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Journal Article Ppublish 13 citations

PubMed: 38553030 DOI: 10.1093/ije/dyae035

Warm season ambient ozone and children's health in the USA.

Int J Epidemiol 53(2)

Authors: Jennifer D Stowell, Yuantong Sun, Emma L Gause, Keith R Spangler, Joel Schwartz, Aaron Bernstein, Gregory A Wellenius, Amruta Nori-Sarma

Affiliations

  • Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
  • Department of Environmental Health, Harvard TH Chan School of Public Health Boston, MA, USA.
  • Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.

Abstract

BACKGROUND

Over 120 million people in the USA live in areas with unsafe ozone (O3) levels. Studies among adults have linked exposure to worse lung function and higher risk of asthma and chronic obstructive pulmonary disease (COPD). However, few studies have examined the effects of O3 in children, and existing studies are limited in terms of their geographic scope or outcomes considered.

METHODS

We leveraged a dataset of encounters at 42 US children's hospitals from 2004-2015. We used a one-stage case-crossover design to quantify the association between daily maximum 8-hour O3 in the county in which the hospital is located and risk of emergency department (ED) visits for any cause and for respiratory disorders, asthma, respiratory infections, allergies and ear disorders.

RESULTS

Approximately 28 million visits were available during this period. Per 10 ppb increase, warm-season (May through September) O3 levels over the past three days were associated with higher risk of ED visits for all causes (risk ratio [RR]: 0.3% [95% confidence interval (CI): 0.2%, 0.4%]), allergies (4.1% [2.5%, 5.7%]), ear disorders (0.8% [0.3%, 1.3%]) and asthma (1.3% [0.8%, 1.9%]). When restricting to levels below the current regulatory standard (70 ppb), O3 was still associated with risk of ED visits for all-cause, allergies, ear disorders and asthma. Stratified analyses suggest that the risk of O3-related all-cause ED visits may be higher in older children.

CONCLUSIONS

Results from this national study extend prior research on the impacts of daily O3 on children's health and reinforce the presence of important adverse health impacts even at levels below the current regulatory standard in the USA.

MeSH

Epidemiology, Hypersensitivity, Pulmonary Disease, Chronic Obstructive, Child Health, Asthma, Emergency Service, Hospital, Child

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