Skip Navigation LinksHome > July 2005 - Volume 16 - Issue 4 > A Meta-Analysis of Time-Series Studies of Ozone and Mortalit...
Epidemiology:
doi: 10.1097/01.ede.0000165817.40152.85
Original Article

A Meta-Analysis of Time-Series Studies of Ozone and Mortality With Comparison to the National Morbidity, Mortality, and Air Pollution Study

Bell, Michelle L.*; Dominici, Francesca†; Samet, Jonathan M.‡

Free Access
Article Outline
Collapse Box

Author Information

From *Yale University, School of Forestry and Environmental Studies, New Haven, CT; and the Departments of †Biostatistics and ‡Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Submitted: 12 August 2004; final version accepted 7 March 2005.

Funding for Drs. Bell and Dominici was provided by the Environmental Protection Agency (EPA 3D-6867-NAEX). Funding for Drs. Dominici and Samet was provided by NIEHS ROI grant (ES012054-01) and by the NIEHS Center in Urban Environmental Health (P30-ES003819).

Publication costs for this paper have been paid by EPA.

Editor’s note: An editorial and commentaries on this article appear on pages 425–435.

Correspondence: Michelle L. Bell, Yale University, 205 Prospect St., New Haven, CT 06511. E-mail: michelle.bell@yale.edu.

Collapse Box

Abstract

Background: Although many time-series studies of ozone and mortality have identified positive associations, others have yielded null or inconclusive results, making the results of these studies difficult to interpret.

Methods: We performed a meta-analysis of 144 effect estimates from 39 time-series studies, and estimated pooled effects by lags, age groups, cause-specific mortality, and concentration metrics. We compared results with pooled estimates from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS), a time-series study of 95 large U.S. urban centers from 1987 to 2000.

Results: Both meta-analysis and NMMAPS results provided strong evidence of a short-term association between ozone and mortality, with larger effects for cardiovascular and respiratory mortality, the elderly, and current-day ozone exposure. In both analyses, results were insensitive to adjustment for particulate matter and model specifications. In the meta-analysis, a 10-ppb increase in daily ozone at single-day or 2-day average of lags 0, 1, or 2 days was associated with an 0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%), whereas the lag 0 NMMAPS estimate is 0.25% (0.12% to 0.39%). Several findings indicate possible publication bias: meta-analysis results were consistently larger than those from NMMAPS; meta-analysis pooled estimates at lags 0 or 1 were larger when only a single lag was reported than when estimates for multiple lags were reported; and heterogeneity of city-specific estimates in the meta-analysis were larger than with NMMAPS.

Conclusions: This study provides evidence of short-term associations between ozone and mortality as well as evidence of publication bias.

Ozone is a common urban air pollutant with well-documented adverse health effects ranging from respiratory symptoms to increased risk for hospital admissions. The U.S. Environmental Protection Agency (U.S. EPA) establishes primary National Ambient Air Quality Standards (NAAQS) for ozone and other criteria pollutants at a level intended to protect human health with an adequate margin of safety. In 1997, the U.S. EPA proposed adding an ozone standard of 80 ppb based on the daily 8-hour maximum concentration.1 The existing daily 1-hour maximum standard of 120 ppb remains in effect for areas in violation. The changes in regulations were in response to demonstrated effects at concentrations below the existing standard, and evidence that the 8-hour averaging time better represented the time course of the short-term effects of ozone exposure on the respiratory system. The U.S. EPA is required by the Clean Air Act to review the NAAQS at least every 5 years and to revise the standards if needed. At the time of this writing, the EPA has just initiated the development of a new criteria document for ozone. Presently, over 100 million people in the United States live in areas that exceed the 8-hour NAAQS.2

Although many studies have demonstrated the damaging health effects of ozone, studies on mortality have been less consistent. Several time-series studies identified a positive association of ozone concentration with daily mortality counts,3–13 whereas others produced inconclusive evidence, including a negative association, no association, or a positive association that was not statistically significant.14–19 The seemingly conflicting findings of these studies could result from many factors, including chance, variation across the populations, differing analytic methods, and issues related to data quality and measurement error.

Combining information across single-city results is a reasonable approach for estimating an overall effect and for exploring sources of heterogeneity. There are 2 main approaches for combining information. The first is a quantitative meta-analysis of published results. The second is a multicity study in which a uniform analytical framework is applied to time-series data for single cities, and then the city-specific estimates are pooled to generate an overall estimate. These 2 approaches can help resolve controversies from seemingly divergent individual study estimates, increase statistical power, and improve the generalizability of results.

The relationship between ozone and mortality has been examined in several previous meta-analyses, each finding a statistically significant relationship. Recently reported meta-analyses of ozone and mortality include a study by Thurston and Ito,20 which combined results of 16 studies and explored differences in approaches to the modeling of weather; the analysis of Levy et al,21 which used 4 U.S. studies based in Cook County, Illinois, and Philadelphia; the work of Stieb et al,22,23 who extracted results from 109 single- and multicity studies for random effects pooling; and a World Health Organization report that investigated ozone and mortality in Europe.24 In previously conducted multicity time-series studies of ozone and mortality, some researchers found a statistically significant association: studies of 15 European cities,25 23 European cities,26 6 French cities,27 and 80 U.S. cities in one of the National Morbidity, Mortality, and Air Pollution Study (NMMAPS) analyses.28 A positive, but not statistically significant, relationship was identified by Saez et al29 for 7 Spanish cities, and analysis of data from 7 major cities of Korea found a negative, nonstatistically significant association.30 Zmirou et al31 identified a relationship between ozone and cardiovascular and respiratory mortality for 4 cities in western Europe.

NMMAPS initially used mortality data for 90 large U.S. urban communities from 1987 to 1994.28,32–37 Our recent analysis of the extended and updated NMMAPS database for the period 1987 to 2000 included 95 urban centers in the United States and used a uniform statistical framework within each city to estimate a national-average association between short-term changes in ozone and mortality.38 This work investigated multiple model structures, a variety of lag times (including a week-long distributed lag and various single-day lags), several concentration metrics, and potential confounding by particulate matter (PM) and weather such as temperature and dew point temperature. We considered total, cardiovascular, and respiratory mortality and several age categories. City-specific estimates were combined using a Bayesian hierarchical approach to calculate the overall effect of ozone on mortality.

The advantages of either of these approaches over a single-city estimate are the gains in statistical power, the estimation of an overall effect, and the exploration of heterogeneity. However, in the meta-analytic approach, the independently conducted single-city studies generally differ in their statistical models, approaches to addressing confounding by weather and long-term trends, and adjustment for additional pollutants. Meta-analyses are also subject to publication bias; papers reporting a positive association may be more likely to be submitted or accepted for publication. Thus, results of meta-analyses may be biased toward an overestimation of the true effect, although the degree of publication bias is difficult to quantify.

Comparison of results from the meta-analysis and multisite studies provides the opportunity to identify a lower and upper bound for the pooled effect, quantify publication bias, and explore sources of heterogeneity of effects across studies. In this article, we conduct a meta-analysis of 144 estimates from 39 time-series studies of ozone and mortality, published from 1990 to June 2004. By combining information across the time-series studies, we estimate pooled effects by several lags, age groups, cause-specific mortality, location, and concentration metrics. To assess publication bias, we compare the pooled estimates from the meta-analysis with results from NMMAPS.

Back to Top | Article Outline

METHODS

Selection of Studies and Estimates for Meta-Analysis

The time-series studies included in the meta-analysis were systematically selected based on the following criteria:

* Studies provided numerical estimates of the relationship between short-term changes in ozone and mortality, as well as an indication of the uncertainty of the central estimate (eg, 95% confidence interval, or t-value).

* Studies were peer-reviewed and published in English.

* Studies were not based on NMMAPS (to compare meta-analysis results with NMMAPS results).

* Studies were published and indexed from 1990 to 21 June 2004.

* Estimates were provided for total, cardiovascular, or respiratory mortality.

Studies were not excluded on the basis of other criteria such as adjustment by copollutants; these factors were explored in later analysis. Studies that met our criteria were identified using Pubmed (www.pubmed.com), a service of the National Library of Medicine that includes over 14 million citations. Searches in Pubmed included the words “mortality” or “time-series” in the title or abstract and “ozone” or “O3.” Additional potential references were provided by the U.S. EPA Office of Air Quality Planning and Standards and the Health Effects Institute report of reanalysis of PM and time-series studies.28 If a study was updated such as through newly available statistical techniques or an updated dataset, the most recent results were chosen. For instance, if time-series studies were reanalyzed in response to concerns about the default implementation of generalized additive models (GAM) in S-Plus software,39 we used the reanalysis results. All selected studies addressed potential confounding by temperature.

