  • respiratory
  • morbidity
  • mortality
  • air pollution

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  • Funding The National Technology Fund (TEKES, Contract 40715/01) and the Ministry of Education (Graduate School in Environment Health SYTYKE).

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.