Health impacts of long-term ozone exposure in China over 2013-2017

The association between long-term exposure to ambient formaldehyde and respiratory mortality risk: A national study in China

INTRODUCTION

While ambient formaldehyde (HCHO) concentrations are increasing worldwide, there was limited research on its health effects.

OBJECTIVES

To assess the association of long-term exposure to ambient HCHO with the risk of respiratory (RESP) mortality and the associated mortality burden in China.

METHODS

Annual and seasonal RESP death and tropospheric HCHO vertical columns data were collected in 466 counties/districts across China during 2013-2016. A difference-in-differences approach combined with a generalized linear mixed-effects regression model was employed to assess the exposure-response association between long-term ambient HCHO exposure and RESP mortality risk. Additionally, we computed the attributable fraction (AF) to gauge the proportion of RESP mortality attributable to HCHO exposure.

RESULTS

This analysis encompassed 560,929 RESP deaths. The annual mean ambient HCHO concentration across selected counties/districts was 8.02×1015 ± 2.22×1015 molec.cm-2 during 2013-2016. Each 1.00×1015 molec.cm-2 increase in ambient HCHO was associated with a 1.61 % increase [excess risk (ER), 95 % confidence interval (CI): 1.20 %, 2.03 %] in the RESP mortality risk. The AF of RESP mortality attributable to HCHO was 12.16 % (95 %CI:9.33 %, 14.88 %), resulting in an annual average of 125,422 (95 %CI:96,404, 153,410) attributable deaths in China. Stratified analyses suggested stronger associations in individuals aged ≥65 years old (ER=1.87 %, 95 %CI:1.43 %, 2.32 %), in cold seasons (ER=1.00 %, 95 %CI:0.56 %, 1.44 %), in urban areas (ER=1.65 %, 95 %CI:1.15 %, 2.16 %), and in chronic obstructive pulmonary disease patients (ER=1.95 %, 95 %CI:1.42 %, 2.48 %).

CONCLUSIONS

This study suggested that long-term HCHO exposure may significantly increase the risk of RESP mortality, leading to a substantial mortality burden. Targeted measures should be implemented to control ambient HCHO pollution promptly.

Short-Term Exposure to Fine Particulate Matter and Ozone: Source Impacts and Attributable Mortalities

Short-term exposure to particles with aerodynamic diameters less than 2.5 μm (PM2.5) and ozone (O3) are important risk factors for human health. Despite the awareness of reducing attributable health burden, region-specific and source-specific strategies remain less explored due to the gap between precursor emissions and health effects. In this study, we isolate the health burden of individual sector sources of PM2.5 and O3 precursors, nitrogen oxides (NOx) and volatile organic compounds (VOCs), across the globe. Specifically, we estimate mortalities attributable to short-term exposure using machine-learning-based daily exposure estimates and quantify sectoral impacts using chemical transport model simulations. Globally, short-term exposure to PM2.5 and O3 result in 713.5 (95% Confidence Interval: 598.8-843.3) thousand and 496.3 (371.3-646.1) thousand mortalities in 2019, respectively, of which 12.5% are contributed by fuel-related NOx emissions from transportation, energy, and industry. Sectoral impacts from anthropogenic NOx and VOC emissions on health burden vary significantly among seasons and regions, requiring a target shift from transportation in winter to industry in summer for East Asia, for instance. Emission control and health management are additionally complicated by unregulated natural influences during climatic events. Fire-sourced NOx and VOC emissions, respectively, contribute to 8.5 (95% CI: 6.2-11.7) thousand and 4.8 (3.6-5.9) thousand PM2.5 and O3 mortalities, particularly for tropics with high vulnerability to climate change. Additionally, biogenic VOC emissions during heatwaves contribute to 1.8 (95% CI: 1.5-2.2) thousand O3-introduced mortalities, posing challenges in urban planning for high-income regions, where biogenic contributions to health burden during heatwaves are 13% of anthropogenic contributions annually. Our study provides important implications for temporally dynamic and sector-targeted emission control and health management strategies, which are of urgency under the projection of continuously increasing energy consumption and changing climate.

The health and economic burden of ozone pollution on Alzheimer's disease and mild cognitive impairment in China

Ozone pollution is increasingly recognized as a serious environmental threat that exacerbates dementia risks, including Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI). Amid rapid industrialization, China faces significant air quality challenges. However, there has been a scarcity of detailed studies assessing the health and economic impacts of ozone pollution on these conditions. This study aims to address this gap by utilizing the BenMap-CE tool and incorporating parameters obtained from systematic reviews of epidemiological studies, official statistics, and weighted averages, to accurately quantify the effects of ozone exposure in China. This research evaluated the health and economic burdens at both national and provincial levels, focusing on the additional impacts attributed to increased ozone levels. The results reveal that in 2023, compared to 2015, ozone pollution contributed to approximately 110,000 new cases (5.6 per 10,000) of AD and 1.6 million new cases (81.7 per 10,000) of MCI, imposing significant economic costs of about US $1200 million for AD and US $18,000 million for MCI, based on 2015 dollar values. Additionally, our projections indicate that reducing the 2023 ozone concentrations to 70 μg/m3 could significantly curb these conditions, potentially preventing over 210,000 new AD cases (10.7 per 10,000) and 2.9 million (148.1 per 10,000) MCI cases. Such reductions are projected to yield substantial economic benefits, estimated at US $2200 million for AD and US $34,000 million for MCI (2015 dollar values). These findings underscore the profound implications of ozone pollution on public health and the economy in China, highlighting the urgent need for effective ozone management strategies to mitigate these impacts.

Long-term variations of air pollutants and public exposure in China during 2000-2020

Since 2000, China has faced severe air pollution challenges，prompting the initiation of comprehensive emission control measures post-2013. The subsequent implementation of these measures has led to remarkable enhancements in air quality. This study aims to enhance our understanding of the long-term trends in fine particulate matter (PM2.5) and gaseous pollutants of ozone (O3) and nitrogen dioxide (NO2) across China from 2000 to 2020. Utilizing the Community Multiscale Air Quality (CMAQ) model, we conducted a nationwide analysis of air quality, systematically quantifying model predictions against observations for pollutants. The CMAQ model effectively captured the trends of air pollutants, meeting recommended performance benchmarks. The findings reveal variations in pollutant concentrations, with initial increases in PM2.5 followed by a decline after 2013. The proportion of the population living in high PM2.5 concentrations (>75 μg/m3) decreased to <5 % after 2015. However, during the period from 2017 to 2020, around 40 % of the population continued to live in regions that did not meet the criteria for Chinese air quality standards (35 μg/m3). From 2000 to 2019, fewer than 20 % of the population met the WHO standard (100 μg/m3) for MDA8 O3. In 2000, 77 % of the population met the NO2 standard (<20 μg/m3), a figure that declined to 60 % between 2005 and 2014, nearly reaching 70 % in 2020. This study offers a comprehensive analysis of the changes in pollutants and public exposure in 2000-2020. It serves as a foundational resource for future efforts in air pollution control and health research.

Effect of ambient ozone pollution on disease burden globally: A systematic analysis for the global burden of disease study 2019

BACKGROUND

Exposure to ambient ozone pollution causes health loss and even death, and both are the main risk factors for the disease burden worldwide. We comprehensively evaluated the ozone pollution-related disease burden.

METHODS

First, numbers and age-standardized rates of deaths and disability-adjusted life years (DALYs) were assessed globally and by sub-types in 2019. Furthermore, the temporal trend of the disease burden was explored by the linear regression model from 1990 to 2019. The cluster analysis was used to evaluate the changing pattern of related disease burden across Global Burden of Disease Study (GBD) regions. Finally, the age-period-cohort (APC) model and the Bayesian age-period-cohort (BAPC) model were used to predict the future disease burden in the next 25 years.

RESULT

Exposure to ozone pollution contributed to 365,222 deaths and 6,210,145 DALYs globally in 2019, which accounted for 0.65 % of deaths globally and 0.24 % of DALYs globally. The disease burden was consistently increasing with age. Males were high-risk populations and low-middle socio-demographic index (SDI) regions were high-risk areas. The disease burden of ozone pollution varied considerably across the GBD regions and the countries. In 2019, the number of deaths and DALYs cases increased by 76.11 % and 56.37 %, respectively compared to those in 1990. The predicted results showed that the number of deaths cases and DALYs cases for both genders would still increase from 2020 to 2044.

CONCLUSION

In conclusion, ambient ozone pollution has threatened public health globally. More proactive and effective strategic measures should be developed after considering global-specific circumstances.

Mitigating air pollution benefits multiple sustainable development goals in China

Achieving the United nations 2030 Sustainable Development Goals (SDGs) remains a significant challenge, necessitating urgent and prioritized strategies. Among the various challenges, air pollution continues to pose one of the most substantial threats to the SDGs due to its widespread adverse effects on human health and ecosystems. However, the connections between air pollution and the SDGs have often been overlooked. This study reveals that out of the 169 SDG targets, 71 are adversely impacted by air pollution, while only 6 show potential positive effects. In China, two major atmospheric nitrogen pollutants, ammonia and nitrogen oxides, resulted in an economic loss of 400 billion United States Dollar (USD) in 2020, which could be reduced by 33% and 34% by 2030, respectively. It would enhance the progress towards SDGs in China by 14%, directly contributing to the achievement of SDGs 1 to 6 and 11 to 15. This improvement is estimated to yield overall benefits totaling 119 billion USD, exceeded the total implementation cost of 82 billion USD with ammonia as the preferential mitigation target. This study underscores the importance of robust scientific evidence in integrated policies aimed at aligning improvements in environmental quality with the priorities of sustainable development.