The authors, as well as other faculty, postdoctoral researchers, and doctoral candidates at the Johns Hopkins Bloomberg School of Public Health, coded the characteristics and results of each selected time-series study. Coding for each time-series study was doublechecked. Investigators of the original studies were contacted to clarify any relevant issues (eg, to ascertain what lag was used).

Only one estimate from each study was included in each meta-analysis result, except when a single study provided results from multiple cities, in which case each city-specific result could be included. Meta-analysis results were not generated if an insufficient number of single estimates (fewer than 4) were available within a particular stratum of results. Estimates of short-term lags were classified as single-day lags of 0 (same day), 1, or 2 days or a 2-day average of lags 0 and 1 or lags 1 and 2. When estimates for multiple lags were provided for a single study, the estimate for lag 0 was used, because this lag was most commonly given. This approach minimizes the bias of choosing the lag with the largest effect, although some studies only presented results for a single lag. If estimates were given for lags 1 and 2 but not for lag 0, the estimate for lag 1 was included. Only estimates based on the whole year’s data were used, except in analyses specifically investigating the warmer time periods. Results are for all ages and without PM adjustment unless otherwise specified.

The selected time-series studies presented results in several forms such as a log-relative rate, the percent increase in mortality, or the regression coefficient—each corresponding to a specified increase in ozone concentrations. The uncertainty of the central estimate was provided as a 95% posterior interval (the Bayesian formulation of the 95% confidence interval), standard error, t-statistic, or ratio of some measure of the central estimate to the standard error. We converted these data to the corresponding log-relative rate (β̂s) with its standard error (√vs), so that multiple studies could be combined in the meta-analysis.

Studies provided results for several concentration metrics. The uncertainty of the central estimate was provided as a 95% interval, standard error, t-statistic, or ratio of some measures of the central estimate to the standard error. We included daily 1-hour and 8-hour maximums calculated for specified time periods that encompassed the daytime but not the whole 24-hour period (eg, 1-hour maximum from 10 am to 8 pm) because the peak ozone levels do not occur at night. Concentration metrics for a specific time period of the day (eg, noon to 8 pm) were not considered because these can differ from the peak average on that day. Results from studies using the 1-hour and 8-hour maximum values were converted to the daily average, except in analyses that specifically addressed comparison across concentration metrics. If information to construct a conversion ratio was provided by the study, this ratio was used. Otherwise, we used a relationship of 20:15:8 for the 1-hour maximum:8-hour maximum:daily average.20 These relationships have been used elsewhere.20 Furthermore, we assumed that 1.96 μg/m3 equals 1 ppb to convert studies into the same metric.

Back to Top | Article Outline
Statistical Methods for Meta-Analysis

We combined information across locations and estimated the pooled effect using a 2-stage Bayesian hierarchical model.40–43 At the first stage, we assumed that the estimated effect β̂s is normally distributed with mean equal to the true effect βs and variance equal to the statistical variance of β̂s, here denoted by vs. At the second stage, we assumed that the true βs is normally distributed with mean μ and between-study variance τ2. The goal of our Bayesian meta-analysis was to estimate the marginal posterior distribution of the pooled effect μ by taking into account the within-city variance (vs), which measures the statistical uncertainty in the estimation of βs and the between-study variance (τ2), which measures the heterogeneity across cities of the true βs. In summary, our model specification can be described as:

We fit model (Eq 1) by use of Monte Carlo Markov chain methods44 implemented by the software Winbugs.45 A priori, we assume that μ has a normal distribution with zero mean and very large variance (uninformative or flat prior) and that 1/τ2 has a gamma distribution with shape and scale parameters equal to 0.001 and 0.001. The use of an “uninformative prior” indicates that all possible values of μ are considered approximately equally likely a priori. The goal of a Bayesian analysis is to evaluate the marginal posterior distributions of μ and τ2, where a posterior distribution is defined as the product of the likelihood function times the prior distribution up to a normalizing constant.46

Equation 1
Equation 1
Image Tools

We investigate the sensitivity of the posterior mean of μ to the specification of the prior distribution for the heterogeneity variance τ2. In addition, to investigate the sensitivity of the posterior mean of μ to outliers in the individual reported time-series study estimates, at the second stage, we also assume that the true βs is distributed as a mixture of 2 normal distributions βs | μ, τ2 ∼ (1 − p)N1, τ2) + pN2, τ2) where μ = (1 − p1 + pλ2, and that the true βs is distributed as a student-t distribution with 3 degrees of freedom βs | μ, τ2t3 (μ,τ2).

Back to Top | Article Outline
Multicity Study

In recent NMMAPS analyses,38 we estimated the national-average short-term effect of ozone on mortality by combining information across 95 large U.S. urban communities from 1987 to 2000. The study explored multiple lag structures and model specifications. A generalized linear model with natural cubic splines was used with adjustment for time-varying confounders (weather, seasonality, and long-term trends). A Bayesian hierarchical model was used to combine the city-specific estimates into an overall effect, as shown in equation 1. The statistical models used have been made available at: http://www.ihapss.jhsph.edu/software/NMMAPS/NMMAPS.htm. Full details are reported elsewhere.38

Back to Top | Article Outline

RESULTS

A total of 144 estimates from 39 studies were included in the meta-analysis.3–5,7,9,11–15,18,19,27,29,47–71 We considered the following:

* Mortality outcome (total, cardiovascular, or respiratory);

* Location (United States or elsewhere);

* Potential confounding by PM (no adjustment for PM or adjustment by either PM10 or PM2.5; PM with an aerodynamic diameter no more than 10 or 2.5 μm, respectively);

* Cycle of analysis (yearly data or warm periods, eg, summer);

* Lag (0, 1, or 2 days; average of days 0 and 1; or average of days 1 and 2);

* Age (all ages, or the elderly—either 64+ or 65+); and

* Concentration metric (daily average, daily 1-hour maximum, or daily 8-hour maximum).

These same issues were also considered in pooled estimates for NMMAPS.

We performed a chi-squared test for heterogeneity on several subsets of studies, including the United States for total mortality and both the United States and non-United States combined for total mortality. When we rejected the hypothesis of homogeneity, we fitted the 2-stage Bayesian hierarchical model in equation 1 and evaluated the posterior distribution of the pooled effect μ. Table 1 shows posterior means and 95% posterior intervals (the Bayesian formulation of the 95% confidence interval) of μ under alternative distributional assumptions for the second stage and under alternative prior specifications. Note that a single study can contribute multiple estimates if it includes data from more than one city.

Table 1
Table 1
Image Tools

The pooled estimates are robust to all of these model specifications. Therefore, as a baseline model, we assume at the second stage that βs | μ, τ2N(μ, τ2) with 1/τ2Gamma (0.001,0.001). We also explored the findings with respect to a problem with the default implementation of generalized additive models (GAM) in the commonly used statistical software package, S-Plus.39,72 The pooled estimate was larger for studies without GAM problems such as those that used other modeling techniques or used GAM exact.39

Table 2 shows the posterior means and 95% posterior regions of the pooled effects for total, cardiovascular, and respiratory causes separately for U.S. cities only and non-U.S. cities, and for all locations. These pooled effects included time-series studies for short-term lags (defined as lags of 0, 1, or 2 days; or average of either days 0 and 1 or days 1 and 2).

Table 2
Table 2
Image Tools

Overall, we found that a 10-ppb increase in ozone in the few previous days (lags of 0, 1, or 2 days or a 2-day average of lags 0 and 1 or lags 1 and 2) is associated with a 0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%). Pooled effects were similar for studies within the United States and when studies outside the United States were included. When studies from all locations were considered, we found that the pooled effect for cardiovascular disease mortality is larger than for total mortality, whereas the pooled effect for respiratory mortality was lower (Table 2).

The pooled estimate for total mortality in the United States was based on 11 estimates from 9 studies in the following 9 communities: St. Louis; Kingston/Harriman, Tennessee; Santa Clara; Buffalo; Chicago; Philadelphia; Los Angeles; Detroit; and the Coachella Valley, California. Eight of these areas (all but the Coachella Valley) were included in NMMAPS ozone analysis.

We made 2 comparisons between the pooled effects obtained from the meta-analysis and from NMMAPS. First, we compared the pooled effects by including all the cities (9 from the meta-analysis and 95 from NMMAPS). Second, we restricted the comparison to the 8 cities that were included both in the meta-analysis and in NMMAPS.

