Association between ambient ozone and health outcomes in Prague

  • Iva Hůnová
  • Marek Malý
  • Jana Řezáčová
  • Martin Braniš
Original Article

Abstract

Purpose

Though numerous studies investigating ambient ozone (O3) effects on human health were published, such a study for Central Europe is still lacking. We have investigated the association between ozone (O3) levels and hospital admissions and mortality due to cardiovascular and respiratory diseases for Prague inhabitants for summer months (April–September) over the 5-year period 2002–2006. Our hypothesis was that ambient O3 levels in Prague resulted in adverse health outcomes and were associated with increased mortality and hospital admissions.

Methods

The effect of O3 on mortality and hospital admissions was investigated using the negative binomial regression after controlling for the influence of meteorological factors (air temperature and relative humidity) and calendar effects (seasonal patterns, long-term trends and day of week).

Results

We found a statistically significant association between O3 levels and daily mortality from respiratory diseases. Relative risk of 1.080 (95% CI: 1.031–1.132) was observed for mortality from respiratory diseases per 10 μg m−3 increase in 1-day lagged daily mean O3 concentration. No statistically significant association was detected between O3 concentrations and daily mortality from all causes, daily mortality from cardiovascular diseases and hospital admissions for respiratory and cardiovascular diseases. The O3 effects differed in men and women, nevertheless, the results were ambiguous with respect to used lag and O3 metrics. No significant confounding effects of PM10 on the investigated association were observed.

Conclusions

O3 exposure in Prague, though lower as compared to many other cities in Europe, is high enough to cause adverse health effects.

Keywords

Ambient ozone Cardiovascular diseases Hospital admissions Mortality Respiratory diseases 