Association between short-term air pollution exposure and perturbation in thyrotropin levels in 1.38 million Chinese women: A national longitudinal analysis, 2014-2019

Prevalence of subclinical hypothyroidism substantially increased during the last decade in China, which has been commonly/clinically diagnosed as elevation in thyrotropin (thyroid-stimulating hormone [TSH]). Tobacco smoke containing toxic substances has been linked to thyroid dysfunction; however, data on perturbation of TSH following air pollution exposure in human has not been assessed at nationwide population level. We investigated the longitudinal impact of daily ambient air pollution estimated at residential level on serum TSH in 1.38 million women from China's 29 mainland provinces between 2014 and 2019. We observed that particulate matter with aerodynamic diameter ≤ 10 and ≤ 2.5 µm (PM10, PM2.5) and nitrogen dioxide (NO2) at cumulative lag 0-7 days of exposure were associated with percent elevations in TSH (0.88% [95% CI: 0.71, 1.05] per [interquartile range, IQR: 54.8 μg/m3] of PM10; 0.89% [95% CI, 0.71, 1.07] per IQR [40.3 μg/m3] of PM2.5; 2.01% [95% CI: 1.81, 2.22] per IQR [27.4 μg/m3] of NO2). Greater associations were observed in participants living in areas with ≥adequate iodine intake and those with low BMI levels and high inflammation status. Our results suggest that increased concentrations of recent ambient air pollutants at exposure ranges commonly encountered in Asia were associated with increases in TSH, supporting disturbing role of short-term air pollution exposure on the regulation of thyroid hormone homeostasis.

Association of long-term ozone air pollution and age-related macular degeneration in older Chinese population

BACKGROUND

Age-related macular degeneration (AMD) is the leading cause of legal blindness. It remains unclear whether and to what extent the ambient ozone pollution could increase the risk of AMD.

METHODS

A nationwide cross-sectional survey was conducted in 129 major cities in 27 of 31 provincial regions across China from 2018 to 2021. Data in relation to demographics, residential address, and medical histories were collected. The exposure-response relationship between ozone exposure and AMD was explored using the restricted cubic splines. A piecewise logistic regression model was used to examine the magnitudes of the association, after adjusting demographic, social-economic and co-pollutants. Residential ozone exposures were estimated using a satellite-based model.

RESULTS

A total of 624,167 middle-aged and older participants were included in the final analyses, the overall prevalence of AMD was 16.76 %. The risk of AMD was consistently increasing with higher warm-season ozone concentration, and the risk became much larger after the cut-off of 110 μg/m3 (approximately 50 ppb). Every 10 μg/m3 increment in warm-season ozone concentration, the adjusted odds ratio (OR) for AMD were 1.15 (1.13, 1.16) and 1.66 (1.63, 1.69) when the warm-season ozone concentration was below or above 110 μg/m3, respectively.

CONCLUSION

This large-scale nationwide study provides the first epidemiological evidence demonstrating significant associations between long-term residential ozone exposure and AMD prevalence. Based on our findings, in conjunction with WHO global air quality guidelines, we suggest that a warm-season ozone of 110 μg/m3 should be adopted for middle-aged and older populations to reduce the risk of AMD. Ongoing efforts to reduce ozone exposure in communities through improved air quality regulations and public education are essential for the improvement of public health.

Spatiotemporal patterns of surface ozone exposure inequality in China

Rising surface ozone (O3) levels in China are increasingly emphasizing the potential threats to public health, ecological balance, and economic sustainability. Using a 1 km × 1 km dataset of O3 concentrations, this research employs subpopulation demographic data combined with a population-weighted quality model. Its aim is to evaluate quantitatively the differences in O3 exposure among various subpopulations within China, both at a provincial and urban cluster level. Additionally, an exposure disparity indicator was devised to establish unambiguous exposure risks among significant urban agglomerations at varying O3 concentration levels. The findings reveal that as of 2018, the population-weighted average concentration of O3 for all subgroups has experienced a significant uptick, surpassing the average O3 concentration (118 μg/m3). Notably, the middle-aged demographic exhibited the highest O3 exposure level at 135.7 μg/m3, which is significantly elevated compared to other age brackets. Concurrently, there exists a prominent positive correlation between educational attainment and O3 exposure levels, with the medium-income bracket showing the greatest susceptibility to O3 exposure risks. From an industrial vantage point, the secondary sector demographic is the most adversely impacted by O3 exposure. In terms of urban-rural structure, urban groups in all regions had higher levels of exposure to O3 than rural areas, with North and East China having the most significant levels of exposure. These findings not only emphasize the intricate interplay between public health and environmental justice but further highlight the indispensability of segmented subgroup strategies in environmental health risk assessment. Moreover, this research furnishes invaluable scientific groundwork for crafting targeted public health interventions and sustainable air quality management policies.

Long- and short-term health benefits attributable to PM2.5 constituents reductions from 2013 to 2021: A spatiotemporal analysis in China

Long- and short-term exposure to constituents of fine particulate matter (PM2.5) substantially affects human health. However, assessments of the health and economic benefits of reducing PM2.5 constituents are scarce. This study estimates the number of premature deaths from all-cause, cardiovascular (CVD), and respiratory diseases avoided due to reductions in daily and annual average concentrations of PM2.5 constituents. The Environmental Benefits Mapping and Analysis Program was used for two scenarios: we used yearly concentrations of PM2.5 constituents from 2013 to 2020 as the baseline concentration surface (Scenario I), and 2021 as the baseline year (Scenario II). With reductions in daily and annual average concentrations of PM2.5 constituents, 309,099 (95 % confidence interval [CI]: 37,265-571,485) and 195,297 (95 % CI: 178,192-211,914) premature deaths were avoided in Scenario I, respectively; meanwhile, 347,296 (95 % CI: 79,258-604,758) and 201,567 (95 % CI: 185,038-217,530) premature deaths were avoided in Scenario II, respectively. Moreover, economic benefits associated with the prevention of premature deaths were estimated using the willingness to pay (WTP) and modified human capital (AHC) methods. The total estimated economic benefits amounted to 563.32 billion RMB (WTP) and 322.03 billion RMB (AHC) in Scenario I. In Scenario II, the associated economic benefits were 751.48 billion RMB (WTP) and 427.56 billion RMB (AHC), accounting for 0.657 and 0.374 % of China's gross domestic product in 2021, respectively. Additionally, we analyzed the sensitivity of CVD-related premature deaths to the concentrations of PM2.5 constituents, and found that CVD-related premature deaths were more sensitive to black carbon.

Assessing the short-term effects of PM2.5 and O3 on cardiovascular mortality using high-resolution exposure: a time-stratified case cross-over study in Southwestern China

Air pollution is a major risk factor of cardiovascular disease (CVD). To date, limited studies have estimated the effects of ambient air pollution on CVD mortality using high-resolution exposure assessment, which might fail to capture the spatial variation in exposure and introduce bias in results. Besides, the three-year action plan (TYAP, 2018-2020) was released; thus, the constitution and health effect of air pollutants may have changed. In this study, we estimated the short-term effect exposed to particulate matters with parameter less than 2.5 µm (PM2.5) and ozone (O3) with 0.05° × 0.05° resolution on CVD mortality and measured the influence of TYAP in the associations. We used random forest models with spatial weight matrices to attain high-resolution pollutant concentrations and conditional Poisson regression to assess the relationship between air pollution and cardiovascular mortality. With an increase of 10 µg/m3 in PM2.5 and O3 during 2018-2021 in the Sichuan Basin (SCB), CVD mortality increased 1.0134 (95% CI 1.0102, 1.0166) and 1.0083 (95% CI 1.0060, 1.0107), respectively, using high-resolution air pollutant concentration, comparing to 1.0070 (95% CI 1.0052, 1.0087) and 1.0057 (95% CI 1.0037, 1.0078) using data from air quality monitoring stations (AQMs). After TYAP, the relative risk (RR) due to PM2.5 rose up to 1.0149 (95% CI 1.0054, 1.0243), and the RR due to O3 rose up to 1.0089 (95% CI 1.0030, 1.0148) in Sichuan Province. We found significantly positive association of cardiovascular mortality and air pollution in Sichuan Province. And using high-resolution exposure would be more accurate to estimate the effect of air pollution on CVD. After TYAP, the cardiovascular mortality risk estimation due to PM2.5 decreased in elderly in SCB, and the risk due to O3 increased in Sichuan Province.

The spatiotemporal pattern of surface ozone and its impact on agricultural productivity in China

The slowing of agricultural productivity growth globally over the past two decades has brought a new urgency to detect its drivers and potential solutions. We show that air pollution, particularly surface ozone (O3), is strongly associated with declining agricultural total factor productivity (TFP) in China. We employ machine learning algorithms to generate estimates of high-resolution surface O3 concentrations from 2002 to 2019. Results indicate that China's O3 pollution has intensified over this 18-year period. We coupled these O3 estimates with a statistical model to show that rising O3 pollution during nonwinter seasons has reduced agricultural TFP by 18% over the 2002-2015 period. Agricultural TFP is projected to increase by 60% if surface O3 concentrations were reduced to meet the WHO air quality standards. This productivity gain has the potential to counter expected productivity losses from 2°C warming.