Figure 1 compares the marginal posterior distributions of the overall effect under the meta-analysis (based on 11 estimates from the 9 cities) and in NMMAPS (95 U.S. cities, all lag 0). When we combined information across the 95 cities, the national average effect of same-day ozone on mortality from NMMAPS was a 0.25% (95% posterior interval = 0.12% to 0.39%) increase in mortality for a 10-ppb increase in the same day’s ozone concentration. Figure 2 compares the marginal posterior distributions of the overall effect under the meta-analysis and in NMMAPS for the 8 cities common to both the approaches (8 U.S. cities, all lag 0). When we combined information across the 8 cities, the NMMAPS pooled effect of same-day ozone concentration was 0.48% (0.03% to 0.92%) as compared with the meta-analysis estimate of 0.83% (0.38% to 1.29%). In both cases (using the 8 cities or using all the estimates), the estimated pooled effects from NMMAPS were lower than estimates from the meta-analysis. This pattern is indicative of possible publication bias.

Figure 1
Figure 1
Image Tools
Figure 2
Figure 2
Image Tools

The pooled effect from the meta-analysis for cardiovascular and respiratory mortality combined was slightly higher than the overall effect for total mortality. This pattern was also observed in the NMMAPS analyses.

Figure 3 shows the posterior distribution of the heterogeneity parameter τ in log scale for total mortality and for the U.S. and non-U.S. studies combined. The city-specific effects included in the meta-analysis were more heterogeneous than estimates from NMMAPS. In the meta-analysis, there were several sources of heterogeneity in addition to potential differences between cities. These included differences in the specification of the statistical models, in the data quality, and the potential for publication bias, among other factors.

Figure 3
Figure 3
Image Tools

In Table 3, we summarize the pooled estimates from the meta-analysis with and without adjustment for PM (either PM10 or PM2.5). In the time-series studies, the adjustment for PM was made by including the daily level of PM as a covariate in the Poisson regression model. Pooled effects were robust to the PM adjustment. These results are consistent with the recent NMMAPS analyses.38

Table 3
Table 3
Image Tools

Table 4 shows posterior means and 95% posterior regions of the pooled effect for total mortality for lags 0, 1, and 2 from both the meta-analysis (using studies from the United States and elsewhere) and NMMAPS. For both analyses, the pooled effects were largest at lag 0 and smallest at lag 2.

Table 4
Table 4
Image Tools

To further explore publication bias with respect to choice of lag, we calculated a pooled estimate for a variety of single-day lag times and compared the estimates for studies that provided results for only a single lag with those that provided multiple lags in the meta-analysis. More specifically, Table 5 compares pooled estimates obtained by combining studies that provided a single lag estimate (0 or 1) versus pooled estimates obtained by combining studies that reported estimates for multiple lags, including lags 0 or 1. The pooled effects from the studies that provided a single lag estimate were larger than those obtained from the studies that provided multiple estimates. This indicates that the lag with the highest effect is more likely to have been reported.

Table 5
Table 5
Image Tools

Meta-analysis effect estimates are larger for the elderly (ie, 64 years and older or 65 and older). For this age category, a 10-ppb increase in daily ozone is associated with a 1.45% increase in total daily mortality (0.67% to 2.23%), including 10 estimates from 9 studies from both in and outside of the United States. This is higher than the estimate for all ages, at 0.87% (0.55% to 1.18%). The NMMAPS analyses found a slightly larger effect for the elderly.38

Table 6 shows the pooled effects for total mortality and for cardiovascular disease mortality, as obtained from studies that used the whole year’s data or that analyzed only data in the warmer time periods. Some time-series studies of ozone and mortality explored the relationship during a particular time of year such as May to October or only the summer. These warmer time periods reflect the peak ozone season, because the chemical reactions that form ozone are temperature-dependent.73 In the NMMAPS analysis, no appreciable difference was observed between the ozone and mortality relationship for the whole year and the association during May to October.

Table 6
Table 6
Image Tools
Back to Top | Article Outline

DISCUSSION

Both the meta-analysis and NMMAPS results provide strong evidence of an association between short-term exposure to ozone and mortality. Results from these 2 approaches have a consistent pattern of findings: larger effects for cardiovascular mortality (for the meta-analysis) and cardiovascular/respiratory mortality (for NMMAPS) than for total mortality; larger effects at lag 0 as compared with lags 1 or 2; and a lack of confounding by PM.

We found several indicators of publication bias in the reporting of time-series studies of ozone and mortality. The effect estimates for meta-analysis were much larger than those for the NMMAPS multicity analysis. In the meta-analysis, larger pooled effects were found among the studies that reported a single lag (either 0 or 1) as compared with those that reported multiple lags. This pattern suggests that the lag with the largest effect was more likely to be reported. A comparison of 21 time-series studies on PM10 and mortality with the NMMAPS analysis of 88 cities also provided evidence for publication bias.74 Evidence was also found in a recent meta-analysis of time-series and panel studies of ozone, particulate matter, and mortality.24 Therefore, although meta-analyses are very useful for combining information from different studies and investigating differences due to factors such as location or study design, they are likely to overestimate the true relationship between ozone and mortality.

Results from the new meta-analysis are consistent with earlier meta-analyses of ozone time-series studies, as shown in Table 7. Our meta-analysis indicates an association between short-term changes in ozone and mortality, with an estimated 0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%) for a 10-ppb increase in the daily average ozone level at lags of 0 (same day), 1 or 2 days or a 2-day average of lags 0 and 1 or lags 1 and 2. This result corresponds to approximately a 0.35% increase in mortality (0.22% to 0.47%) for a 10-ppb increase in the daily 1-hour maximum. To compare this estimate with other meta-analyses, all estimates must be based on the same measure of ozone concentration such as the daily average. Although the relationship between different ozone metrics varies by location, we used a relationship of 20:15:8 for the 1-hour maximum:8-hour maximum:daily average, so that results are roughly comparable.20,21 For example, a 10-ppb increase in the daily average ozone concentration corresponds to approximately a 25-ppb increase in the daily 1-hour maximum concentration.

Table 7
Table 7
Image Tools

A recent multicity study of 23 European cities found a 0.33% (95% CI = 0.17% to 0.52%) increase in daily mortality associated with a 10-μg/m3 increase in the average of the daily 1-hour maximum of the same and previous days during the warm season.26 These results are approximately comparable to a 1.63% (0.76% to 2.50%) increase in mortality for a 10-ppb increase in the daily average during the warm season, which is similar to the meta-analysis estimate of 1.62% (0.41% to 2.84%) for non-U.S. studies in the warm season based on 7 estimates from 7 studies. The European study found approximately a 2.22% (1.06% to 3.40%) increase in cardiovascular mortality for a 10-ppb increase in the daily average during the warm season, which is slightly lower than our meta-analysis estimates of 2.45% (0.88% to 4.10%) for cardiovascular mortality based on U.S. and non-U.S. studies combined for the warm season. We lacked a sufficient number of time-series studies to calculate a cardiovascular mortality estimate for the warm season for non-U.S. studies only.

The 1997 modification to the existing NAAQS was based largely on evidence of adverse respiratory effects that could be produced in laboratory experiments at ozone concentrations that were prevalent in many metropolitan areas of the United States. At that time, limited single-city time-series analyses indicated that ozone might also increase mortality on a short-term basis. The continued accumulation of results over the subsequent years shows consistent evidence of an effect of ozone on daily mortality counts (Table 7). As for the effect of particulate matter on mortality, a variety of mechanisms may be relevant, reflecting ozone’s potential to cause airway and pulmonary inflammation.

Although the meta-analysis results provide strong evidence for an effect of ozone on mortality, the comparison with results from NMMAPS provides evidence of publication bias. Such publication bias may have multiple explanations, from the choice of analytic strategies and pathways taken in model development to the tendency of investigators to submit findings that are “positive” and for journals to preferentially publish reports of statistically significant associations. Quantitative analyses of the public health impact of ozone based on single-city results or meta-analyses of such results would tend to overestimate the detrimental effect of ozone and the benefits of control. We recommend caution against using the results of single-city studies, whether individually or pooled, for impact assessment. Multicity approaches such as NMMAPS and APHENA offer a now-feasible alternative that is less subject to publication bias.

Back to Top | Article Outline

ACKNOWLEDGMENTS

We thank Roger D. Peng, Leah J. Welty, Joseph H. Abraham, Sorina Eftim, and Brian S. Caffo for their aid in coding the time-series studies.

Back to Top | Article Outline

REFERENCES

1. US Environmental Protection Agency. National ambient air quality standards for particulate matter, final rule 62. Federal Register. 1997:38651.

2. US Environmental Protection Agency. The Ozone Report. EPA454/K-01-001. Research Triangle Park, NC: US EPA Office of Air Quality Planning and Standards; 2004.

3. Anderson HR, Ponce de Leon A, Bland JM, et al. Air pollution and daily mortality in London: 1987–92. BMJ. 1996;321:665–669.

4. Cifuentes LA, Vega J, Köpfer K, et al. Effect of the fine fraction of particulate matter versus the coarse mass and other pollutants on daily mortality in Santiago, Chile. J. Air Waste Manage Assoc. 2000;50:1287–1298.

