Temporal and spatial evolution of short-term exposure to ozone pollution: Its health impacts in China based on a meta-analysis

Increased ozone pollution has greatly negative impact on human health. This study aimed to update evidence on the effects of short-term ozone exposure on three major health endpoints in China: all-cause, cardiovascular and respiratory mortality. The specific epidemiological study in a single city or a typical region cannot fully describe the health risk of ozone pollution all over China. Therefore, this study used the results (relative risks) from a meta-analysis based on the epidemiological studies conducted in China for quantitative health burden analysis from 2014 to 2020. In 2013-2017, the implementation of the Air Pollution Prevention and Control Action Plan policy responsible for the increase of ozone concentration during the warm season (i.e., April-September) from 157.9 +/- 43.9 mu gm(-3) to 172.8 +/- 32.3 mu gm(-3). Whereas during the implementation of the Three-Year Action Plan for Blue Sky Defense War (2018-2020) policy, ozone concentration decreased and its value was 157.8 +/- 26.2 mu g m(-3) in 2020. In this study, we found that the premature mortality attributable to short-term exposure to the 4th highest annual daily maximum 8 h ozone concentration in 2020 that was equal to 218.9 (95% CI: 187.3, 255.2), 136.4 (95% CI: 116.5, 154.0) and 24.4 (95% CI: 15.3, 33.3) thousand, increased by 8.73%, 10.40%, and 3.27%, for all-cause, cardiovascular, and respiratory mortality, respectively compared to 2014. At the province-level, Shandong province has the highest number of all-cause mortalities, accounting for 9.42% in 2020, followed by Henan (7.54%), Hebei (7.52%), Guangdong (6.39%) and Jiangsu (6.30%). This study presents a robust assessment based upon a meta-analysis and further provides important insights into new public health research fields. These results of this study provide a scientific reference for optimizing the division of air pollution prevention and control areas and the design of pollutant emission reduction strategies at different time periods.

Automated summary

Increased ozone pollution has had a significant negative impact on human health in China. Short-term exposure to ozone has led to an increase in all-cause, cardiovascular, and respiratory mortality. The study also identified regional differences, with Shandong province having the highest number of deaths.