Assessing the effect of COVID-19 pandemic on air quality change and human health outcomes in a capital city, southwestern Iran

The aimsof this study were to assess the spatial variation of PM2.5, NO2, and O3 between 2019 (before) and 2020 (during COVID-19 pandemic); and calculation the health outcomes of exposure to these pollutants. The daily PM2.5, NO2, and O3 concentrations were applied to assess health effects by relative risk, and baseline incidence. The annual PM2.5 and NO2 mean concentrations exceeded the WHO guideline values, while O3 did not exceed. The restrictive measures associated to COVID-19 led to reduction at the annual means of PM2.5 and NO2 by -25.5% and -23.1%, respectively, while the annual mean of O3 increased by +7.9%. The number of M-CVD and M-RD (-25.6%, -26.1%) related to PM2.5 exposure, and HA-COPD and HA-RD >65 years old (-21% and -3.84%) related to NO2 exposure were reduced in 2020, and O3 exposure-related M-CVD (+30.1%) and HA-RD >65 years old (+23.4%) increased compared to the previous year 2019.

Association between gestational exposure and risk of orofacial clefts: a systematic review and meta-analysis

BACKGROUND

The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the occurrence of OFCs. However, there are still some controversies about the current research results, and there is no relevant research to review the latest results in recent years.

OBJECTIVE

In this paper, the authors conducted a systematic review and meta-analysis to explore the correlation between ambient air pollution and the occurrence of neonatal OFCs deformity.

METHODS

We searched Pubmed, Web of science, and Embase databases from the establishment of the database to May 2023. We included observational studies on the relationship between prenatal exposure to fine particulate matter 2.5 (PM2.5), fine particulate matter 10 (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO) and the risk of cleft lip (CL), cleft palate (CP), cleft lip with or without palate (CL/P). the Newcastle-Ottawa quality assessment scale (NOS) was used to evaluate the quality of the literature. Funnel plot and Egger's regression were used to verify the publication bias. Random effect model or fixed effect model was used to estimate the combined relative risk (RR) and 95% confidence interval (95%CI).

RESULTS

A total of eleven studies were included in this study, including four cohort studies and seven case-control studies, including 22,453 cases of OFCs. Ten studies had low risk of bias and only one study had high risk of bias. Three studies reported that PM2.5 was positively correlated with CL and CP, with a combined RR and 95%CI of 1.287(1.174,1.411) and 1.267 (1.105,1.454). Two studies reported a positive correlation between O3 and CL, with a combined RR and 95%CI of 1.132(1.047,1.225). Two studies reported a positive correlation between PM10 and CL, with a combined RR and 95%CI of 1.108 (1.017,1.206). No association was found between SO2, CO, NO2 exposure during pregnancy and the risk of OFCs.

CONCLUSION

The results of this study showed that there was a significant statistical correlation between exposure to PM10, PM2.5, O3 and the risk of OFCs in the second month of pregnancy. Exposure assessment, research methods and mechanisms need to be further explored.

Analysis of severe ozone-related human health and weather influence over China in 2019 based on a high-resolution dataset

Ozone pollution in 2019 in China is particularly severe posing a tremendous threat to the health of Chinese inhabitants. In this study, we constructed a more reliable and accurate 1-km gridded dataset for 2019 with as many sites as possible using the inverse distance weight interpolation method to analyze spatiotemporal ozone pollution characteristics and health burden attributed to ozone exposure from the perspective of different diseases and weather influence. The accuracy of this new dataset is higher than other public datasets, with the coefficient of determination of 0.84 and root-mean-square error of 8.77 ppb through the validation of 300 external sites which were never used for establishing retrieval methods by the datasets mentioned-above. The averaged MDA8 (the daily maximum 8 h average) ozone concentrations over China was 43.5 ppb, and during April-July, 83.9% of total grids occurred peak-month ozone concentrations. Overall, the highest averaged exceedance days (60 days) and population-weighted ozone concentrations (55.0 ppb) both concentrated in central-eastern China including 9 provinces (only 11.4% of the national territory); meanwhile, all-cause premature deaths attributable to ozone exposure reached up to 142,000 (54.9% of national total deaths) with higher deaths for cardiovascular and respiratory, and the provincial per capita premature mortality was 0.27~0.44‰. The six most polluted weather types in the central-eastern China are in order as follows: westerly (SW and W), cyclonic, northerly, and southerly (NW, N, and S) types, which accounts for approximately 73.2% of health burden attributed to daily ozone exposure and poses the greatest public health risk with mean daily premature deaths ranging from 466 to 610. Our findings could provide an effective support for regional ozone pollution control and public health management in China.

Effects of Ambient O3 on Respiratory Mortality, Especially the Combined Effects of PM2.5 and O3

BACKGROUND

In China, the increasing concentration of ozone (O3) has emerged as a significant air pollution issue, leading to adverse effects on public health, particularly the respiratory system. Despite the progress made in managing air pollution in China, it is crucial to address the problem of environmental O3 pollution at present.

METHODS

The connection between O3 exposure and respiratory mortality in Shenyang, China, from 2014 to 2018 was analyzed by a time-series generalized additive regression model (GAM) with quasi-Poisson regression. Additionally, the potential combined effects of fine particulate matter (PM2.5) and O3 were investigated using the synergy index (SI).

RESULTS

Our findings indicate that each 10 μg/m3 increase in O3 at lag 2 days was associated with a maximum relative risk (RR) of 1.0150 (95% CI: 1.0098-1.0202) for respiratory mortality in the total population. For individuals aged ≥55 years, unmarried individuals, those engaged in indoor occupations, and those with low educational attainment, each 10 μg/m3 increase in O3 at lag 07 days was linked to RR values of 1.0301 (95% CI: 1.0187-1.0417), 1.0437 (95% CI: 1.0266-1.0610), 1.0317 (95% CI: 1.0186-1.0450), and 1.0346 (95% CI: 1.0222-1.0471), respectively. Importantly, we discovered a synergistic effect of PM2.5 and O3, resulting in an SI of 2.372 on the occurrence of respiratory mortality.

CONCLUSIONS

This study confirmed a positive association between O3 exposure and respiratory mortality. Furthermore, it highlighted the interaction between O3 and PM2.5 in exacerbating respiratory deaths.

Short-term exposure to ambient ozone and cardiovascular mortality in China: a systematic review and meta-analysis

Air pollution is a major public health concern in China. Notwithstanding this, there is limited evidence regarding the impact of short-term exposure to ambient ozone on cardiovascular mortality in the Chinese population. Therefore, we conducted this meta-analysis to address this important question. The random-effects model was applied to pool the results from individual studies. Finally, 32 effect estimates extracted from 19 studies were pooled in this meta-analysis. The pooled relative risk for cardiovascular mortality for each 10 µg/m3 increment in ozone concentration was 1.0068 (95% CI: 1.0049, 1.0086). Ths significant positive association between ozone exposure and cardiovascular mortality was also observed in different two-pollutant models. This meta-analysis revealed that exposure to ozone was associated with an increased risk of cardiovascular mortality in China, and more efforts on controlling the population from ozone are needed to improve cardiovascular health of Chinese population.

Ozone Pollution and Acute Exacerbation of Asthma in Residents of China: An Ecological Study

Purpose

The evidence for a causal relationship between high-level ozone (O3) exposure and acute exacerbation of asthma among adults is limited, and the conclusions are less definitive.

Patients and methods

Here we collected the daily data on asthma cases, O3 exposure, and meteorological factors from 2010 to 2016 in Shijiazhuang, China. We investigated the risk of asthma exacerbation associated with high-level ozone exposure using a polynomial distributed lag model (PDLM). Using a generalized additive model (GAM), we estimated the interactive effects between O3 and other pollutants as well as meteorological factors on asthma exacerbation.

Results

A total of 7270 patients with asthma were enrolled from 22 governmental hospitals in 13 counties. Each 10 μg/m3 increase in O3 concentration on the exacerbation of asthma was associated with a 1.92% (95% CI = 0.80-3.03%) higher risk of asthma exacerbation on day lag 7. The cumulative risk of O3 on asthma exacerbation increased by 18.9% (95% CI = 12.8-25.4%) on the 14th day. High consecutive levels of O3 increase the risk of asthma exacerbation, and the interactive effect of O3 and sulfur dioxide (SO2) appears before the exacerbation onset.

Conclusion

These findings suggested that O3 should be an important risk factor for asthma exacerbation, and health benefits in reducing asthma exacerbation risk would be gained with continued efforts to improve the air quality in China.