5. Ha EH, Lee JT, Kim H, et al. Infant susceptibility of mortality to air pollution in Seoul, South Korea. Pediatrics. 2003;111:284–290.

6. Hoek G, Brunekreef B, Verhoeff A, et al. Daily mortality and air pollution in the Netherlands. J Air Waste Manage Assoc. 2000;50:1380–1389.

7. Kim SY, Lee JT, Hong YC, et al. Determining the threshold effect of ozone on daily mortality: an analysis of ozone and mortality in Seoul, Korea, 1995–1999. Environ Res. 2004;94:113–119.

8. Kown HJ, Cho SH, Nyberg F, et al. Effects of ambient air pollution on daily mortality in a cohort of patients with congestive heart failure. Epidemiology. 2001;12:413–419.

9. Moolgavkar SH. Air pollution and daily mortality in two US counties: season-specific analyses and exposure response relationships. Inhal Toxicol. 2003;15:877–907.

10. Loomis DP, Borja-Aburto VH, Bangdiwala SI, et al. Ozone exposure and daily mortality in Mexico City: a time-series analysis. Res Rep Health Eff Inst. 1996;75:1–37; discussion 39-45.

11. Moolgavkar SH. Air pollution and mortality in three US counties. Environ Health Perspect. 2000;108:777–784.

12. Simpson R, Denison L, Petroeschevsky A, et al. Effects of ambient particle pollution on daily mortality in Melbourne, 1991–1996. J Expo Anal Environ Epidemiol. 2000;10:448–496.

13. O’Neill MS, Loomis D, Borja-Aburto VH. Ozone, area social conditions, and mortality in Mexico City. Environ Res. 2004;94:234–242.

14. Anderson HR, Bremner SA, Atkinson RW, et al. Particulate matter and daily mortality and hospital admissions in the west midlands conurbation of the United Kingdom: associations with fine and coarse particles, black smoke and sulfates. Occup Environ Med. 2001;58:504–510.

15. Fairley D. Mortality and air pollution for Santa Clara County, California, 1989–1996. In: Revised Analyses of Time-Series Studies of Air Pollution and Health. Cambridge: Health Effects Institute; 2003:97:–106.

16. Hong YC, Leem JH, Ha EH. Air pollution and daily mortality in Inchon, Korea. J Korean Med Sci. 1999;14:239–244.

17. Klemm RJ, Mason RM. Aerosol Research and Inhalation Epidemiological Study (ARIES): air quality and daily mortality statistical modeling - interim results. J Air Waste Manage Assoc. 2000;50:1433–1439.

18. Ostro BD, Broadwin R, Lipsett MJ. Coarse and fine particles and daily mortality in the Coachella Valley, California: a follow-up study. J Expo Anal Environ Epidemiol. 2000;10:412–419.

19. Roemer WH, vanWijnen JH. Daily mortality and air pollution along busy streets in Amsterdam, 1987–1998. Epidemiology. 2001;12:649–653.

20. Thurston GD, Ito K. Epidemiological studies of acute ozone exposures and mortality. J Expo Anal Environ Epidemiol. 2001;11:286–294.

21. Levy JI, Carrothers TJ, Tuomisto JT, et al. Assessing the public health benefits of reduced ozone concentrations. Environ Health Perspect. 2001;109:1215–1226.

22. Stieb DM, Judek S, Burnett RT. Meta-analysis of time-series studies of air pollution and mortality: effects of gases and particles and the influence of cause of death, age, and season. J Air Waste Manage Assoc. 2002;52:470–484.

23. Stieb DM, Judek S, Burnett RT. Meta-analysis of time-series studies of air pollution and mortality: update in relation to the use of generalized additive models. J Air Waste Manage Assoc. 2003;53:258–261.

24. Anderson HR, Atkinson RW, Peacock JL, et al. Meta-Analysis of Time-Series Studies and Panel Studies of Particulate Matter (PM) and Ozone (O3). Report of a WHO Task Group. Copenhagen: World Health Organization; 2004.

25. Touloumi G, Katsouyanni K, Zmirou D, et al. Short-term effects of ambient oxidant exposure on mortality: a combined analysis within the APHEA project. Air Pollution and Health: a European Approach. Am J Epidemiol. 1997;146:177–185.

26. Gryparis A, Forsberg B, Katsouyanni K, et al. Acute effects of ozone on mortality from the ‘Air Pollution and Health: A European Approach’ project. Am J Respir Crit Care Med. 2004;170:1080–1087.

27. Le Tertre A, Quenel P, Eilstein D, et al. Short-term effects of air pollution on mortality in nine French cities: a quantitative summary. Arch Environ Health. 2002;57:311–319.

28. Health Effects Institute. Revised Analyses of Time-Series Studies of Air Pollution and Health: Revised Analyses of the National Morbidity, Mortality, and Air Pollution Study, Part II, Revised Analyses of Selected Time-Series Studies. Cambridge, MA: Health Effects Institute; 2003.

29. Saez M, Ballester F, Barcelo MA, et al. A combined analysis of the short-term effects of photochemical air pollutants on mortality within the EMECAM project. Environ Health Perspect. 2002;110:221–218.

30. Lee JT, Kim H, Hong YC, et al. Air pollution and daily mortality in seven major cities of Korea, 1991–1997. Environ Res. 2000;84:247–254.

31. Zmirou D, Schwartz J, Saez M, et al. Time-series analysis of air pollution and cause-specific mortality. Epidemiology. 1998;9:495–503.

32. Samet JM, Dominici F, Curriero FC, et al. Fine particulate air pollution and mortality in 20 U.S. cities, 1987–1994. N Engl J Med. 2000;343:1742–1749.

33. Samet JM, Dominici F, Zeger SL, et al. The National Morbidity, Mortality, and Air Pollution Study Part I: Methods and Methodologic Issues. Cambridge, MA: Health Effects Institute; 2000.

34. Samet JM, Zeger SL, Dominici F, et al. The National Morbidity, Mortality, and Air Pollution Study Part II: Morbidity and Mortality from Air Pollution in the United States. Cambridge, MA: Health Effects Institute; 2000.

35. Dominici F, McDermott A, Zeger SL, et al. National maps of the effects of particulate matter on mortality: exploring geographical variation. Environ Health Perspect. 2003;111:39–43.

36. Dominici F, Daniels M, Zeger SL, et al. Air pollution and mortality: estimating regional and national dose–response relationships. J Am Stat Assoc. 2002;97:100–111.

37. Dominici F, Samet J, Zeger S. Combining evidence on air pollution and daily mortality from the largest 20 US cities: a hierarchical modeling strategy. J R Stat Soc [Ser A]. 2000;163:263–302.

38. Bell ML, McDermott A, Zeger SL, et al. Ozone and mortality in 95 US urban communities, 1987–2000. JAMA. 2004;292:2372–2378.

39. Dominici F, McDermott A, Zeger SL, et al. On the use of generalized additive models in time-series studies of air pollution and health. Am J Epidemiol. 2002;156:193–203.

40. Lindley DV, Smith AFM. Bayes estimates for the linear model. J R Stat Soc. 1972;34:1–41.

41. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188.

42. DuMouchel W. Bayesian Metaanalysis. New York: Dekker; 1990.

43. DuMouchel WH, Harris JE. Bayes methods for combining the results of cancer studies in humans and other species. J Am Stat Assoc. 1983;78:293–315.

44. Gelman A, Carlin J, Stern H, et al. Bayesian Data Analysis. Chapman and Hall; 1995.

45. Spiegelhalter D, Thomas A, Best N, et al. Winbugs, version 1.4. 2003.

46. Bernardo JM, Smith AFM. Bayesian Theory. New York: John Wiley & Sons; 2000.

47. Bremner SA, Anderson HR, Atkinson RW, et al. Short term associations between outdoor air pollution and mortality in London 1992–4. Occup Environ Med. 1999;56:237–244.

48. Borja-Aburto VH, Loomis DP, Bangdiwala SI, et al. Ozone, suspended particulates, and daily mortality in Mexico City. Am J Epidemiol. 1997;145:258–268.

49. Borja-Aburto VH, Castillejos M, Gold DR, et al. Mortality and ambient fine particles in southwest Mexico City, 1993–1995. Environ Health Perspect. 1998;106:849–855.

50. Burnett RT, Cakmak S, Raizenne ME, et al. The association between ambient carbon monoxide levels and daily mortality in Toronto, Canada. J Air Waste Manage Assoc. 1998;48:689–700.

51. Dab W, Medina S, Quénel P, et al. Short-term respiratory health effects of ambient air pollution: results of the APHEA project in Paris. J Epidemiol Community Health. 1996;50:S42–46.

52. Dockery DW, Schwartz J, Spengler JD. Air pollution and daily mortality: associations with particulates and acid aerosols. Environ Res. 1992;59:362–373.

