Ambient ozone pollution and years of life lost: Association, effect modification, and additional life gain from a nationwide analysis in China

Jie Li, Peng Yin（殷鹏）, Lijun Wang（王黎君）, Xiao Zhang（张笑）, Jiangmei Liu（刘江美）, Yunning Liu（刘韫宁）, Maigeng Zhou（周脉耕）？

ABSTRACT

Background: Ozone is one of the dominant air pollutants due to its impact on disease burden and increasing trend in concentration. However, evidence regarding short-term effect of ozone on years of life lost (YLL) is scarce.

Methods: A national time-series study was conducted in 48 large Chinese cities from 2013 to 2017. Generalized additive model coupled with random effects model were used to estimate national-average associations of ozone with YLL. Potential modifiers and additional life gain due to avoidable YLL under certain scenario were also evaluated.

Results: The average annual mean ozone concentration of these cities was 86.9 μg/m3 . For 10 μg/m3 increase in 3-day moving average ozone concentration, we estimated 0.37% [95% confidence interval (CI): 0.29%, 0.46%] increase in YLL from nonaccidental causes, 0.38% (95% CI: 0.30%, 0.46%) increase in YLL from cardiovascular diseases, and 0.36% (95% CI: 0.16%, 0.56%) increase in YLL from respiratory diseases. Moreover, the associations were more evident in people with less education and in cities with lower carbon monoxide concentration or those located at north region with lower mean temperature. Finally, an estimated life of 0.055 (95% CI: 0.043, 0.068) years would be gained per deceased people if ozone concentration could fall to 100 μg/ m3 .