Cross-sectional and longitudinal relationships between ozone exposure and glucose homeostasis: Exploring the role of systemic inflammation and oxidative stress in a general Chinese urban population

The adverse health effects of ozone pollution have been a globally concerned public health issue. Herein we aim to investigate the association between ozone exposure and glucose homeostasis, and to explore the potential role of systemic inflammation and oxidative stress in this association. A total of 6578 observations from the Wuhan-Zhuhai cohort (baseline and two follow-ups) were included in this study. Fasting plasma glucose (FPG) and insulin (FPI), plasma C-reactive protein (CRP, biomarker for systemic inflammation), urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG, biomarker for oxidative DNA damage), and urinary 8-isoprostane (biomarker for lipid peroxidation) were repeatedly measured. After adjusting for potential confounders, ozone exposure was positively associated with FPG, FPI, and homeostasis model assessment of insulin resistance (HOMA-IR), and negatively associated with HOMA of beta cell function (HOMA-β) in cross-sectional analyses. Each 10 ppb increase in cumulative 7-days moving average ozone was associated with a 13.19%, 8.31%, and 12.77% increase in FPG, FPI, and HOMA-IR, respectively, whereas a 6.63% decrease in HOMA-β (all P < 0.05). BMI modified the associations of 7-days ozone exposure with FPI and HOMA-IR, and the effects were stronger in subgroup whose BMI ≥24 kg/m². Consistently high exposure to annual average ozone was associated with increased FPG and FPI in longitudinal analyses. Furthermore, ozone exposure was positively related to CRP, 8-OHdG, and 8-isoprostane in dose-response manner. Increased CRP, 8-OHdG, and 8-isoprostane could dose-dependently aggravate glucose homeostasis indices elevations related to ozone exposure. Increased CRP and 8-isoprostane mediated 2.11-14.96% of ozone-associated glucose homeostasis indices increment. Our findings suggested that ozone exposure could cause glucose homeostasis damage and obese people were more susceptible. Systemic inflammation and oxidative stress might be potential pathways in glucose homeostasis damage induced by ozone exposure.

VAR-tree model based spatio-temporal characterization and prediction of O3 concentration in China

Ozone (O₃) pollution in the atmosphere is getting worse in many cities. In order to improve the accuracy of O₃ prediction and obtain the spatial distribution of O₃ concentration over a continuous period of time, this paper proposes a VAR-XGBoost model based on Vector autoregression (VAR), Kriging method and XGBoost (Extreme Gradient Boosting). China is used as an example and its spatial distribution of O₃ is simulated. In this paper, the O₃ concentration data of the monitoring sites in China are obtained, and then a spatial prediction method of O₃ mass concentration based on the VAR-XGBoost model is established, and finnally its influencing factors are analyzed. This paper concludes that O₃ features the highest correlation with PM_2.5 and the lowest correlation with SO₂. Among the measurement factors, wind speed and temperature are the most important factors affecting O₃ pollution, which are positively correlated to O₃ pollution. In addition, precipitation is negatively correlated with 8-hour ozone concentration. In this paper, the performance of the VAR-XGBoost model is evaluated based on the ten-fold cross-validation method of sample, site and time, and a comparison with the results of XGBoost, CatBoost (categorical boosting), ExtraTrees, GBDT (gradient boosting decision tree), AdaBoost (adaptive boosting), RF (random forest), Decision tree, and LightGBM (light gradient boosting machine) models is conducted. The result shows that the prediction accuracy of the VAR-XGBoost model is better than other models. The seasonal and annual average R² reaches 0.94 (spring), 0.93 (summer), 0.92 (autumn), 0.93 (winter), and 0.95 (average from 2016 to 2021). The data show that the applicability of the VAR-XGBoost model in simulating the spatial distribution of O₃ concentrations in China performs well. The spatial distribution of O₃ concentrations in the Chinese region shows an obvious feature of high in the east and low in the west, and the spatial distribution is strongly influenced by topographical factors. The mean concentration is clearly low in winter and high in summer within a season. The results of this study can provide a scientific basis for the prevention and control of regional O₃ pollution in China, and can also provide new ideas for the acquisition of data on the spatial distribution of O₃ concentrations within cities.

Chemical drivers of ozone change in extreme temperatures in eastern China

Surface ozone pollution has become the biggest issue in China's air pollution since particulate matters have been improved in the atmosphere. Compared with normal winter/summer, extremely cold/hot weather sustained several days and nights by unfavorable meteorology is more impactful in this regard. However, ozone changes in extreme temperatures and their driving processes remain rarely understood. Here, we combine comprehensive observational data analysis and 0-D box models to quantify the contributions of different chemical processes and precursors to ozone change in these unique environments. Analyses of radical cycling indicate that temperature accelerates OH-HO₂-RO₂, optimizing ozone production efficiency in higher temperatures. The HO₂ + NO → OH + NO₂ reaction was the most influenced by temperature change, followed by OH + VOCs → HO₂/RO₂. Although most reactions in ozone formation increased with temperature, the increase in ozone production rates was greater than the rate of ozone loss, leading to a fast net ozone accumulation in heat waves. Our results also show that the ozone sensitivity regime is VOC-limited in extreme temperatures, highlighting the significance of volatile organic compound (VOC) control (particularly the control of alkenes and aromatics). In the context of global warming and climate change, this study helps us deeply understand ozone formation in extreme environments and design abatement policies for ozone pollution in such conditions.

Ozone exposure and health risks of different age structures in major urban agglomerations in People's Republic of China from 2013 to 2018

High concentration of surface ozone (O₃) will cause health risks to people. In order to analyze the spatiotemporal characteristics of O₃ and assess O₃ exposure and health risks for different age groups in China, we applied multiple methods including standard deviation ellipse, spatial autocorrelation, and exposure-response functions. Results show that O₃ concentrations increased in 64.5% of areas in China from 2013 to 2018. The central plain urban agglomeration (CPU), Beijing-Tianjin-Hebei (BTH), and Yangtze River Delta (YRD) witnessed the greatest incremental rates of O₃ by 16.7%, 14.3%, and 13.1%. Spatially, the trend of O₃ shows a significant positive autocorrelation, and high trend values primarily in central and east China. The proportion of the total population exposed to high O₃ (above 160 μg/m³) increased annually. Compared to 2013, the proportion of the young, adult, and old populations exposed to high O₃ increased to different extents in 2018 by 26.8%, 29.6%, and 27.2%, respectively. The extent of population exposure risk areas in China expanded in size, particularly in north and east China. The total premature respiratory mortalities attributable to long-term O₃ exposure in six urban agglomerations were about 177,000 in 2018 which has increased by 16.4% compared to that in 2013. Among different age groups, old people are more vulnerable to O₃ pollution, so we need to strengthen their relevant health protection of them.

Increases in ozone-related mortality in China over 2013-2030 attributed to historical ozone deterioration and future population aging

We systematically examine historical and future changes in premature respiratory mortalities attributable to ozone (O₃) exposure (O₃-mortality) in China and identify the leading cause of respective change for the first time. The historical assessment for 2013-2019 is based on gridded O₃ concentrations generated by a multi-source-data-fusion algorithm; the future prediction for 2019-2030 uses gridded O₃ concentrations projected by four Coupled Model Intercomparison Project Phase 6 (CMIP6) models under three Shared Socioeconomic Pathways (SSP) scenarios. During 2013-2019, national annual O₃-mortality is 176.3 thousand (95%CI: 123.5-224.0 thousand) averaged over 2013-2019 with an increasing trend of 14.1 thousand yr^-1 (95%CI: 10.2-17.4 thousand yr^-1); sensitivity experiments show that the O₃-mortality varies at a rate of +12.7 (95%CI: 9.2-15.6), +5.8 (95%CI: 4.0-7.4), +1.0 (95%CI: 0.7-1.2), -5.4 (95%CI: -6.9 to -3.7) thousand yr^-1, owing to changes in O₃ concentration, population age structure, population size, mortality rate for respiratory disease, respectively. The deterioration of O₃ air quality, shown as significant increase in O₃ concentration, is identified as the primary factor which contributes 90.1 % of 2013-2019 O₃-mortality rise. Compared with O₃-mortality estimated in this study, the widely-used O₃-mortality assessment method based on urban-site-dominant O₃ measurements generates close national O₃-mortality but overestimates (underestimates) provincial O₃-mortality in coastal (central) provinces. From 2019 to 2030, national O₃-mortality is projected to increase by 50.4-103.7 thousand under different SSP scenarios. The change in age structure (i.e. population aging) alone will result in significant O₃-mortality rises of 137.9-160.5 thousand. Compared with 2013-2019 rapid O₃ increase (+2.5 μg m^-3 yr^-1 at national level), O₃ concentrations are projected to increase at a lower rate (+0.4 μg m^-3 yr^-1 in SSP5-8.5) or even decrease (-0.7 μg m^-3 yr^-1 in SSP1-2.6) from 2019 to 2030. Therefore, population aging, in place of O₃ air quality deterioration, will become the leading cause of future O₃-mortality rises during the coming decade.

Autogeddon or autoheaven: Environmental and social effects of the automotive industry from launch to present

The automotive industry is one of the most significant and increasing sources of pollution worldwide. Previous studies examining its impacts focus on the post-1950 era as data available before this period is scarce. This study carefully reconstructs six datasets from the early 20th century to 2019 for the UK: annual number of motor cars, road lengths, road fatalities, NOx and CO emissions, and fuel consumption. Interpolation was prudently used to fill gaps in the data sets. Results highlight changing health, social and environmental effects throughout the growth of the automotive sector. Ratios of fatalities to cars indicate social ingraining of the car and rapid response to legislation. Significant emissions resulted from the early industry. Successful remediation of emissions occurred in the late 20th century. All variables studied were interrelated, but expansion of road networks particularly contributed to a range of both positive and (unintended) negative consequences. World War 2 appears to have been a landmark for the automotive industry, producing capacity for mass production, personal mobility and research and therefore a struggle between impacts and social policies. We have demonstrated that technological developments and regulatory interventions relating to the motor industry, alongside events that have catalysed societal change, have been crucial in terms of subsequently providing benefits to society whilst also acting to mitigate (but not prevent) the adverse and frequently devastating impacts of motor vehicles on human health and the environment. A periodic, regular, overarching, independent review (~ every 5 years) of the collective positive and negative impacts of the motor vehicle industry and appropriate interventions are essential to maintain and improve social benefits and public and environmental health, as well as supporting delivery of the United Nations' Sustainable Development Goals by 2030 and beyond.