53. Goldberg MS, Burnett RT, Brook J, et al. Associations between daily cause-specific mortality and concentrations of ground-level ozone in Montreal, Quebec. Am J Epidemiol. 2001;154:817–826.

54. Gwynn RC, Burnett RT, Thurston GD. A time-series analysis of acidic particulate matter and daily mortality and morbidity in the Buffalo, New York, region. Environ Health Perspect. 2000;108:125–133.

55. Hoek G. Daily mortality and air pollution in The Netherlands. In: Revised Analysis of Time-Series Studies of Air Pollution and Health. Cambridge, MA: Health Effects Institute; 2003:133–141.

56. Hong YC, Lee JT, Kim H, et al. Effects of air pollutants on acute stroke mortality. Environ Health Perspect. 2002;110:187–191.

57. Ito K, Thurston GD. Daily PM10/mortality associations: an investigation of at-risk subpopulations. J Expo Anal Environ Epidemiol. 1996;6:79–95.

58. Kelsall JE, Samet JM, Zeger SL, et al. Air pollution and mortality in Philadelphia, 1974–1988. Am J Epidemiol. 1997;146:750–762.

59. Kinney PL, Ito K, Thurston GD. A sensitivity analysis of mortality/PM10 associations in Los Angeles. Inhal Toxicol. 1995;7:59–69.

60. Lee JT, Shin D, Chung Y. Air pollution and daily mortality in Seoul and Ulsan, Korea. Environ Health Perspect. 1999;107:149–154.

61. Lippmann M, Ito K, Nadas A, et al. Association of particulate matter components with daily mortality and morbidity in urban populations. Res Rep Health Eff Inst. 2000;95:5–72; discussion 73-82.

62. Zmirou D, Barumandzadeh T, Balducci F, et al. Short term effects of air pollution on mortality in the city of Lyon, France, 1985–90. J Epidemiol Community Health. 1996;50:S30–35.

63. Moolgavkar SH, Luebeck EG, Hall TA, et al. Air pollution and daily mortality in Philadelphia. Epidemiology. 1995;6:476–484.

64. Morgan G, Corbett S, Wlodarczyk J, et al. Air pollution and daily mortality in Sydney, Australia, 1989 through 1993. Am J Public Health. 1998;88:759–764.

65. Ostro B. Fine particulate air pollution and mortality in two Southern California counties. Environ Res. 1995;70:98–104.

66. Ostro BD, Sanchez JM, Aranda C, et al. Air pollution and mortality: results from a study of Santiago, Chile. J Expo Anal Environ Epidemiol. 1996;6:97–114.

67. Ostro BD, Hurley S, Lipsett MJ. Air pollution and daily mortality in the Coachella Valley, California: a study of PM10 dominated by coarse particles. Environ Res. 1999;81:231–238.

68. Prescott GJ, Cohen GR, Elton RA, et al. Urban air pollution and cardiopulmonary ill health: a 14.5 year time series study. Occup Environ Med. 1998;55:697–704.

69. Sunyer J, Castellsagué J, Sáez M, et al. Air pollution and mortality in Barcelona. J Epidemiol Community Health. 1996;50:S76–80.

70. Verhoeff AP, Hoek G, Schwartz J, et al. Air pollution and daily mortality in Amsterdam. Epidemiology. 1996;7:225–230.

71. Wietlisbach V, Pope CA, Ackermann-Liebrich U. Air pollution and daily mortality in three Swiss urban areas. Soz Praventivmed. 1996;41:107–115.

72. Ramsay TO, Burnett RT, Krewski D. The effect of concurvity in generalized additive models linking mortality to ambient particulate matter. Epidemiology. 2003;14:18–23.

73. Seinfeld JH, Pandis SN. Atmospheric Chemistry and Physics: From Air Pollution to Climate Change. New York: John Wiley & Sons, Inc; 1998.

74. Smith R, Guttorp P, Sheppard L, et al. Comments on the Criteria Document for Particulate Matter Air Pollution. NRCSE Technical Report Series No. 066. 2001.

Cited By:

This article has been cited 101 time(s).

Science of the Total Environment
Assessing the public health impacts of urban air pollution in 25 European cities: Results of the Aphekom project
Pascal, M; Corso, M; Chanel, O; Declercq, C; Badaloni, C; Cesaroni, G; Henschel, S; Meister, K; Haluza, D; Martin-Olmedo, P; Medina, S
Science of the Total Environment, 449(): 390-400.
10.1016/j.scitotenv.2013.01.077
CrossRef
Environmental Health
Ozone is associated with cardiopulmonary and stroke emergency hospital visits in Reykjavik, Iceland 2003-2009
Carlsen, HK; Forsberg, B; Meister, K; Gislason, T; Oudin, A
Environmental Health, 12(): -.
ARTN 28
CrossRef
Journal of Exposure Science and Environmental Epidemiology
Impact of NOx emissions reduction policy on hospitalizations for respiratory disease in New York State
Lin, S; Jones, R; Pantea, C; Ozkaynak, H; Rao, ST; Hwang, SA; Garcia, VC
Journal of Exposure Science and Environmental Epidemiology, 23(1): 73-80.
10.1038/jes.2012.69
CrossRef
Jama-Journal of the American Medical Association
Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases
Dominici, F; Peng, RD; Bell, ML; Pham, L; McDermott, A; Zeger, SL; Samet, JM
Jama-Journal of the American Medical Association, 295(): 1127-1134.

American Journal of Respiratory and Critical Care Medicine
Ozone, a malady for all ages
Pinkerton, KE; Balmes, JR; Fanucchi, MV; Rom, WN
American Journal of Respiratory and Critical Care Medicine, 176(2): 107-108.
10.1164/rccm.200704-607ED
CrossRef
New England Journal of Medicine
Long-Term Ozone Exposure and Mortality
Jerrett, M; Burnett, RT; Pope, CA; Ito, K; Thurston, G; Krewski, D; Shi, YL; Calle, E; Thun, M
New England Journal of Medicine, 360(): 1085-1095.

Inhalation Toxicology
Chemicals present in automobile traffic tunnels and the possible community health hazards: A review of the literature
Kuykendall, JR; Shaw, SL; Paustenbach, D; Fehling, K; Kacew, S; Kabay, V
Inhalation Toxicology, 21(): 747-792.
10.1080/08958370802524357
CrossRef
Environmental Health Perspectives
Ozone and daily mortality in Shanghai, China
Zhang, YH; Huang, W; London, SJ; Song, GX; Chen, GH; Jiang, LL; Zhao, NQ; Chen, BH; Kan, HD
Environmental Health Perspectives, 114(8): 1227-1232.
10.1289/ehp.9014
CrossRef
Atmospheric Environment
European characterization factors for human health damage of PM10 and ozone in life cycle impact assessment
van Zelm, R; Huijbregts, MAJ; den Hollander, HA; van Jaarsveld, HA; Sauter, FJ; Struijs, J; van Wijnen, HJ; de Meent, DV
Atmospheric Environment, 42(3): 441-453.
10.1016/j.atmosenv.2007.09.072
CrossRef
Atmospheric Environment
Ozone interactions with human hair: Ozone uptake rates and product formation
Pandrangi, LS; Morrison, GC
Atmospheric Environment, 42(): 5079-5089.
10.1016/j.atmosenv.2008.02.009
CrossRef
Environmental Health
A 10-year time-series analysis of respiratory and cardiovascular morbidity in Nicosia, Cyprus: the effect of short-term changes in air pollution and dust storms
Middleton, N; Yiallouros, P; Kleanthous, S; Kolokotroni, O; Schwartz, J; Dockery, DW; Demokritou, P; Koutrakis, P
Environmental Health, 7(): -.
ARTN 39
CrossRef
Ecology Law Quarterly
The Ozone Saga
Baumhefner, M
Ecology Law Quarterly, 35(3): 557-572.

