Measurement-based assessment of health burdens from long-term ozone exposure in the United States, Europe, and China

Christopher Malley, Karl Seltzer, Drew Shindell

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Long-term ozone (O3) exposure estimates from chemical transport models are frequently paired with
exposure-response relationships from epidemiological studies to estimate associated health burdens.
Impact estimates using such methods can include biases from model-derived exposure estimates. We
use data solely from dense ground-based monitoring networks in the United States, Europe, and
China for 2015 to estimate long-term O3 exposure and calculate premature respiratory mortality using
exposure-response relationships derived from two separate analyses of the American Cancer Society
Cancer Prevention Study-II(ACS CPS-II) cohort. Using results from the larger, extended ACS CPS-II
study, 34 000 (95% CI: 24, 44 thousand), 32 000 (95% CI: 22, 41 thousand), and 200 000 (95% CI: 140,
253 thousand) premature respiratory mortalities are attributable to long-term O3 exposure in the
USA, Europe and China, respectively, in 2015. Results are approximately 32%–50% lower when using
an older analysis of the ACS CPS-II cohort. Both sets of results are lower(∼20%–60%) on a region-byregion
basis than analogous prior studies based solely on modeled O3, due in large part to the fact that
the latter tends to be high biased in estimating exposure. This study highlights the utility of dense
observation networks in estimating exposure to long-term O3 exposure and provides an observational
constraint on subsequent health burdens for three regions of the world. In addition, these results
demonstrate how small biases in modeled results of long-term O3 exposure can amplify estimated
health impacts due to nonlinear exposure-response curves.
Original languageEnglish
Article number104018
JournalEnvironmental Research Letters
Publication statusPublished - 11 Oct 2018

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© 2018 The Author(s). Published by IOP Publishing Ltd.

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