Susceptibility Factors to Ozone-related Mortality

Abstract

A greater vulnerability of elderly people and women was indicated; subjects who died at home and had diabetes emerged as especially affected.

Evaluating Potential Response-Modifying Factors for Associations between Ozone and Health Outcomes: A Weight-of-Evidence Approach

“…The majority of multicity studies that presented age-stratified results—conducted in the United States (Medina-Ramón and Schwartz 2008; Zanobetti and Schwartz 2008), Chile (Cakmak et al 2007, 2011), and Italy (Stafoggia et al 2010)—as well as in single-city studies (e.g., Kan et al 2008) found a trend of increased risk estimates for mortality due to short-term O 3 exposure in older adults (≥ 65 years of age) compared with younger age groups. Exceptions include the Air Pollution and Health: a European and North American Approach (APHENA) (Katsouyanni et al 2009), which found increased percent change in mortality risk in the population ≥ 75 years of age in only one study location (i.e., Canada), and a study conducted in Finland (Halonen et al 2009), which found no evidence of an increased relative risk in the population ≥ 65 years of age compared with the population < 65 years of age.…”

“…Exceptions include the Air Pollution and Health: a European and North American Approach (APHENA) (Katsouyanni et al 2009), which found increased percent change in mortality risk in the population ≥ 75 years of age in only one study location (i.e., Canada), and a study conducted in Finland (Halonen et al 2009), which found no evidence of an increased relative risk in the population ≥ 65 years of age compared with the population < 65 years of age. Some of the studies that reported evidence of an increased relative risk in older adults have shown inconsistent results when focusing on individuals who were > 85 years of age, with the relative risk being higher in some cases (Stafoggia et al 2010) and lower in others (Cakmak et al 2007). A limited number of epidemiologic studies have examined potential differences in the relative risk by age in studies of respiratory-related HAs and ED visits (Arbex et al 2009; Halonen et al 2009) and studies of cardiovascular-related HAs (Buadong et al 2009; Halonen et al 2009) and have reported generally inconsistent results.…”

“…These studies, conducted in the United States (Medina-Ramón and Schwartz 2008), Italy (Stafoggia et al 2010), and Asia (Kan et al 2008), reported larger effect estimates in females than in males, with some evidence of the relative risk of mortality among females being larger, specifically among those ≥ 60 years of age (Medina-Ramón and Schwartz 2008). However, another study did not find any difference in the relative risk of O 3 -related mortality among men and women (Cakmak et al 2011).…”

“…Increases in O 3 -related mortality have also been observed in studies using individual-level education, individual-level occupation, and neighborhood-level income as measures of SES (Cakmak et al 2011). Other studies conducted in China and Italy reported inconsistent or null findings using individual-level educational attainment (Kan et al 2008), a neighborhood-level deprivation index (Wong et al 2008), and neighborhood-level income (Stafoggia et al 2010). The influence of SES on mortality has also been examined in studies of infant mortality in Mexico.…”

Subacute inhalation exposure to ozone induces systemic inflammation but not insulin resistance in a diabetic mouse model

“…Increased ambient ozone levels have been shown to be significantly associated with insulin resistance in the Korean Elderly Environmental Panel study (Kim and Hong, 2012). In addition, several epidemiological studies have linked ozone inhalation to increased risk of death in diabetic patients (Zanobetti and Schwartz, 2011, Stafoggia et al, 2010). However, a significant number of other reports failed to demonstrate associations of ozone inhalation with diabetic mortality (Goldberg et al, 2013) or acute complications of diabetes (Dales et al, 2012, Tolbert et al, 2007, Lee et al, 2008, Chiu and Yang, 2009), suggesting that in contrast to its well-established adverse effects on the respiratory system, how ozone inhalation affects the development of T2DM and its complications has yet to be determined.…”