Environmental Health
Evidence-based selection of environmental factors and datasets for measuring multiple environmental deprivation in epidemiological research
Richardson, EA; Mitchell, RJ; Shortt, NK; Pearce, J; Dawson, TP
Environmental Health, 8(): -.
ARTN S18
CrossRef
Journal of Toxicology and Environmental Health-Part A-Current Issues
Air pollution risk estimates: Determinants of heterogeneity
Samet, JM
Journal of Toxicology and Environmental Health-Part A-Current Issues, 71(): 578-582.
10.1080/15287390801997666
CrossRef
Environmental Science & Technology
Summertime State-Level Source-Receptor Relationships between Nitrogen Oxides Emissions and Surface Ozone Concentrations over the Continental United States
Tong, DQ; Mauzerall, DL
Environmental Science & Technology, 42(): 7976-7984.
10.1021/es7027636
CrossRef
Inhalation Toxicology
Critical considerations in evaluating scientific evidence of health effects of ambient ozone: a conference report
McClellan, RO; Frampton, MW; Koutrakis, P; McDonnell, WF; Moolgavkar, S; North, DW; Smith, AE; Smith, RL; Utell, MJ
Inhalation Toxicology, 21(): 1-36.
10.1080/08958370903176735
CrossRef
Environmental Health
Modifiers of short-term effects of ozone on mortality in eastern Massachusetts - A case-crossover analysis at individual level
Ren, C; Melly, S; Schwartz, J
Environmental Health, 9(): -.
ARTN 3
CrossRef
Environmental Science & Technology
Integrated assessment of the spatial variability of ozone impacts from emissions of nitrogen oxides
Tong, DQ; Muller, NZ; Mauzerall, DL; Mendelsohn, RO
Environmental Science & Technology, 40(5): 1395-1400.
10.1021/es052452n
CrossRef
Environmental Progress
Air pollution: Why is public perception so different from reality?
Schwartz, J
Environmental Progress, 25(4): 291-297.
10.1002/ep.10160
CrossRef
Journal of Epidemiology and Community Health
Cardiac arrhythmia emergency room visits and environmental air pollution in Sao Paulo, Brazil
Santos, UP; Terra, M; Lin, CA; Pereira, LAA; Vieira, TCB; Saldiva, PHN; Braga, ALF
Journal of Epidemiology and Community Health, 62(3): 267-272.
10.1136/jech.2006.058123
CrossRef
American Journal of Epidemiology
Effect modification by community characteristics on the short-term effects of ozone exposure and mortality in 98 US communities
Bell, ML; Dominici, F
American Journal of Epidemiology, 167(8): 986-997.
10.1093/aje/kwm396
CrossRef
Atmospheric Chemistry and Physics
The influence of European pollution on ozone in the Near East and northern Africa
Duncan, BN; West, JJ; Yoshida, Y; Fiore, AM; Ziemke, JR
Atmospheric Chemistry and Physics, 8(8): 2267-2283.

Archives Des Maladies Professionnelles Et De L Environnement
Air pollution and cardiovascular diseases: Insights from the French air pollution and health surveillance program
Lefranc, A; Pascal, L; Larrieu, S; Blanchard, M; Wagner, V; Declercq, C
Archives Des Maladies Professionnelles Et De L Environnement, 70(3): 339-345.
10.1016/j.admp.2009.03.001
CrossRef
Indoor Air
Ozone-surface reactions in five homes: surface reaction probabilities, aldehyde yields, and trends
Wang, H; Morrison, G
Indoor Air, 20(3): 224-234.
10.1111/j.1600-0668.2010.00648.x
CrossRef
Toxicology and Applied Pharmacology
Is it true that ozone is always toxic? The end of a dogma
Bocci, V
Toxicology and Applied Pharmacology, 216(3): 493-504.
10.1016/j.taap.2006.06.009
CrossRef
American Journal of Respiratory and Critical Care Medicine
Mortality displacement in the association of ozone with mortality - An analysis of 48 cities in the United States
Zanobetti, A; Schwartz, J
American Journal of Respiratory and Critical Care Medicine, 177(2): 184-189.
10.1164/rccm.200706-823OC
CrossRef
Revue Des Maladies Respiratoires
Short-term health effects of air pollution on mortality
Pascal, L
Revue Des Maladies Respiratoires, 26(2): 207-219.
10.1019/20094029
CrossRef
Inhalation Toxicology
Concentrated ambient fine particles and not ozone induce a systemic interleukin-6 response in humans
Urch, B; Speck, M; Corey, P; Wasserstein, D; Manno, M; Lukic, KZ; Brook, JR; Liu, L; Coull, B; Schwartz, J; Gold, DR; Silverman, F
Inhalation Toxicology, 22(3): 210-218.
10.3109/08958370903173666
CrossRef
Environment International
Using air quality modeling to study source-receptor relationships between nitrogen oxides emissions and ozone exposures over the United States
Tong, DQ; Muller, NZ; Kan, HD; Mendelsohn, RO
Environment International, 35(8): 1109-1117.
10.1016/j.envint.2009.06.008
CrossRef
Environmental Management
An integrated framework for multipollutant air quality management and its application in georgia
Cohan, DS; Boylan, JW; Marmur, A; Khan, MN
Environmental Management, 40(4): 545-554.
10.1007/s00267-006-0228-4
CrossRef
Journal of the Air & Waste Management Association
The health benefits of reduced tropospheric ozone in California
Ostro, BD; Tran, H; Levy, JI
Journal of the Air & Waste Management Association, 56(7): 1007-1021.

Environmental Science & Technology
Cumulative cancer risk from air pollution in Houston: Disparities in risk burden and social disadvantage
Linder, SH; Marko, D; Sexton, K
Environmental Science & Technology, 42(): 4312-4322.
10.1021/es072042u
CrossRef
Environmental Health Perspectives
Season, sex, age, and education as modifiers of the effects of outdoor air pollution on daily mortality in Shanghai, China: The Public Health and Air Pollution in Asia (PAPA) study
Kan, HD; London, SJ; Chen, GH; Zhang, YH; Song, GX; Zhao, NQ; Jiang, LL; Chen, BH
Environmental Health Perspectives, 116(9): 1183-1188.
10.1289/ehp.10851
CrossRef
Biostatistics
On outcome-dependent sampling designs for longitudinal binary response data with time-varying covariates
Schildcrout, JS; Heagerty, PJ
Biostatistics, 9(4): 735-749.
10.1093/biostatistics/kxn006
CrossRef
Environmental Health Perspectives
Ozone's impact on public health: Contributions from indoor exposures to ozone and products of ozone-initiated chemistry
Weschler, CJ
Environmental Health Perspectives, 114(): 1489-1496.
10.1289/ehp.9256
CrossRef
Comptes Rendus Geoscience
Human mortality effects of future concentrations of tropospheric ozone
West, JJ; Szopa, S; Hauglustaine, DA
Comptes Rendus Geoscience, 339(): 775-783.
10.1016/j.crte.2007.08.005
CrossRef
Environmental Health
An outbreak of cardiovascular syndromes requiring urgent medical treatment and its association with environmental factors: an ecological study
Turner, RM; Muscatello, DJ; Zheng, W; Willmore, A; Arendts, G
Environmental Health, 6(): -.
ARTN 37
CrossRef
Environmental Health
Ancillary human health benefits of improved air quality resulting from climate change mitigation
Bell, ML; Davis, DL; Cifuentes, LA; Krupnick, AJ; Morgenstern, RD; Thurston, GD
Environmental Health, 7(): -.
ARTN 41
CrossRef
B E Journal of Economic Analysis & Policy
Regulating NOx and SO2 Emissions in Atlanta
Muller, N; Tong, D; Mendelsohn, R
B E Journal of Economic Analysis & Policy, 9(2): -.
ARTN 3
CrossRef
Health Economics
DO Current Levels of Air Pollution Kill? the Impact of Air Pollution on Population Mortality in England
Janke, K; Propper, C; Henderson, J
Health Economics, 18(9): 1031-1055.
10.1002/hec.1475
CrossRef
Occupational and Environmental Medicine
Ozone exposure, antioxidant genes, and lung function in an elderly cohort: VA normative aging study
Alexeeff, SE; Litonjua, AA; Wright, RO; Baccarelli, A; Suh, H; Sparrow, D; Vokonas, PS; Schwartz, J
Occupational and Environmental Medicine, 65(): 736-742.
10.1136/oem.2007.035253
CrossRef
Neurotoxicology
Neurobehavioral effects of ambient air pollution on cognitive performance in US adults
Chen, JC; Schwartz, J
Neurotoxicology, 30(2): 231-239.
10.1016/j.neuro.2008.12.011
CrossRef
Climatic Change
Climate change, ambient ozone, and health in 50 US cities
Bell, ML; Goldberg, R; Hogrefe, C; Kinney, PL; Knowlton, K; Lynn, B; Rosenthal, J; Rosenzweig, C; Patz, JA
Climatic Change, 82(): 61-76.
10.1007/s10584-006-9166-7
CrossRef
Toxicological Sciences
The complexities of air pollution regulation: The need for an integrated research and regulatory perspective
Nadadur, SS; Miller, CA; Hopke, PK; Gordon, T; Vedal, S; Vandenberg, JJ; Costa, DL
Toxicological Sciences, 100(2): 318-327.
10.1093/toxsci/kfm170
CrossRef
Environmental Research
A time-series analysis of any short-term effects of meteorological and air pollution factors on preterm births in London, UK
Lee, SJ; Hajat, S; Steer, PJ; Filippi, V
Environmental Research, 106(2): 185-194.
10.1016/j.envres.2007.10.003
CrossRef
Revue Francaise D Allergologie
Short-term health effects of air pollution on mortality
Pascal, L
Revue Francaise D Allergologie, 49(6): 466-476.
10.1016/j.reval.2009.08.005
CrossRef
Environmental Health
Air pollution and mortality in the Canary Islands: a time-series analysis
Lopez-Villarrubia, E; Ballester, F; Iniguez, C; Peral, N
Environmental Health, 9(): -.
ARTN 8
CrossRef
Proceedings of the National Academy of Sciences of the United States of America
Global health benefits of mitigating ozone pollution with methane emission controls
West, JJ; Fiore, AM; Horowitz, LW; Mauzerall, DL
Proceedings of the National Academy of Sciences of the United States of America, 103(): 3988-3993.

