Journal Article Ppublish 2 citations
PubMed: 40169077 DOI: 10.1016/j.jare.2025.03.044
Loss of life expectancy attributed to long-term ozone exposure in Chinese older adults: Cross-cohort analysis from 3 national cohorts.
J Adv Res 74:531-540
Authors: Minjin Peng, Yang Yuan, Haitong Zhe Sun, Jing Wu, Lifeng Zhu, Yi Zeng, Yunquan Zhang, Yao Yao
Affiliations
- Department of Outpatient, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China.
- Shenzhen Bao'an District Songgang People's Hospital, Shenzhen 518100, China; School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117609 Singapore.
- Center for Healthy Aging Transdisciplinary Sciences, China Center for Health Development Studies, Peking University, Beijing, China.
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, USA.
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
- Center for Healthy Aging Transdisciplinary Sciences, China Center for Health Development Studies, Peking University, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodelling, Peking University, Beijing, China; Key Laboratory of Major Disease Epidemiology under the Ministry of Education of China (Peking University).
Abstract
BACKGROUND
Cohort evidence linking ozone (O 3) exposure with mortality was sparsely investigated among the elderly in low- and middle-income countries. This study aims to quantify mortality risk and burden attributed to chronic O 3 exposure in Chinese older adults.
METHODS
A total of 30,874 older adults aged ≥65 years were recruited from 3 national dynamic cohorts across 29 provincial regions in China, 2005-2018. Annual warm-season (April-September) O 3 and year-round PM 2.5 concentrations were estimated through well-validated satellite-based spatiotemporal models and were assigned to participants for each survey year. Time-dependent Fragility Cox models with random intercept for study cohort were employed to quantify O 3-mortality association, adjusting for demographic, behavioral, health, and environmental covariates. A counterfactual causal framework was used for assessment of O 3-attributable premature deaths in older adults based on exposure-response relationship derived from multi-cohort two-pollutant analysis (+PM 2.5). Years of life lost and loss of life expectancy were subsequently evaluated based on the burden estimation model by incorporating the comparative risk assessment method and reference life tables.
RESULTS
16,939 death events occurred during 0.16 million person-years of follow-up surveys. Each 10-ppb increase in O 3 exposure was linked with a hazard ratio of 1.076 (95% confidence interval [CI]: 1.050, 1.102) for all-cause mortality. By achieving the counterfactual target (WHO AQG 2021) of 60 μg/m 3 for warm-season O 3, 0.88 (95% CI: 0.60, 1.14) million premature deaths could be avoidable among Chinese older population in 2019, yielding an inconspicuous reduction of 0.11 million compared to the estimate in 2011 (0.99 million, 95% CI: 0.68, 1.28). O 3-attributable deaths amounted to 9.05 (95% CI: 6.19, 11.70) million years of life lost in 2019, equivalent to a loss of life expectancy of 0.93 (95% CI: 0.63, 1.20) years for older population in China.
CONCLUSIONS
Our multi-cohort analysis suggested that reducing ambient O 3 exposure could increase the life expectancy of Chinese older adults, which may contribute to the development of healthy aging strategies and national cleaning air policies.
MeSH
Mortality, Multiple Chronic Conditions, Life Expectancy, Aged, Mortality, Premature