Spatiotemporal variation of PM2.5-related preterm birth in China and India during 1990-2019 and implications for emission controls

Preterm birth is the leading threat to neonatal health. The variation of PM_2.5-associated preterm birth in China and India from 1990 through 2019 was estimated in this study. Meanwhile, four mitigation scenarios were proposed, and the corresponding PM_2.5-related preterm birth was projected for 2030. Owing to differences in emission control policies and the effects of various factors (e.g., differences in population-control policies), the PM_2.5 concentration and PM_2.5-associated preterm birth in the two countries presented disparate spatiotemporal characteristics and variation trends during 1990-2019. The 30-year average of annual PM_2.5-associated preterm birth in India was 1018 (95% confidence interval, 718-1289) thousand, which was much larger than in China (280 [196-358] thousand). To fight air pollution, China launched several control strategies in the past two decades, and the nationwide maternal exposure risk dramatically decreased after 2010. In contrast, India's air-pollution control measures and policies have not effectively mitigated the nationwide PM_2.5 pollution. Under current mitigation measures and policies, the projected decrease in maternal exposure risk by 2030 is greater for China than India, and the scope for controlling air pollutant emissions and reducing maternal exposure risk is much large for India. The results of all four scenarios revealed that the annual PM_2.5-associated preterm birth in the two countries is likely to decrease in the future. In particular, if China and India implement more robust emission control strategies than those currently, the number of associated preterm birth is projected to be more than 50% lower in 2030 compared with 2019 rates.

Surface ozone pollution in China: Trends, exposure risks, and drivers

Introduction

Within the context of the yearly improvement of particulate matter (PM) pollution in Chinese cities, Surface ozone (O₃) concentrations are increasing instead of decreasing and are becoming the second most important air pollutant after PM. Long-term exposure to high concentrations of O₃ can have adverse effects on human health. In-depth investigation of the spatiotemporal patterns, exposure risks, and drivers of O₃ is relevant for assessing the future health burden of O₃ pollution and implementing air pollution control policies in China.

Methods

Based on high-resolution O₃ concentration reanalysis data, we investigated the spatial and temporal patterns, population exposure risks, and dominant drivers of O₃ pollution in China from 2013 to 2018 utilizing trend analysis methods, spatial clustering models, exposure-response functions, and multi-scale geographically weighted regression models (MGWR).

Results

The results show that the annual average O₃ concentration in China increased significantly at a rate of 1.84 μg/m³/year from 2013 to 2018 (160 μg/m³) in China increased from 1.2% in 2013 to 28.9% in 2018, and over 20,000 people suffered premature death from respiratory diseases attributed to O₃ exposure each year. Thus, the sustained increase in O₃ concentrations in China is an important factor contributing to the increasing threat to human health. Furthermore, the results of spatial regression models indicate that population, the share of secondary industry in GDP, NOx emissions, temperature, average wind speed, and relative humidity are important determinants of O₃ concentration variation and significant spatial differences are observed.

Discussion

The spatial differences of drivers result in the spatial heterogeneity of O₃ concentration and exposure risks in China. Therefore, the O₃ control policies adapted to various regions should be formulated in the future O₃ regulation process in China.

Tracking long-term population exposure risks to PM2.5 and ozone in urban agglomerations of China 2015-2021

China has experienced severe air pollution in the past decade, especially PM2.5 and emerging ozone pollution recently. In this study, we comprehensively analyzed long-term population exposure risks to PM2.5 and ozone in urban agglomerations of China during 2015-2021 regarding two-stage clean-air actions based on the Ministry of Ecology and the Environment (MEE) air monitoring network. Overall, the ratio of the population living in the regions exceeding the Chinese National Ambient Air Quality Standard (35 μg/m3) decreases by 29.9 % for PM2.5 from 2015 to 2021, driven by high proportions in the Middle Plain (MP, 42.3 %) and Lan-Xi (35.0 %) regions. However, this ratio almost remains unchanged for ozone and even increases by 1.5 % in the MP region. As expected, the improved air quality leads to 234.7 × 103 avoided premature mortality (ΔMort), mainly ascribed to the reduction in PM2.5 concentration. COVID-19 pandemic may influence the annual variation of PM2.5-related ΔMort as it affects the shape of the population exposure curve to become much steeper. Although all eleven urban agglomerations share stroke (43.6 %) and ischaemic heart disease (IHD, 30.1 %) as the two largest contributors to total ΔMort, cause-specific ΔMort is highly regional heterogeneous, in which ozone-related ΔMort is significantly higher (21 %) in the Tibet region than other urban agglomeration. Despite ozone-related ΔMort being one order of magnitude lower than PM2.5-related ΔMort from 2015 to 2021, ozone-related ΔMort is predicted to increase in major urban agglomerations initially along with a continuous decline for PM2.5-related ΔMort from 2020 to 2060, highlighting the importance of ozone control. Coordinated controls of PM2.5 and O3 are warranted for reducing health burdens in China during achieving carbon neutrality.

Assessing the contribution of open crop straw burning to ground-level ozone and associated health impacts in China and the effectiveness of straw burning bans

In recent years, ozone pollution in China has been shown to increase in frequency and persistence despite the concentrations of fine particulate matter (PM_2.5) decreasing steadily. Open crop straw burning (OCSB) activities are extensive in China and emit large amounts of trace gases during a short period that could lead to elevated ozone concentrations. This study addresses the impacts of OCSB emissions on ground-level ozone concentration and the associated health impact in China. Total VOCs and NOx emissions from OCSB in 2018 were 798.8 Gg and 80.6 Gg, respectively, with high emissions in Northeast China (31.7%) and North China (23.7%). Based on simulations conducted for 2018, OCSB emissions are estimated to contribute up to 0.95 µg/m³ increase in annual averaged maximum daily 8-hour (MDA8) ozone and up to 1.35 µg/m³ for the ozone season average. The significant impact of OCSB emissions on ozone is mainly characterized by localized and episodic (e.g., daily) changes in ozone concentration, up to 20 µg/m³ in North China and Yangtze River Delta region and even more in Northeast China during the burning season. With the implementation of straw burning bans, VOCs and NOx emissions from OCSB dropped substantially by 46.9%, particularly over YRD (76%) and North China (60%). Consequently, reduced OCSB emissions result in an overall decrease in annual averaged MDA8 ozone, and reductions in monthly MDA8 ozone could be over 10 µg/m³ in North China. The number of avoided premature death due to reduced OCSB emissions (considering both PM_2.5 and ozone) is estimated to be 6120 (95% Confidence Interval: 5320-6800), with most health benefits gained over east and central China. Our results illustrate the effectiveness of straw burning bans in reducing ozone concentrations at annual and national scales and the substantial ozone impacts from OCSB events at localized and episodic scales.

Ambient PM2.5 and O3 pollution and health impacts in Iranian megacity

The main objectives of this study were to (i) assess variation within fine particles (PM_2.5) and tropospheric ozone (O₃) time series in Khorramabad (Iran) between 2019 (before) and 2020 (during COVID-19 pandemic); (ii) assess relationship between PM_2.5 and O₃, the PM_2.5/O₃ ratio, and energy consumption; and (iii) estimate the health effects of exposure to ambient PM_2.5 and O₃. From hourly PM_2.5 and O₃ concentrations, we applied both linear-log and integrated exposure-response functions, city-specific relative risk, and baseline incidence values to estimate the health effects over time. A significant correlation was found between PM_2.5 and O₃ (r =-0.46 in 2019, r =-0.55 in 2020, p < 0.05). The number of premature deaths for all non-accidental causes (27.5 and 24.6), ischemic heart disease (7.3 and 6.3), chronic obstructive pulmonary disease (17 and 19.2), and lung cancer (9.2 and 6.25) attributed to ambient PM_2.5 exposure and for respiratory diseases (4.7 and 5.4) for exposure to O₃ above 10 µg m^-3 for people older than 30-year-old were obtained in 2019 and 2020. The number of years of life lost declined by 11.6% in 2020 and exposure to PM_2.5 reduced the life expectancy by 0.58 and 0.45 years, respectively in 2019 and 2020. Compared to 2019, the restrictive measures associated to COVID-19 pandemic led to reduction in PM_2.5 (-25.5%) and an increase of O₃ concentration (+ 8.0%) in Khorramabad.

Climate change and COVID-19: Interdisciplinary perspectives from two global crises

The repercussions of the COVID-19 pandemic and climate change - two major current global crises - are far-reaching, the parallels between the two are striking, and their influence on one another are significant. Based on the wealth of evidence that has emerged from the scientific literature during the first two years of the pandemic, this study argues that these two global crises require holistic multisectoral mitigation strategies. Despite being different in nature, neither crisis can be effectively mitigated without considering their interdependencies. Herein, significant interactions between these two crises are highlighted and discussed. Major implications related to the economy, energy, technology, environment, food systems and agriculture sector, health systems, policy, management, and communities are detailed via a review of existing joint literature. Based on these outcomes, practical recommendations for future research and management are provided. While the joint timing of these crises has created a global conundrum, the COVID-19 pandemic has demonstrated opportunities and lessons for devising sustainable recovery plans in relation to the climate crisis. The findings indicated that governments should work collaboratively to develop durable and adjustable strategies in line with long-term, global decarbonisation targets, promote renewable energy resources, integrate climate change into environmental policies, prioritise climate-smart agriculture and local food systems, and ensure public and ecosystem health. Further, differences in geographic distributions of climate change and COVID-19 related death cases revealed that these crises pose different threats to different parts of the world. These learnings provide insights to address the climate emergency - and potential future global problems with similar characteristics - if international countries act urgently and collectively.