Environmental Health Perspectives
The impact of secondary particles on the association between ambient ozone and mortality
Franklin, M; Schwartz, J
Environmental Health Perspectives, 116(4): 453-458.
10.1289/ehp.10777
CrossRef
Environment International
Does temperature modify short-term effects of ozone on total mortality in 60 large eastern US communities? An assessment using the NMMAPS data
Ren, C; Williams, GM; Mengersen, K; Morawska, L; Tong, S
Environment International, 34(4): 451-458.
10.1016/j.envint.2007.10.001
CrossRef
Journal of Exposure Science and Environmental Epidemiology
Does one size fit all? The suitability of standard ozone exposure metric conversion ratios and implications for epidemiology
Anderson, GB; Bell, ML
Journal of Exposure Science and Environmental Epidemiology, 20(1): 2-11.
10.1038/jes.2008.69
CrossRef
Environmental Science & Technology
Intercontinental Impacts of Ozone Pollution on Human Mortality
Anenberg, SC; West, JJ; Fiore, AM; Jaffe, DA; Prather, MJ; Bergmann, D; Cuvelier, K; Dentener, FJ; Duncan, BN; Gauss, M; Hess, P; Jonson, JE; Lupu, A; MacKenzie, IA; Marmer, E; Park, RJ; Sanderson, MG; Schultz, M; Shindell, DT; Szopa, S; Vivanco, MG; Wild, O; Zang, G
Environmental Science & Technology, 43(): 6482-6487.
10.1021/es900518z
CrossRef
Journal of the Air & Waste Management Association
Using Backup Generators for Meeting Peak Electricity Demand: A Sensitivity Analysis on Emission Controls, Location, and Health Endpoints
Gilmore, EA; Adams, PJ; Lave, LB
Journal of the Air & Waste Management Association, 60(5): 523-531.
10.3155/1047-3289.60.5.523
CrossRef
American Journal of Epidemiology
Ambient Ozone Concentrations and Cardiac Mortality in Southern California 1983-2000: Application of a New Marginal Structural Model Approach
Moore, K; Neugebauer, R; Lurmann, F; Hall, J; Brajer, V; Alcorn, S; Tager, I
American Journal of Epidemiology, 171(): 1233-1243.
10.1093/aje/kwq064
CrossRef
Environmental Pollution
Cumulative effects and threshold levels in air pollution mortality: Data analysis of nine large US cities using the NMMAPS dataset
Stylianou, M; Nicolich, MJ
Environmental Pollution, 157(): 2216-2223.
10.1016/j.envpol.2009.04.011
CrossRef
Inhalation Toxicology
Reassessing the relationship between ozone and short-term mortality in US urban communities
Smith, RL; Xu, BW; Switzer, P
Inhalation Toxicology, 21(): 37-61.
10.1080/08958370903161612
CrossRef
Science of the Total Environment
Association of ambient air pollution with hospital outpatient and emergency room visits in Shanghai, China
Cao, JS; Li, WH; Tan, JG; Song, WM; Xu, XH; Jiang, C; Chen, GH; Chen, RJ; Ma, WJ; Chen, BH; Kan, HD
Science of the Total Environment, 407(): 5531-5536.
10.1016/j.scitotenv.2009.07.021
CrossRef
Epidemiologia & Prevenzione
Health impact of ozone in 13 Italian cities
Mitis, F; Iavarone, I; Martuzzil, M
Epidemiologia & Prevenzione, 31(6): 323-332.

Lancet
Health and Climate Change 5 Public health benefits of strategies to reduce greenhouse-gas emissions: health implications of short-lived greenhouse pollutants
Smith, KR; Jerrett, M; Anderson, HR; Burnett, RT; Stone, V; Derwent, R; Atkinson, RW; Cohen, A; Shonkoff, SB; Krewski, D; Pope, CA; Thun, MJ; Thurston, G
Lancet, 374(): 2091-2103.
10.1016/S0140-6736(09)61716-5
CrossRef
Journal of Power Sources
The air quality and human health effects of integrating utility-scale batteries into the New York State electricity grid
Gilmore, EA; Apt, J; Walawalkar, R; Adams, PJ; Lave, LB
Journal of Power Sources, 195(8): 2405-2413.
10.1016/j.jpowsour.2009.10.072
CrossRef
Journal of Epidemiology and Community Health
Air pollution and cardiovascular admissions association in Spain: results within the EMECAS project
Ballester, F; Rodriguez, P; Iniguez, C; Saez, M; Daponte, A; Galan, I; Taracido, M; Arribas, F; Bellido, J; Cirarda, FB; Canada, A; Guillen, JJ; Guillen-Grima, F; Lopez, E; Perez-Hoyos, S; Lertxundi, A; Toro, S
Journal of Epidemiology and Community Health, 60(4): 328-336.
10.1136/jech.2005.037978
CrossRef
Journal of Epidemiology and Community Health
Air pollution and emergency admissions in Boston, MA
Zanobetti, A; Schwartz, J
Journal of Epidemiology and Community Health, 60(): 890-895.
10.1136/jech.2005.039834
CrossRef
Environmental Health Perspectives
Potential confounding of particulate matter on the short-term association between ozone and mortality in multisite time-series studies
Bell, ML; Kim, JY; Dominici, F
Environmental Health Perspectives, 115(): 1591-1595.
10.1289/ehp.10108
CrossRef
Atmospheric Chemistry and Physics
Effect of regional precursor emission controls on long-range ozone transport - Part 2: Steady-state changes in ozone air quality and impacts on human mortality
West, JJ; Naik, V; Horowitz, LW; Fiore, AM
Atmospheric Chemistry and Physics, 9(): 6095-6107.

Building and Environment
Passive reduction of human exposure to indoor ozone
Kunkel, DA; Gall, ET; Siegel, JA; Novoselac, A; Morrison, GC; Corsi, RL
Building and Environment, 45(2): 445-452.
10.1016/j.buildenv.2009.06.024
CrossRef
Environmental Science & Technology
Adjoint sensitivity analysis of ozone nonattainment over the continental United States
Hakami, A; Seinfeld, JH; Chai, TF; Tang, YH; Carmichael, GR; Sandu, A
Environmental Science & Technology, 40(): 3855-3864.
10.1021/es052135g
CrossRef
4Th International Conference Citizens and Governance for Sustainable Development
Relation between ozone level and human health from a sustainable development viewpoint
Girgzdiene, R; Girgzdys, A
4Th International Conference Citizens and Governance for Sustainable Development, (): 200-204.

Environmental Health Perspectives
Protective role of matrix metalloproteinase-9 in ozone-induced airway inflammation
Yoon, HK; Cho, HY; Kleeberger, SR
Environmental Health Perspectives, 115(): 1557-1563.
10.1289/ehp.10289
CrossRef
Environmental Research
The environmental burden of disease in Canada: Respiratory disease, cardiovascular disease, cancer, and congenital affliction
Boyd, DR; Genuis, SJ
Environmental Research, 106(2): 240-249.
10.1016/j.envres.2007.08.009
CrossRef
Seasonal Forecasts, Climatic Change and Human Health
Impacts of heat and ozone on mortality risk in the New York City metropolitan region under a changing climate
Knowlton, K; Hogrefe, C; Lynn, B; Rosenzweig, C; Rosenthal, J; Kinney, PL
Seasonal Forecasts, Climatic Change and Human Health, 30(): 143-160.

