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Epidemiological studies of acute ozone exposures and mortality

Abstract

Many, but not all, observational epidemiological studies of ozone (O 3) air pollution have yielded significant associations between variations in daily ambient concentrations of this pollutant and a wide range of adverse health outcomes. We evaluate some past epidemiological studies that have assessed the short-term association of O 3 with mortality, and investigate one possible reason for variations in their O 3 effect estimate, i.e., differences in their approaches to the modeling of weather influences on mortality. For all of the total mortality–air pollution time-series studies considered, the combined analysis yielded a relative risk, RR=1.036 per 100-ppb increase in daily 1-h maximum O 3 (95% CI: 1.023–1.050). However, the subset of studies that specified the nonlinear nature of the temperature–mortality association yielded a combined estimate of RR=1.056 per 100 ppb (95% CI: 1.032–1.081). This indicates that past time-series studies using linear temperature–mortality specifications have underpredicted the premature mortality effects of O 3 air pollution. For Detroit, MI, an illustrative analysis of daily total mortality during 1985–1990 also indicated that the model weather specification choice can influence the O 3 health effects estimate. Results were intercompared for alternative weather specifications. Nonlinear specifications of temperature and relative humidity (RH) yielded lower intercorrelations with the O 3 coefficient, and larger O 3 RR estimates, than a base model employing a simple linear spline of hot and cold temperature. We conclude that, unlike for particulate matter (PM) mass, the mortality effect estimates derived by time-series analyses for O 3 can be sensitive to the way that weather is addressed in the model. The same may well also be true for other pollutants with largely temperature-dependent formation mechanisms, such as secondary aerosols. Generally, we find that the O 3–mortality effect estimate increases in size and statistical significance when the nonlinearity and the humidity interaction of the temperature–health effect association are incorporated into the model weather specification. We recommend that a minimization of the intercorrelations of model coefficients be considered (along with other critical factors such as goodness of fit, autocorrelation, and overdispersion) when specifying such a model, especially when individual coefficients are to be interpreted for risk estimation.

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References

  1. Akaike H, A new look at statistical model identification, IEEE Trans Autom Control (1974) AU-19: 716–722

    Article  Google Scholar 

  2. Anderson HR Ponce de Leon A Bland JM Bowers JS and Strachan DP, Air pollution and daily mortality in London: 1987–1992, Br Med J (1996) 312: 665–669

    Article  CAS  Google Scholar 

  3. Borja-Aburto VH Loomis DP Bangdiwaia SI Shy CM and Rascon-Pacheco RA, Ozone, suspended particulates, and daily mortality in Mexico City, Am J Epidemiol (1997) 145: 258–268

    Article  CAS  Google Scholar 

  4. Cakmak S, Burnett R, Krewski D, Adjusting for temporal variation in the analysis of parallel time series of health and environmental variables, J Exposure Anal Environ Epidemiol (Apr–Jun 1998) 8(2): 129–44

    CAS  Google Scholar 

  5. California Department of Public Health, Clean air for California: initial report of the Air Pollution Study Project. State of California, Department of Public Health, San Francisco, CA 1955

  6. Caroll RJ Ruppert D and Stefanski LA, Measurement error in nonlinear models. Monographs on statistics and Applied Probability 63. Chapman & Hall, London 1995 p. 22

    Book  Google Scholar 

  7. Cifuentes LA and Lave L, Association of daily mortality and air pollution in Philadelphia, 1983–1988, J Air Waste Manage Assoc (1997) Submitted for publication

  8. Cleveland WS, Robust locally weighted regression and smoothing scatterplots, J Am Stat Assoc (1979) 74: 829–836

    Article  Google Scholar 

  9. Dersimonian R, and Laird N, Meta-analysis in clinical trials, Control Clin Trials (1986) 7: 177–188

    Article  CAS  Google Scholar 

  10. Ellis FP, Mortality from heat illness and heat-aggravated illness in the United States, Environ Res (1972) 5: 1–58

    Article  CAS  Google Scholar 

  11. Hastie T, and Tibshirani R, Generalized additive models. Chapman & Hall, London, UK 1990

    Google Scholar 

  12. Hoek G Schwartz JD Groot B and Eilers P, Effects of ambient particulate matter and ozone on daily mortality in Rotterdam, The Netherlands, Arch Environ Health (1997) 52: 455–463

    Article  CAS  Google Scholar 

  13. Ito K, Kinney P, and Thurston GD, Variations in PM10 concentrations within two metropolitan areas and their implications to health effects analyses, Inhalation Toxicol (1995) 7: 735–745

    Article  CAS  Google Scholar 

  14. Ito K, Thurston G, Nadas A, and Lippman M, Monitor-to-monitor temporal correlation of air pollution and weather variables in the North-Central U.S, J Exposure Anal and Environ Epidemiol (2001) 11(1): 21–32

    Article  CAS  Google Scholar 

  15. Kelsall JE Samet JM Zeger JE and Xu J, Air pollution and mortality in Philadelphia 1974–1988, Am J Epidemiol (1997) 146: 750–762

    Article  CAS  Google Scholar 

  16. Kinney PL and Ozkaynak H, Associations of daily mortality and air pollution in Los Angeles County, Environ Res (1991) 54: 99–120

    Article  CAS  Google Scholar 

  17. Kinney PL and Ozkaynak H, Associations between ozone and daily mortality in Los Angeles and New York City, Am Rev Respir Dis (1992) 145: A95(Abstract)