Observed sensitivities of PM2.5 and O3 extremes to meteorological conditions in China and implications for the future

Frequent extreme air pollution episodes in China accompanied with high concentrations of particulate matters (PM2.5) and ozone (O3) are partly supported by meteorological conditions. However, the relationships between meteorological variables and pollution extremes can be poorly estimated solely based on mean pollutant level. In this study, we use quantile regression to investigate meteorological sensitivities of PM2.5 and O3 extremes, benefiting from nationwide observations of air pollutants over 2013-2019 in China. Results show that surface winds and humidity are identified as key drivers for high PM2.5 events during both summer and winter, with greater sensitivities at higher percentiles. Higher humidity favors the hydroscopic growth of particles during winter, but it tends to decrease PM2.5 through wet scavenging during summer. Surface temperature play dominant role in summer O3 extremes, especially in VOC-limited regime, followed by surface winds and radiation. Sensitivities of O3 to meteorological conditions are relatively unchanging across percentiles. Under the fossil-fueled development pathway (SSP5-8.5) scenario, meteorological conditions are projected to favor winter PM2.5 extremes in North China Plain (NCP), Yangtze River Delta (YRD) and Sichuan Basin (SCB), mainly due to enhanced surface specific humidity. Summer O3 extremes are likely to occur more frequently in the NCP and YRD, associated with warmer temperature and stronger solar radiation. Besides, meteorological conditions over a relatively longer period play a more important role in the formation of pollution extremes. These results improve our understanding of the relationships between extreme PM2.5 and O3 pollution and meteorology, and can be used as a valuable reference of model predicted air pollution extremes.

Analysis of the meteorological factors affecting the short-term increase in O3 concentrations in nine global cities during COVID-19

Surface ozone (O₃) is a major air pollutant around the world. This study investigated O₃ concentrations in nine cities during the Coronavirus disease 2019 (COVID-19) lockdown phases. A statistical model, named Generalized Additive Model (GAM), was also developed to assess different meteorological factors, estimate daily O₃ release during COVID-19 lockdown and determine the relationship between the two. We found that: (1) Daily O₃ significantly increased in all selected cities during the COVID-19 lockdown, presenting relative increases from -5.7% (in São Paulo) to 58.9% (in Guangzhou), with respect to the average value for the same period in the previous five years. (2) In the GAM model, the adjusted coefficient of determination (R²) ranged from 0.48 (Sao Paulo) to 0.84 (Rome), and it captured 51-85% of daily O₃ variations. (3) Analyzing the expected O₃ concentrations during the lockdown, using GAM fed by meteorological data, showed that O₃ anomalies were dominantly controlled by meteorology. (4) The relevance of different meteorological variables depended on the cities. The positive O₃ anomalies in Beijing, Wuhan, Guangzhou, and Delhi were mostly associated with low relative humidity and elevated maximum temperature. Low wind speed, elevated maximum temperature, and low relative humidity were the leading meteorological factors for O₃ anomalies in London, Paris, and Rome. The two other cities had different leading factor combinations.

Trends and characteristics of ozone and nitrogen dioxide related health impacts in Chinese cities

Ambient ozone pollution has been becoming severe and attributed to considerable health impacts in China. Nitrogen dioxide (NO₂) is involved in atmospheric ozone production while also affecting public health directly. Joint control ozone and NO₂ pollution would be of significance. This study quantitatively assessed the health impact attributed to ambient ozone and NO₂ pollution in 338 Chinese cities from 2015 to 2020. The results reveal the generally opposite trends of ozone- and NO₂-related health impacts in China. From 2015-2020, respiratory and chronic obstructive pulmonary disease (COPD) health impacts attributed to ozone in 338 cities increased by 65.30% and 63.98%. The NO₂-attributed health impacts decreased by 24.80% and 24.62%. In 2020, the ozone- and NO₂-related respiratory health impacts were 3.96 million DALYs (disability-adjusted life years) and 1.47 million DALYs. High health impacts are concentrated in big cities and city clusters. In 2020, the sum of ozone- and NO₂-related respiratory health impacts in the top 20 cities was 0.98 million DALYs and 0.44 million DALYs, accounting for 24.70% and 30.24% of the 338 cities. The population attribution fraction analysis identified the increasing distributional consistency of ozone and NO₂-related health impacts, emphasizing the necessity and possible efficiency of ozone-NO₂ joint control. Emission source analysis based on gridded data provided a reference for understanding health impacts and developing targeted strategies.

Hourly Seamless Surface O3 Estimates by Integrating the Chemical Transport and Machine Learning Models in the Beijing-Tianjin-Hebei Region

Surface ozone (O3) is an important atmospheric trace gas, posing an enormous threat to ecological security and human health. Currently, the core objective of air pollution control in China is to realize the joint treatment of fine particulate matter (PM2.5) and O3. However, high-accuracy near-surface O3 maps remain lacking. Therefore, we established a new model to determine the full-coverage hourly O3 concentration with the WRF-Chem and random forest (RF) models combined with anthropogenic emission data and meteorological datasets. Based on this method, choosing the Beijing-Tianjin-Hebei (BTH) region in 2018 as an example, full-coverage hourly O3 maps were generated at a horizontal resolution of 9 km. The performance evaluation results indicated that the new model is reliable with a sample (station)-based 10-fold cross-validation (10-CV) R2 value of 0.94 (0.90) and root mean square error (RMSE) of 14.58 (19.18) µg m−3. In addition, the estimated O3 concentration is accurately determined at varying temporal scales with sample-based 10-CV R2 values of 0.96, 0.98 and 0.98 at the daily, monthly, and seasonal scales, respectively, which is highly superior to traditional derivation algorithms and other techniques in previous studies. An initial increase and subsequent decrease, which constitute the diurnal variation in the O3 concentration associated with temperature and solar radiation variations, were captured. The highest concentration reached approximately 112.73 ± 9.65 μg m−3 at 15:00 local time (1500 LT) in the BTH region. Summertime O3 posed a high pollution risk across the whole BTH region, especially in southern cities, and the pollution duration accounted for more than 50% of the summer season. Additionally, 43 and two days exhibited light and moderate O3 pollution, respectively, across the BTH region in 2018. Overall, the new method can be beneficial for near-surface O3 estimation with a high spatiotemporal resolution, which can be valuable for research in related fields.

[Angiotensin-converting enzyme 2 particapates in ozone-induced lung inflammation and airway remodeling in mice]

OBJECTIVE

To investigate the roles of angiotensin-converting enzyme 2 (ACE2) in ozone-induced pulmonary inflammation and airway remodeling in mice.

METHODS

Sixteen wild-type (WT) C57BL/6J mice and 16 ACE2 knock-out (KO) mice were exposed to either filtered air or ozone (0.8 ppm) for 3 h per day for 5 consecutive days. Masson's staining and HE staining were used to observe lung pathologies. Bronchoalveolar lavage fluid (BALF) was collected and the total cell count was determined. The total proteins and cytokines in BALF were determined by BCA and ELISA method. The transcription levels of airway remodeling-related indicators in the lung tissues were detected using real-time quantitative PCR. The airway resistance of the mice was measured using a small animal ventilator with methacholine stimulation.

RESULTS

Following ozoneexposure ACE2 KO mice had significantly higher lung pathological scores than WT mice (P < 0.05). Masson staining results showed that compared with ozone-exposed WT mice, ozone-exposed ACE2 KO mice presented with significantly larger area of collagen deposition in the bronchi [(19.62±3.16)% vs (6.49±1.34)%, P < 0.05] and alveoli [(21.63±3.78)% vs (4.44±0.99)%, P < 0.05]. The total cell count and total protein contents in the BALF were both higher in ozone-exposed ACE2 KO mice than in WT mice, but these differences were not statistically significant (P > 0.05). The concentrations of IL-6, IL-1β, TNF-α, CXCL1/KC and MCP-1 in the BALF were all higher in ozone-exposed ACE2 KO mice than in ozone-exposed WT mice, but only the difference in IL-1β was statistically significant (P < 0.05). The transcription levels of MMP-9, MMP-13, TIMP 4, COL1A1, and TGF-β in the lung tissues were all significantly higher in ozone-exposed ACE2 KO mice (P < 0.01). No significant difference was found in airway resistance between ozone-exposed ACE KO mice and WT mice after challenge with 0, 10, 25, or 100 mg/mL of methacholine.

CONCLUSION

ACE2 participates in ozone-induced lung inflammation and airway remodeling in mice.