Environmental Health
Is there adaptation in the ozone mortality relationship: A multi-city case-crossover analysis
Zanobetti, A; Schwartz, J
Environmental Health, 7(): -.
ARTN 22
CrossRef
Journal of Epidemiology and Community Health
The temporal pattern of mortality responses to ambient ozone in the APHEA project
Samoli, E; Zanobetti, A; Schwartz, J; Atkinson, R; LeTertre, A; Schindler, C; Perez, L; Cadum, E; Pekkanen, J; Paldy, A; Touloumi, G; Katsouyanni, K
Journal of Epidemiology and Community Health, 63(): 960-966.
10.1136/jech.2008.084012
CrossRef
Environmental Health Perspectives
Adverse cardiovascular effects with acute particulate matter and ozone exposures: Interstrain variation in mice
Hamade, AK; Rabold, R; Tankersley, CG
Environmental Health Perspectives, 116(8): 1033-1039.
10.1289/ehp.10689
CrossRef
Publius-the Journal of Federalism
You Get What You Pay For: Environmental Policy and Public Health
Woods, ND; Konisky, DM; Bowman, AO
Publius-the Journal of Federalism, 39(1): 95-116.
10.1093/publius/pjn024
CrossRef
Science of the Total Environment
Factors influencing relationships between personal and ambient concentrations of gaseous and particulate pollutants
Brown, KW; Sarnat, JA; Suh, HH; Coull, BA; Koutrakis, P
Science of the Total Environment, 407(): 3754-3765.
10.1016/j.scitotenv.2009.02.016
CrossRef
Toxicology Letters
Effects of ozone and fine particulate matter (PM2.5) on rat system inflammation and cardiac function
Wang, GH; Jiang, RF; Zhao, ZH; Song, WM
Toxicology Letters, 217(1): 23-33.
10.1016/j.toxlet.2012.11.009
CrossRef
Environmental Monitoring and Assessment
Human health damage caused by particulate matter PM10 and ozone in urban environments: the case of Athens, Greece
Kassomenos, PA; Dimitriou, K; Paschalidou, AK
Environmental Monitoring and Assessment, 185(8): 6933-6942.
10.1007/s10661-013-3076-8
CrossRef
International Archives of Occupational and Environmental Health
Association between ambient ozone and health outcomes in Prague
Hunova, I; Maly, M; Rezacova, J; Branis, M
International Archives of Occupational and Environmental Health, 86(1): 89-97.
10.1007/s00420-012-0751-y
CrossRef
Environmental Research Letters
Changes in the frequency and return level of high ozone pollution events over the eastern United States following emission controls
Rieder, HE; Fiore, AM; Polvani, LM; Lamarque, JF; Fang, Y
Environmental Research Letters, 8(1): -.
ARTN 014012
CrossRef
Environmental Pollution
Comparing ozone metrics on associations with outpatient visits for respiratory diseases in Taipei Metropolitan area
Lin, YK; Chang, SC; Lin, CS; Chen, YC; Wang, YC
Environmental Pollution, 177(): 177-184.
10.1016/j.envpol.2012.12.010
CrossRef
Environmental Science & Technology
Impact of Human Presence on Secondary Organic Aerosols Derived from Ozone-Initiated Chemistry in a Simulated Office Environment
Fadeyi, MO; Weschler, CJ; Tham, KW; Wu, WY; Sultan, ZM
Environmental Science & Technology, 47(8): 3933-3941.
10.1021/es3050828
CrossRef
Atmospheric Environment
Which metric of ambient ozone to predict daily mortality?
Moshammer, H; Hutter, HP; Kundi, M
Atmospheric Environment, 65(): 171-176.
10.1016/j.atmosenv.2012.10.032
CrossRef
International Journal of Environmental Research and Public Health
Valuation of Mortality Risk Attributable to Climate Change: Investigating the Effect of Survey Administration Modes on a VSL
Scasny, M; Alberini, A
International Journal of Environmental Research and Public Health, 9(): 4760-4781.
10.3390/ijerph9124760
CrossRef
Environment International
A framework to spatially cluster air pollution monitoring sites in US based on the PM2.5 composition
Austin, E; Coull, BA; Zanobetti, A; Koutrakis, P
Environment International, 59(): 244-254.
10.1016/j.envint.2013.06.003
CrossRef
Journal of Environmental Protection and Ecology
Monitoring of Ozone Concentrations in the Belgrade Urban Area
Arsic, M; Nikolic, D; Mihajlovic, I; Zivkovic, Z; Djordjevic, P
Journal of Environmental Protection and Ecology, 13(4): 2057-2067.

European Respiratory Journal
Impact of climate change on ozone-related mortality and morbidity in Europe
Orru, H; Andersson, C; Ebi, KL; Langner, J; Astrom, C; Forsberg, B
European Respiratory Journal, 41(2): 285-294.
10.1183/09031936.00210411
CrossRef
American Journal of Epidemiology
Re: Is the Relation Between Ozone And Mortality Confounded by Chemical Components of Particulate Matter? Analysis of 7 Components in 57 us Communities
Anderson, GB; Krall, JR; Peng, RD; Bell, ML
American Journal of Epidemiology, 177(): 1460-1462.
10.1093/aje/kwt080
CrossRef
Nature Climate Change
El Nino and health risks from landscape fire emissions in southeast Asia
Marlier, ME; DeFries, RS; Voulgarakis, A; Kinney, PL; Randerson, JT; Shindell, DT; Chen, Y; Faluvegi, G
Nature Climate Change, 3(2): 131-136.
10.1038/NCLIMATE1658
CrossRef
Atmospheric Environment
The short-term effect of ambient ozone on mortality is modified by temperature in Guangzhou, China
Liu, T; Li, TT; Zhang, YH; Xu, YJ; Lao, XQ; Rutherford, S; Chu, C; Luo, Y; Zhu, Q; Xu, XJ; Xie, HY; Liu, ZR; Ma, WJ
Atmospheric Environment, 76(): 59-67.
10.1016/j.atmosenv.2012.07.011
CrossRef
Atmospheric Environment
A numerical study of the impact of climate and emission changes on surface ozone over South China in autumn time in 2000-2050
Liu, Q; Lam, KS; Jiang, F; Wang, TJ; Xie, M; Zhuang, BL; Jiang, XY
Atmospheric Environment, 76(): 227-237.
10.1016/j.atmosenv.2013.01.030
CrossRef
Environmental Health Perspectives
Time-Series Analyses of Air Pollution and Mortality in the United States: A Subsampling Approach
Moolgavkar, SH; McClellan, RO; Dewanji, A; Turim, J; Luebeck, EG; Edwards, M
Environmental Health Perspectives, 121(1): 73-78.
10.1289/ehp.1104507
CrossRef
Environmental Health Perspectives
Source Attribution of Health Benefits from Air Pollution Abatement in Canada and the United States: An Adjoint Sensitivity Analysis
Pappin, AJ; Hakami, A
Environmental Health Perspectives, 121(5): 572-579.
10.1289/ehp.1205561
CrossRef
Air Quality Atmosphere and Health
The public health context for PM2.5 and ozone air quality trends
Fann, N; Risley, D
Air Quality Atmosphere and Health, 6(1): 1-11.
10.1007/s11869-010-0125-0
CrossRef
Current Medicinal Chemistry
Free Radicals and Antioxidants: How to Reestablish Redox Homeostasis in Chronic Diseases?
Bocci, V; Valacchi, G
Current Medicinal Chemistry, 20(): 3397-3415.

Environmental Monitoring and Assessment
Seasonal variation in the acute effects of ozone on premature mortality among elderly Japanese
Ng, CFS; Ueda, K; Nitta, H; Takeuchi, A
Environmental Monitoring and Assessment, 185(): 8767-8776.
10.1007/s10661-013-3211-6
CrossRef
The American Journal of the Medical Sciences
Outdoor Air Pollution: Ozone Health Effects
Chen, T; Gokhale, J; Shofer, S; Kuschner, WG
The American Journal of the Medical Sciences, 333(4): 244-248.
10.1097/MAJ.0b013e31803b8e8c
PDF (123) | CrossRef
Epidemiology
Air Pollution and Heart Rate Variability: Effect Modification by Chronic Lead Exposure
Park, SK; O'Neill, MS; Vokonas, PS; Sparrow, D; Wright, RO; Coull, B; Nie, H; Hu, H; Schwartz, J
Epidemiology, 19(1): 111-120.
10.1097/EDE.0b013e31815c408a
PDF (370) | CrossRef
Epidemiology
On Health Effects of Ozone Exposure and Exposing the Epidemiologic Process
The Editors,
Epidemiology, 16(4): 425-426.
10.1097/01.ede.0000165818.17573.76
PDF (81) | CrossRef
Epidemiology
Ambient Ozone and Mortality
Bates, DV
Epidemiology, 16(4): 427-429.
10.1097/01.ede.0000165793.71278.ec
PDF (118) | CrossRef
Epidemiology
The Methodologic Ozone Effect
Goodman, SN
Epidemiology, 16(4): 430-435.
10.1097/01.ede.0000165813.07327.35
PDF (209) | CrossRef
Epidemiology
Errata

Epidemiology, 19(4): 637.
10.1097/EDE.0b013e3181773476
PDF (49) | CrossRef
Back to Top | Article Outline

© 2005 Lippincott Williams & Wilkins, Inc.

Twitter  Facebook

Login

Article Tools

Images

Share