    Google Scholar 

  18. Kinney PL Ito K and Thurston GD, A sensitivity analysis of mortality/PM-10 associations in Los Angeles, Inhalation Toxicol (1995) 7: 59–69

    Article  CAS  Google Scholar 

  19. Lipfert FW, Air pollution and community health: a critical review and data sourcebook. Van Nostrand Reinhold, New York, NY 1994

    Google Scholar 

  20. Mage DT and Buckley TJ, The relationship between personal exposures and ambient concentrations of particulate matter, Paper No. 95-MP18.01. Proceedings of the 88th Annual Meeting of the Air and Waste Management Association, Pittsburgh, PA (1995

  21. Mage D, Wilson W, Hasselblad V, and Grant L, Assessment of human exposure to ambient particulate matter, J Air Waste Manage Assoc (1999) 49: 1280–1291

    Article  CAS  Google Scholar 

  22. Moolgavkar SH Luebeck EG Hall TA and Anderson EL, Air pollution and daily mortality in Philadelphia, Epidemiology (1995) 6(5): 476–484

    Article  CAS  Google Scholar 

  23. Ozkaynak H, Xue J, Severance P, Burnett R, and Raizenne M, Associations between daily mortality, ozone and particulate air pollution in Toronto, Canada, Paper presented at the Colloquium on Particulate Air Pollution, Irvine, CA, January 24–25, 1995

  24. Ostro BD Sanchez JM Aranda C and Eskeland GS, Air pollution and mortality: results from a study of Santiago, Chile, J Exposure Anal Environ Epidemiol (1996) 6: 97–114

    CAS  Google Scholar 

  25. Pope CA III, and Kalkstein LS, Synoptic weather modeling and estimates of the exposure–response relationship between daily mortality and particulate air pollution, Environ Health Perspect (Apr 1996) 104(4): 414–420

    Article  Google Scholar 

  26. Samet JM Zeger SL Kelsall JE Xu J and Kalkstein LS, Particulate air pollution and daily mortality: analysis of the effects of weather and multiple air pollutants, The Phase I.B Report of the Particle Epidemiology Evaluation Project. Health Effects Institute, Cambridge, MA March 1997

    Google Scholar 

  27. Samet J, Zeger S, Kelsall J, Xu J, and Kalkstein L, Does weather confound or modify the association of particulate air pollution with mortality? An analysis of the Philadelphia data, 1973–1980, Environ Res (1998 Apr) 77(1): 9–19

    Article  CAS  Google Scholar 

  28. Schwartz J, Health effects of air pollution from traffic: ozone and particulate matter. In: Fletcher T., and McMichael A.J. (Eds.), Health at the Crossroads: Transport Policy and Urban HealthJohn Wiley & Sons Ltd. NY, NY 1997

  29. Simpson RW Williams G Petroeschevsky A Morgan G and Rutherford S, The association between outdoor air pollution and daily mortality in Brisbane, Aust Arch Environ Health (1997) 52: 442–454

    Article  CAS  Google Scholar 

  30. Snedecor GW and Cochran WG, Statistical Methods 7th edn. Iowa State University Press, Ames, IA 1980 pp. 343, 353

    Google Scholar 

  31. Thurston GD and Kinney PL, Air pollution epidemiology: considerations in time-series modelling, Inhalation Toxicol (1995) 7: 71–83

    Article  CAS  Google Scholar 

  32. Touloumi G Katsouyanni K Zmirou D Schwartz J Spix C de Leon AP Tobias A Quennel P Rabczenko D Bacharova L Bisanti L Vonk JM and Ponka A, Short term effects of ambient oxidants exposure on mortality: a combined analysis within the APHEA project, Am J Epidemiol (1997) 146(2): 177–185

    Article  CAS  Google Scholar 

  33. U.S. Bureau of the Census, County and City Data Book, 1983. U.S. Department of Commerce. U.S. Government Printing Office, Washington, DC 1983

  34. U.S. Environmental Protection Agency (U.S. EPA), Air quality criteria for ozone and other photochemical oxidants. EPA Report No. EPA-600/P-93/004aF. Environmental Criteria and Assessment Office, Research Triangle Park, NC 1996 Apr 7–94

  35. U.S. Environmental Protection Agency (U.S. EPA), Regulatory impact analysis for the particulate matter and ozone National Ambient Air Quality Standards and proposed regional haze rule. Appendix J. Table 3. Office of Air Quality Planning and Standards, Research Triangle Park, NC 1997

  36. Verhoeff AP Hoek G Schwartz J and Wijnen JH, Air pollution and daily mortality in Amsterdam, Epidemiology (1996) 7: 225–230

    Article  CAS  Google Scholar 

  37. Wechsler CJ Shields HC and Naik DV, Indoor ozone exposures, J Air Pollut Control Assoc (1989) 39: 1562

    Google Scholar 

Download references

Acknowledgements

Funding for this study was provided by the National Institute of Environmental Health Sciences (NIEHS) under Grant ES05711. This study is also funded as a part of a Center Program supported by the NIEHS under Grant ES00260. The authors also thank Dr. Morton Lippmann for his comments on this paper.

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Correspondence to GEORGE D THURSTON.

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THURSTON, G., ITO, K. Epidemiological studies of acute ozone exposures and mortality. J Expo Sci Environ Epidemiol 11, 286–294 (2001). https://doi.org/10.1038/sj.jea.7500169

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