Tracking PM2.5 and O3 Pollution and the Related Health Burden in China 2013-2020

Based on the exposure data sets from the Tracking Air Pollution in China (TAP, http://tapdata.org.cn/), we characterized the spatiotemporal variations in PM_2.5 and O₃ exposures and quantified the long- and short-term exposure related premature deaths during 2013-2020 with respect to the two-stage clean air actions (2013-2017 and 2018-2020). We find a 48% decrease in national PM_2.5 exposure during 2013-2020, although the decrease rate has slowed after 2017. At the same time, O₃ pollution worsened, with the average April-September O₃ exposure increased by 17%. The improved air quality led to 308 thousand and 16 thousand avoided long- and short-term exposure related deaths, respectively, in 2020 compared to the 2013 level, which was majorly attributed to the reduction in ambient PM_2.5 concentration. It is also noticed that with smaller PM_2.5 reduction, the avoided long-term exposure associated deaths in 2017-2020 (13%) was greater than that in 2013-2017 (9%), because the exposure-response curve is nonlinear. As a result of the efforts in reducing PM_2.5-polluted days with the daily average PM_2.5 higher than 75 μg/m³ and the considerable increase in O₃-polluted days with the daily maximum 8 h average O₃ higher than 160 μg/m³, deaths attributable to the short-term O₃ exposure were greater than those due to PM_2.5 exposure since 2018. Future air quality improvement strategies for the coordinated control of PM_2.5 and O₃ are urgently needed.

Drivers of 2013-2020 ozone trends in the Sichuan Basin, China: Impacts of meteorology and precursor emission changes

The Sichuan Basin (SCB) of China is known for excessive ozone (O₃) pollution owing to high anthropogenic emissions combined with terrain-induced poor ventilation and weak wind fields against the surrounding mountains. While O₃ pollution has emerged as a prominent concern in southwestern China yet variations in O₃ levels during 2013-2020 are still unclear and the dominant factor in explaining the long-term O₃ trend throughout the SCB remains elusive due to uncertainties in emission inventory and variability associated with meteorological conditions. Here, we use extensive basin-wide ambient measurements to examine the spatial pattern and trend of O₃ and leverage OMI and TROPOMI satellites in conjunction with MEIC emission inventory to track emission changes. Sensitivity simulations are conducted by using WRF-CMAQ model to investigate the impacts of meteorological variability and emission changes on O₃ changes over 2013-2020. O₃ concentrations exhibit obvious interannual increases during 2013-2019 and a slight decrease in 2020. Both decreases in the MEIC emission inventory (-2.9% yr^-1) and OMI NO₂ column density (-3.1% yr^-1) reflects the declining trend in NO_x emissions over 2013-2020, while anthropogenic VOCs were not adequately regulated during 2013-2017, which explained the majority of deteriorated O₃ pollution from 2013 to 2017. Furthermore, attribution analysis based on CMAQ simulations indicate that the unexpected aggravated O₃ levels in 2019 is not only modulated by disproportional reductions in VOCs and NO_x emissions, but also associated with unfavorable meteorological conditions featured by profound heatwaves and frequent stagnant conditions. In 2020, the abnormal meteorological conditions in May leads to substantial increase of O₃ by 26.8 μg m^-3 as compared to May 2019, while the considerable enhancement was fully offset by low O₃ levels over the whole period which attributes to substantial emission reductions. This study reveals the long-term trend of O₃ levels and precursor emissions and highlights the effects of meteorological variability and emission changes on O₃ pollution over the SCB, with strong implications for designing effective O₃ control measures.

Quantifying ecological and health risks of ground-level O3 across China during the implementation of the "Three-year Action Plan for Cleaner Air"

After China implemented the Air Pollution Prevention and Control Action Plan (APPCAP), PM_2.5 concentrations decreased but were still higher than national standards in major areas and ozone (O₃) concentration increased unintentionally. To further decrease PM_2.5 concentrations and reduce days with severe air pollution, the government promulgated the "Three-year (2018-2020) Action Plan for Cleaner Air" (the Three-year Action Plan) in 2018. During the three-year Action Plan, a few studies reported a continuous decline in PM_2.5, but it is unclear whether O₃ and its effects also increase with the decrease of PM_2.5 like during APPCAP. In this study, for the first time, we systematically assessed changes in ground-level O₃ concentrations and related ecological and health risks during the period of the Three-year Action Plan using nationwide O₃ measurements. The national MDA8, Exceedance, and SOMO35 indicators were reduced by 3.8%, 28.5%, and 12.6%, respectively, ecological risk indicators of M12, M7, SUM06, AOT40, and W126 were reduced by 5.4%, 5.6%, 19.5%, 15.4%, and 18.6%, respectively, from 2018 to 2020. Spatially, the greatest reduction in all the indicators except MDA8 occurred in Pearl River Delta, followed by Fen Wei Plains, while Beijing-Tianjin-Hebei, Chengdu-Chongqing, and Yangtze River Delta presented relatively small reductions. Between 2018 and 2020, the production losses caused by O₃ for wheat and rice decreased by 21.4% and 17.6%, respectively. Long-term exposure to O₃ across China over 2020 was estimated to cause about 160,795 (95% CI: 81,515-312,983) for all-cause mortality, 107,128 (95% CI: 36,703-173,823) for cardiovascular mortality, and 34,444 (95% CI: 0-72,609) for respiratory mortality, indicating decreases of 9.93%, 9.86%, and 9.78%, respectively, compared to the year 2018. Taken together, our results provided the first direct evidence for China's efforts to control O₃ pollution in recent years.

An intercomparison of ozone taken from the Copernicus atmosphere monitoring service and the second Modern-Era retrospective analysis for research and applications over China during 2018 and 2019

Spatiotemporal variations of ozone (O₃) taken from the Copernicus Atmosphere Monitoring Service (CAMS) and the second Modern-Era Retrospective Analysis for Research and Applications (MERRA-2) were intercompared and evaluated with ground and ozone-sonde observations over China in 2018 and 2019. Intercomparison of the surface ozone from CAMS and MERRA-2 reanalysis showed significant negative bias (CAMS minus MERRA-2, same below) at Tibetan Plateau of up to 80 µg/m³, and the average R² was about 0.6 across China. Evaluated with the ground observations from China National Environmental Monitoring Center (CNEMC), we found that CAMS and MERRA-2 reanalysis were capable of capturing the key patterns of monthly and diurnal variations of surface ozone over China except for the western region, and MERRA-2 overestimated the observations compared to CAMS. Vertically, the CAMS profiles overestimated the ozone-sonde from the World Ozone and Ultraviolet Radiation Data Center (WOUDC) above 200 hPa with the magnitude reaching up to 150 µg/m³, while little bias was found between the reanalysis and observations below 200 hPa. Intercomparison drawn from the vertical distribution between CAMS and MERRA-2 reanalysis showed that the negative bias appeared throughout the troposphere over China, while the positive bias emerged in the upper troposphere and lower stratosphere (UTLS) with high order of magnitude exceeding 100 µg/m³, indicating large uncertainties at higher altitudes. In summary, we concluded that CAMS reanalysis showed better agreement with the observations in contrast to MERRA-2, and the large discrepancy especially at higher altitudes between these two reanalysis datasets could not be ignored.

Development of high-resolution spatio-temporal models for ambient air pollution in a metropolitan area of China from 2013 to 2019

Modeling high-resolution air pollution concentrations is essential to accurately assess exposure for population studies. The aim of this study is to establish an advanced exposure model to predict spatiotemporal changes in fine particulate matter (PM_2.5), nitrogen dioxides (NO₂), and ozone (O₃) concentrations in Shanghai, China. The model is constructed on a geo-statistical modeling framework that incorporates a dimension reduction regression approach and a spatial smoothing function to deal with fine-scale exposure variations. We used a dataset with comprehensive observational and predictor variables that included monitoring data from both national and local agencies from 2013 to 2019, a high-resolution geographical dataset of predictor variables, and a full-coverage weekly satellite data of the aerosol optical depth at a 1 × 1 km² resolution. Our model performed well in terms of the spatial and temporal prediction ability assessed by cross-validation (CV) for PM_2.5 (spatial R² = 0.89, temporal R² = 0.91), NO₂ (R² = 0.49, 0.78), and O₃ (R² = 0.67, 0.81) at the national monitors over seven years according to the leave-one-out CV. For the predictions at the local agency monitoring stations, the overall CV R² was between 0.77 and 0.89 across the air pollutants. We visualized the long-term and seasonal averaged predictions of the PM_2.5, NO_2, and O₃ exposure on maps with a spatial resolution of 100 × 100 m². Our study provides a useful tool to accurately estimate air pollution exposure with high spatial and temporal resolution at the urban scale. These model predictions will be useful to assess both short-term and long-term air pollution exposure for health studies.

Reductions in crop yields across China from elevated ozone

Exposure of crops to high concentrations of ozone can cause substantial reductions in yield that pose a serious threat to global food security. Here we provide comprehensive estimates of yield losses for key crops across China between 2014 and 2017 attributed to ozone using a number of new approaches. We use an air quality model at 5 km resolution and crop-specific dose-response functions developed for both concentration- and flux-based metrics. We bias correct modelled ozone concentrations and metrics using observations from more than 1000 locations. We find that on a 4-year average basis, production losses of key crops are 34-91 million metric tonnes (Mt/yr), dependent on the approach used, with highest losses in Henan province. At a national level, loss of winter wheat production derived using a China-specific dose-response function increased by 82% from 2014 to 2017, with large interannual variations in the North China Plain and in eastern China. Winter wheat losses estimated using flux-based functions, which require robust simulation of stomatal conductance and underlying vegetation physiology, are significantly lower, at 30 Mt/yr. We show that the definition of the growing season may have a greater impact on estimated losses than small biases in ozone surface concentrations. Although uncertainties remain, our findings demonstrate that increasing ozone concentrations have substantial adverse impacts on crop yields and threaten food security in China. It is important to control ozone concentrations to mitigate these negative impacts.

