Journal of Asthma and Allergy (Sep 2023)
Ozone Pollution and Acute Exacerbation of Asthma in Residents of China: An Ecological Study
Abstract
Yunlei Ma,1 Hanjun Zhao,2 Yinghao Su1 1Department of Respiratory Medicine, Traditional Chinese Medicine Hospital of Hebei Province, Shijiazhuang, People’s Republic of China; 2Department of Respiratory Medicine, Fourth Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of ChinaCorrespondence: Yinghao Su, Department of Respiratory Medicine, Traditional Chinese Medicine Hospital of Hebei Province, 389 Zhongshan Road, Shijiazhuang, 050017, People’s Republic of China, Tel/Fax +86-13785143851, Email [email protected]: 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.Keywords: ozone, asthma exacerbation, PDLM, GAM, interaction
