Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Abstract

Ground level ozone is a potent respiratory toxicant with decades of accumulated data demonstrating respiratory harms to children. Despite the ubiquity of ozone in the United States, impacting both urban and rural communities, the associated harms of exposure to this important air pollutant are often infrequently or inadequately covered during medical training including pulmonary specialization. Thus, many providers caring for children's respiratory health may have limited knowledge of the harms which may result in reduced discussion of ozone pollution during clinical encounters. Further, the current US air quality standard for ozone does not adequately protect children. In this nonsystematic review, we present basic background information for healthcare providers caring for children's respiratory health, review the US process for setting air quality standards, discuss the respiratory harms of ozone for healthy children and those with underlying respiratory disease, highlight the urgent need for a more protective ozone standard to adequately protect children's respiratory health, review impacts of climate change on ozone levels, and provide information for discussion in clinical encounters.

“Air That Once Was Breath” Part 1: Wildfire-Smoke-Induced Mechanisms of Airway Inflammation – “Climate Change, Allergy and Immunology” Special IAAI Article Collection: Collegium Internationale Allergologicum Update 2023

“…The importance of O 3 in airway disease is supported by the fact that in cities with high O 3 levels, people have an over 30% increase in risk of dying from airway disease [59] and children playing outdoor sports have a three times greater chance of developing asthma [8,60]. O 3 , a direct source of oxidative stress (reviewed by Enweasor et al [61]), can reduce lung function and induce inflammation of the airways, chest pain, coughing, wheezing, and shortness of breath, even in healthy people.…”

Ground-level ozone concentration and emergency conditions in patients with bronchial asthma on southern coast of Crimea: retrospective study

“…Связь между уровнем приземного озона и неблагоприятными респираторными последствиями указывает на необходимость учета этих данных регулирующими органами и постоянной переоценкой стандартов загрязнения окружающей среды, которые должны быть предназначены для защиты наиболее уязвимых слоев населения, и выработкой стратегии по уменьшению воздействия атмосферного озона на человека [10][11][12]. При этом отмечается, что в практической медицине имеются ограниченные знания о вреде, который может оказывать озон, что снижает эффективность тактики лечения [13].…”