Mimicking atmospheric photochemical modelling with a deep neural network

Fast and accurate prediction of ambient ozone (O₃) formed from atmospheric photochemical processes is crucial for designing effective O₃ pollution control strategies in the context of climate change. The chemical transport model (CTM) is the fundamental tool for O₃ prediction and policy design, however, existing CTM-based approaches are computationally expensive, and resource burdens limit their usage and effectiveness in air quality management. Here we proposed a novel method (noted as DeepCTM) that using deep learning to mimic CTM simulations to improve the computational efficiency of photochemical modeling. The well-trained DeepCTM successfully reproduces CTM-simulated O₃ concentration using input features of precursor emissions, meteorological factors, and initial conditions. The advantage of the DeepCTM is its high efficiency in identifying the dominant contributors to O₃ formation and quantifying the O₃ response to variations in emissions and meteorology. The emission-meteorology-concentration linkages implied by the DeepCTM are consistent with known mechanisms of atmospheric chemistry, indicating that the DeepCTM is also scientifically reasonable. The DeepCTM application in China suggests that O₃ concentrations are strongly influenced by the initialized O₃ concentration, as well as emission and meteorological factors during daytime when O₃ is formed photochemically. The variation of meteorological factors such as short-wave radiation can also significantly modulate the O₃ chemistry. The DeepCTM developed in this study exhibits great potential for efficiently representing the complex atmospheric system and can provide policymakers with urgently needed information for designing effective control strategies to mitigate O₃ pollution.

Assessing the health impacts attributable to PM2.5 and ozone pollution in 338 Chinese cities from 2015 to 2020

China has effectively reduced the fine particulate (PM_2.5) pollution from 2015 to 2020. Ozone pollution and related health impacts have become severe contemporaneously. The coordinated control of PM_2.5 and ozone is becoming a new issue for China's air pollution control. This study quantitatively assessed the health impacts attributed to PM_2.5 and ozone pollution in 338 Chinese cities from 2015 to 2020 and estimated the possible health benefits from achieving dual concentration targets during 2021-2025. Results show PM_2.5 caused a total health impact of 2.45 × 10⁷ disability-adjusted life years (DALYs) in 2020. All-cause and respiratory ozone-related health impact in 2020 was 1.04 × 10⁷ DALYs and 1.56 × 10⁶ DALYs. Between 2015 and 2020, the PM_2.5-related health impacts decreased by 14.97%, while those ozone-related increased by 94.61% and 96.54% for all-cause and respiratory. Cities in the North China Plain have suffered higher health impacts attributable to PM_2.5 and ozone pollution, indicating that the two-pollutant coordinated control is primarily needed. By achieving aggressive concentration target (decreasing 10%) between 2020 and 2025, China will reduce the PM_2.5-related health impacts in 338 cities by 1.56 × 10⁶ DALYs (improving 6.37%). By achieving general target (decreasing 10% or within the Interim target-1 of World Health Organization), the PM_2.5-related health benefit will be 7.98 × 10⁵ DALYs (improving 3.25%). The deteriorating ozone health risks will also be improved. Controlling air pollution in large cities and regional center cities can achieve remarkable health benefits. Due to the inter-region, inter-province, and inter-city difference of health impacts, targeted and differentiated pollution prevention and control need to be implemented.

Effects of using different exposure data to estimate changes in premature mortality attributable to PM2.5 and O3 in China

The assessment of premature mortality associated with the dramatic changes in fine particulate matter (PM_2.5) and ozone (O₃) has important scientific significance and provides valuable information for future emission control strategies. Exposure data are particularly vital but may cause great uncertainty in health burden assessments. This study, for the first time, used six methods to generate the concentration data of PM_2.5 and O₃ in China between 2014 and 2018, and then quantified the changes in premature mortality due to PM_2.5 and O₃ using the Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. The results show that PM_2.5-related premature mortality in China decreases by 263 (95% confidence interval (CI95): 142-159) to 308 (CI95: 213-241) thousands from 2014 to 2018 by using different concentration data, while O₃-related premature mortality increases by 67 (CI95: 26-104) to 103 (CI95: 40-163) thousands. The estimated mean changes are up to 40% different for the PM_2.5-related mortality, and up to 30% for the O₃-related mortality if different exposure data are chosen. The most significant difference due to the exposure data is found in the areas with a population density of around 10³ people/km², mostly located in Central China, for both PM_2.5 and O₃. Our results demonstrate that the exposure data source significantly affects mortality estimations and should thus be carefully considered in health burden assessments.

Spatiotemporal assessment of health burden and economic losses attributable to short-term exposure to ground-level ozone during 2015-2018 in China

BACKGROUND

Ground-level ozone (O3) pollution is currently the one of the severe environmental problems in China. Although existing studies have quantified the O3-related health impact and economic loss, few have focused on the acute health effects of short-term exposure to O3 and have been limited to a single temporal and spatial dimension.

METHODS

Based on the O3 concentration obtained from ground monitoring networks in 334 Chinese cities in 2015-2018, this study used a two-stage exposure parameter weighted Log-linear exposure-response function to estimate the cause-specific mortality for short-term exposure to O3.

RESULTS

The value of statistical life (VSL) method that were used to calculate the economic loss at the city-level. Our results show that in China, the national all-cause mortality attributed to O3 was 0.27(95% CI: 0.14-0.55) to 0.39 (95% CI: 0.20-0.67) million across 2015-2018. The estimated economic loss caused by O3 was 387.76 (95% CI: 195.99-904.50) to 594.08 (95% CI: 303.34-1140.65) billion CNY, accounting for 0.52 to 0.69% of total reported GDP. Overall, the O3 attributed health and economic burden has begun to decline in China since 2017. However, highly polluted areas still face severe burden, and undeveloped areas suffer from high GDP losses.

CONCLUSIONS

There are substantial health impacts and economic losses related to short-term O3 exposure in China. The government should pay attention to the emerging ozone pollution, and continue to strengthen the intervention in traditional priority areas while solving the pollution problem in non-priority areas.

Origin of regional springtime ozone episodes in the Sichuan Basin, China: Role of synoptic forcing and regional transport

The Sichuan Basin (SCB) located in southwestern China has long been considered the most polluted city cluster with exposure to unhealthy levels of ozone (O₃) at times. However, the features of O₃ regional transport and source contributions in SCB are poorly understood. In this study, ambient measurements, ERA5 reanalysis dataset, IASI O₃ column, and the Weather Research and Forecasting-Community Multiscale Air Quality (WRF-CMAQ) modeling system coupled with the Integrated Source Apportionment Method (ISAM) module were used to investigate the formation mechanism and sources of a severe O₃ episode in spring 2020 over the SCB. In the first stage of the O₃ episode, a high-pressure system persisted over the western SCB and caused northeasterly wind fields, leading to enhanced regional transport from the northern boundary with the O₃ contribution from the boundary exceeding 50% across the SCB. As the synoptic pattern evolved, southeasterly winds dominated the SCB and the stagnant zone over the Chengdu Plain confined O₃ originating from the southern SCB and Chongqing city, leading to the accumulation of precursors and elevated O₃ levels. During the O₃ episode, transportation and industrial sources were major contributors to O₃ formation especially for the Chengdu Plain and Chongqing city. In addition, the O₃-rich air mass in the nocturnal residual layer that formed over Chongqing city was transported to the Chengdu Plain through southeastern corridor at 400-1600m above ground-level under the prevailing southeasterly winds. With sunrise and the development of the atmospheric boundary layer, the O₃-rich air mass in the residual layer (RL) was entrained to the ground-level via vertical mixing, which further enhanced O₃ pollution across the Chengdu Plain. Our results revealed the mechanism of regional transport via northeastern and southeastern corridors during an O₃ episode and demonstrated the need for joint emission regulation across the SCB to mitigate O₃ pollution.

Assessing the potential of unmanned aerial vehicle spraying of aqueous ozone as an outdoor disinfectant for SARS-CoV-2

The COVID-19 pandemic has revealed gaps in our understanding of safe, effective and efficient means of disinfecting high use public spaces. Whilst this creates an opportunity for development and application of innovative approaches such as unmanned aerial vehicle (UAV) based disinfection, unregulated outdoor disinfection using chlorine has led to environmental and public health risks. This study has quantified the efficiency, safety and efficacy of UAV-based spraying of aqueous ozone. Optimised UAV flight characteristics of 4.7 km/h at 1.7 m elevation spraying 2.4 L/min were able to provide >97% and >92% coverage of a 1 m and 2 m wide swath respectively. During spraying operations using 1 mg/L aqueous ozone, atmospheric concentrations of ozone remained within background levels (<0.04 ppm). Highly efficient inactivation of two different isolates of SARS-CoV-2 virus was achieved at aqueous ozone concentrations of 0.75 mg/L after an incubation period of only 5 min, with 0.375 mg/L achieving 82-91.5% inactivation in this time. Exposure of diamondback moth larvae and parasitic wasps to 1 mg/L aqueous ozone did not significantly affect their survivorship. These results indicate for the first time that aqueous ozone may provide the required balance between human and environmental safety and viral inactivation efficacy for targeted application in high risk outdoor settings.