Excess mortality associated with high ozone exposure:A national cohort study in China

Emerging epidemiological studies suggest that long-term ozone(O_(3))exposure may increase the risk of mortality,while pre-existing evidence is mixed and has been generated predominantly in North America and Europe.In this study,we investigated the impact of long-term O_(3)exposure on all-cause mortality in a national cohort in China.A dynamic cohort of 20882 participants aged
40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study.A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season(Aprile September)O_(3)exposure.The annual average level of participant exposure to warm-season O_(3)concentrations was 100 mg m^(-3)(range:61 e142 mg m^(-3)).An increase of 10 mg m^(-3)in O_(3)was associated with a hazard ratio(HR)of 1.18(95%confidence interval[CI]:1.13e1.23)for all-cause mortality.Compared with the first exposure quartile of O_(3),HRs of mortality associated with the second,third,and highest exposure quartiles were 1.09(95%CI:0.95e1.25),1.02(95%CI:0.88e1.19),and 1.56(95%CI:1.34e1.82),respectively.A J-shaped concentration eresponse associationwas observed,revealing a non-significant increase in risk below a concentration of approximately 110 mg m^(-3).Low-temperature-exposure residents had a higher risk of mortality associated with long-term O_(3)exposure.This study expands current epidemiological evidence from China and reveals that high-concentration O_(3)exposure curtails the long-term survival of middle-aged and older adults.

Cohort-based long-term ozone exposure-associated mortality risks with adjusted metrics:A systematic review and meta-analysis

Long-term ozone(O_(3))exposure may lead to non-communicable diseases and increase mortality risk.However,cohort-based studies are relatively rare,and inconsistent exposure metrics impair the credibility of epidemiological evidence synthetization.To provide more accurate meta-estimations,this study updates existing systematic reviews by including recent studies and summarizing the quantitative associations between O_(3) exposure and cause-specific mortality risks,based on unified exposure metrics.Cross-metric conversion factors were estimated linearly by decadal observations during 1990-2019.

China’s unwavering determination in protecting pregnancy and perinatal health

ACHIEVEMENTS AND CHALLENGES Before the advent ofmodern medicine,childbirth carried extremely high risk of mortality,both maternal and perinatal(the period beginning at the 20–28th week of gestation and ending at 1–4 weeks after delivery).Fortunately,with advances in prenatal healthcare,the prevalence of maternal and perinatal mortalities has significantly reduced.A press conference held on May 30,2022,by the National Health Commission of the People’s Republic of China,reviewed the major progress and achievements in Chinese maternal and child health over the past decade.It highlighted that the maternal mortality rate dropped to 161 per million in 2021,the lowest level in recorded history.

Antagonism between ambient ozone increase and urbanization-oriented population migration on Chinese cardiopulmonary mortality

Everincreasing ambient ozone(O3)pollution in China has been exacerbating cardiopulmonary premature deaths.However,the urban-rural exposure inequity has seldom been explored.Here,we assess populationcale 03 exposure and mortality burdens between 1990 and 2019 based on integrated pollution tracking and epidemiological evidence.We find Chinese population have been suffering from climbing 03 exposure by 4.3±2.8 ppb per decade as a result of rapid urbanization and growing prosperity of socioeconomic activities.Rural residents are broadly exposed to 9.8±4.1 ppb higher ambient O3 than the adjacent urban citizens,and thus urbaniza-tion-oriented migration compromises the exposure-associated mortality on total population.Cardiopulmonary excess premature deaths attributable to longterm 03 exposure,373,500(95%uncertainty interval[U]:240,600-510,900)in 2019,is underestimated in previous studies due to ignorance of cardiovascular causes.Future 03 pollution policy should focus more on rural population who are facing an aggravating threat of mortality risks to ameliorate environmental health injustice.