References

  1. Anderson HR (2009) Air pollution and mortality: a history. Atmos Environ 43:142–152CrossRefGoogle Scholar
  2. Anderson H, Atkinson R, Peacock J, Marston L, Konstantinou K (2004) Meta—analysis of time—series sudies and panel studies of particulate matter (PM) and ozone (O3). Report of a WHO task group. http://www.euro.who.int. Accessed 30 Jan 2011
  3. Anenberg SC, Horowitz LW, Tong DO, West J (2010) An estimate of the global burden of anthropogenic ozone and fine particulate matter on premature human mortality using atmospheric modeling. Environ Health Perspect 118:189–195CrossRefGoogle Scholar
  4. Bell M, McDermott A, Zeger S, Samet J, Dominici F (2004) Ozone and short-term mortality in 95 US urban communities, 1987–2000. JAMA—J Am Med Assoc 292:2372–2378CrossRefGoogle Scholar
  5. Bell ML, Dominici F, Samet JM (2005) A meta-analysis of time-series studies of ozone and mortality with comparison to the national morbidity, mortality and air pollution study. Epidemiology 16:436–445CrossRefGoogle Scholar
  6. Braniš M (2009) Air quality of Prague: traffic as a main pollution source. Environ Monit Assess 156:377–390CrossRefGoogle Scholar
  7. Braniš M, Vyškovská J, Malý M, Hovorka J (2010) Association of size-resolved number concentrations of particulate matter with cardiovascular and respiratory hospital admissions and mortality in Prague, Czech Republic. Inhal Toxicol 156:377–390Google Scholar
  8. Bree L, Mara M, Scheindelen HJ, Fischer PH, Loos S, Buringh E, Rombout PJA (1995) Dose-effect models for ozone exposure: tool for quantitative risk estimation. Toxicol Lett 82(83):317–321CrossRefGoogle Scholar
  9. CHMI (2007) Air pollution in the Czech Republic in 2006. CHMI, PragueGoogle Scholar
  10. Clougherty J (2010) A growing role for gender analysis in air pollution epidemiology. Environ Health Perspect 118:167–176CrossRefGoogle Scholar
  11. de Almeida SP, Casimiro E, Calheiros J (2011) Short-term association between exposure to ozone and mortality in Oporto, Portugal. Environ Res 111:406–410CrossRefGoogle Scholar
  12. Delfino RJ, Murphy-Moulton AM, Becklake MR (1998) Emergency room visits for respiratory illnesses among elderly in montreal: association with low level ozone exposure. Environ Res A 76:67–77CrossRefGoogle Scholar
  13. EC (2008) Directive 2008/50/EC of the European parliament and of the council of 21 May 2008 on ambient air quality and cleaner air for Europe. OJEC L 152Google Scholar
  14. EEA (2009) Spatial assessment of PM10 and ozone concentrations in Europe, 2005. Technical report. EEA, CopenhagenGoogle Scholar
  15. Fiala J, Cernikovsky L, de Leeuw F, Kurfurst P (2003) Air pollution by ozone in Europe in summer 2003. Topic report. EEA, CopenhagenGoogle Scholar
  16. Filleul L, Cassadou S, Médina S, Fabres P, Lefranc A, Eilstein D, La Tertre A, Pascal L, Chardon B, Blanchard M, Declerq Ch, Jusot JF, Prouvost H, Ledrans M (2006) The relation between temperature, ozone, and mortality in nine French cities during the heat wave of 2003. Environ Health Persp 9:1344–1347CrossRefGoogle Scholar
  17. Fischer PH, Brunekreef B, Lebret E (2004) Air pollution related deaths during the 2003 heat wave in the Netherlands. Atmos Environ 38:1083–1085CrossRefGoogle Scholar
  18. Goldberg MS, Burnett RT, Yale JF, Valois MF, Brook JR (2006) Association between ambient air pollution and daily mortality among persons with diabetes and cardiovascular disease. Environ Res 100:255–267CrossRefGoogle Scholar
  19. Gryparis A, Forsberg B, Katsouyanni K, Analitis A, Toulom G et al (2004) Acute effects of ozone on mortality from the “air pollution and health: a European approach” project. Am J Resp Crit Care 170:1080–1087CrossRefGoogle Scholar
  20. Hazucha MJ, Lefohn AS (2007) Nonlinearity in human health response to ozone: experimental laboratory considerations. Atmos Environ 41:4559–4570CrossRefGoogle Scholar
  21. Hilbe JM (2007) Negative binomial regression. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  22. Hůnová I, Livorová H, Ostatnická J (2003) Potential ambient ozone impact on ecosystems in the Czech Republic as indicated by exposure index AOT40. Ecol Indic 3:35–47CrossRefGoogle Scholar
  23. Hůnová I, Šantroch J, Ostatnická J (2004) Ambient air quality and deposition trends at rural stations in the Czech Republic during 1993–2001. Atmos Environ 38:887–898CrossRefGoogle Scholar
  24. Jelínková J, Braniš M (2001) Mortality during winter smog episodes 1982, 1985, 1987 and 1993 in the Czech Republic. Int Arch Occ Env Hea 74:565–573Google Scholar
  25. Jerrett M, Burnett RT, Pope CA III, Ito K, Thurston G et al (2009) Long-term ozone exposure and mortality. New Engl J Med 360:1085–1095CrossRefGoogle Scholar
  26. Katsouyanni K (2003) Ambient air pollution and health. Br Med Bull 68:143–156CrossRefGoogle Scholar
  27. Lin S, Bell EM, Liu W, Walker RJ, Kim NK, Hwang S (2008) Ambient ozone concentration and hospital admission due to childhood respiratory diseases in New York State, 1991–2001. Environ Res 108:42–47CrossRefGoogle Scholar
  28. Lippmann M (2003) Surface ozone (human health). In: Holton JR, Curry JA, Pyle JA (eds) Encyclopedia of Atmospheric Sciences, vol 4. Academic Press, Elsevier Science, Ltd., London, pp 1655–1663Google Scholar
  29. Menzel DB (1994) The toxicity of air pollution in experimental animals and humans: the role of oxidative stress. Toxicol Lett 72:269–277CrossRefGoogle Scholar
  30. Miller FJ (1995) Uptake and fate of ozone in respiratory tract. Toxicol Lett 82(83):277–285CrossRefGoogle Scholar
  31. Neidell M, Kinney PL (2010) Estimates of the association between ozone and asthma hospitalizations that account for behavioural responses to air quality information. Environ Sci Policy 13:97–103CrossRefGoogle Scholar
  32. O’Neill MS, Loomis D, Borja-Aburto VH (2004) Ozone, area social conditions, and mortality in Mexico City. Environ Res 94:234–242CrossRefGoogle Scholar
  33. Parodi S, Vercelli M, Garrone E, Fontana V, Izzotti A (2005) Ozone air pollution and daily mortality in Genoa, Italy between 1993 and 1996. Public Health 119:844–850CrossRefGoogle Scholar
  34. Peters A, Skorkovsky J, Kotesovec F, Brynda J, Wichmann HE, Heinrich J (2000) Associations between mortality and air pollution in Central Europe. Environ Health Persp 108:283–287CrossRefGoogle Scholar
  35. Ren C, Williams GM, Mengersen K, Morawska L, Tong S (2008) Does temperature modify short—term effects of ozone on total mortality in 60 large eastern US communities?—An assessment using the NMMAPS data. Environ Int 34:451–458CrossRefGoogle Scholar
  36. Ren C, Melly S, Schwartz J (2010) Modifiers of short-term effects of ozone on mortality in eastern Massaachusetts—a case-crossover analysis at individual level. Environ Health 9:3–10CrossRefGoogle Scholar
  37. Revich B, Shaposhnikov D (2010) The effects of particulate and ozone pollution on mortality in Moscow, Russia. Air Qual Atmos Health 3:117–123CrossRefGoogle Scholar
  38. Sartor F, Demuth C, Snacken R, Walckiers D (1997) Mortality in elderly and ambient ozone concentration during the hot summer, 1994, in Belgium. Environ Res 72:109–117CrossRefGoogle Scholar
  39. Schwartz J (2005) How sensitive is the association between ozone and daily deaths to control for temperature? Am J Respir Crit Care Med 171:628–631Google Scholar
  40. Seinfeld JH, Pandis SN (2006) Atmospheric chemistry and physics. From air pollution to climate change. Wiley, New YorkGoogle Scholar
  41. Smith RL, Xu B, Switzer P (2009) Reassessing the relationship between ozone and short-term mortality in the US urban communities. Inhal Toxicol 21(suppl. 2):37–61CrossRefGoogle Scholar
  42. Stafoggia M, Forastiere F, Faustini A, Biggeri A, Bisanti L et al (2010) Susceptibility factors to ozone-related mortality. Am J Res Critical Care Med 182:376–384CrossRefGoogle Scholar
  43. Stanners D, Bourdeau P (1995) Europe’s environment: the debris assessment. EEA, CopenhgenGoogle Scholar
  44. Stedman JR (2004) The predicted number of air pollution related deaths in the UK during the August 2003 heatwave. Atmos Environ 38:1087–1090CrossRefGoogle Scholar
  45. Thurston GD, Ito K (2001) Epidemiological studies of acute ozone exposures and mortality. J Expo Anal Env Epid 11:286–294CrossRefGoogle Scholar
  46. WHO (2005) Air quality guidelines. Global update 2005. Particulate matter, ozone, nitrogen dioxide and sulfur dioxide. Denmark, CopenhagenGoogle Scholar
  47. Yang Z, Ballinger SW (2005) Environmental contributions to cardiovascular disease: particulates and ozone. Drug Discov Today Dis Mech 2:71–75CrossRefGoogle Scholar
  48. Zanobetti A, Schwartz J (2008) Mortality displacement in the association of ozone with mortality. Am J Respir Crit Care Med 177:184–189CrossRefGoogle Scholar
  49. Zhang Y, Huang W, London SJ, Song G, Chen G, Jiang L, Zhao N, Chen B, Kan H (2006) Ozone and daily mortality in Shanghai, China. Research 114:1227–1232Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Iva Hůnová
    • 1
    • 2
  • Marek Malý
    • 3
    • 4
  • Jana Řezáčová
    • 1
  • Martin Braniš
    • 1
  1. 1.Faculty of Science, Institute for Environmental StudiesCharles University in PraguePragueCzech Republic
  2. 2.Czech Hydrometeorological InstitutePragueCzech Republic
  3. 3.National Institute of Public HealthPragueCzech Republic
  4. 4.Institute of Computer Science, Academy of Sciences of the Czech RepublicPragueCzech Republic

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