In recent years, with the significant decline in fine particulate matter (PM2.5) concentrations, ozone (O3) has emerged as a major composite air pollutant during the warm season in China, attracting increasing attention due to its associated health burden and economic costs. This study focuses on Tianjin, using ozone monitoring data from 2017 to 2023 combined with health statistics to assess the health impacts and economic losses attributable to ozone pollution. First, ozone exposure indicators and compliance criteria were constructed based on national air quality standards, and the interannual variation and spatial differences of O3 levels were analyzed at both citywide and district scales. Second, multiple machine learning classification models, including logistic regression, decision tree, k-nearest neighbors, and gradient boosting, were developed using ozone and meteorological variables to predict the occurrence risks of five diseases: cardiovascular diseases, respiratory diseases, hand-foot-and-mouth disease (HFMD), influenza, and dengue fever. Finally, excess cases were estimated using health impact functions, and the associated economic losses were quantified by combining the value of a statistical life (VSL) with cost-of-illness and willingness-to-pay (WTP) approaches. The results showed that the annual evaluation value of ozone in Tianjin, defined as the 90th percentile of the daily maximum 8 h average O3 concentration, exhibited a pattern of initially increasing, then decreasing, and subsequently rebounding. It peaked at 201 µg/m3 in 2018, declined to a minimum of 164 µg/m3 in 2021, and rebounded to 188 µg/m3 in 2023. Machine-learning results indicated that the logistic regression model showed relatively stable overall performance across predictions of different diseases, while the gradient boosting tree model also achieved high accuracy in predicting certain infectious diseases. Overall, ozone pollution exhibits significant heterogeneous effects across different disease types, and the associated health-related economic losses show stage-wise fluctuations in response to pollution levels. Based on these findings, it is recommended to implement refined control measures during periods of high ozone exceedance and in key regions, while strengthening protection for vulnerable populations such as the elderly, children, and patients with respiratory diseases, in order to achieve synergistic improvements in air quality management and public health outcomes.
The health hazards caused by air pollution vary significantly depending on factors such as the composition of pollutants in the region, climate, and the susceptibility of the population. Although numerous studies have explored the relationship between air quality and pneumonia, specific research evidence from a particular inland energy city like Qingyang in China is still scarce. This study aims to quantify the short-term impact of air pollution in this under-researched region on pneumonia hospitalizations. We collected the medical records of patients with pneumonia from January 1, 2015, to December 31, 2019, and also obtained data on 6 types of common air pollutants and meteorological conditions. We performed a time series analysis using a generalized additive model and a distributed nonlinear lag model. All measured data exhibited pronounced seasonality: particulate matter less than 2.5 μm in diameter, particulate matter less than 10 μm in diameter, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) concentrations and pneumonia admissions were higher in the cold season and lower in the warm season, a pattern conversely mirrored by ozone (O3) concentrations, average temperature, and relative humidity. In the single pollutant model, for every 10 μg/m3 increase in exposure levels of particulate matter less than 2.5 μm in diameter, particulate matter less than 10 μm in diameter, SO2, NO2, and O3 8 hours and for every 1 mg/m3 increase in CO exposure level, the risk of pneumonia admission was 1.004 (0.991, 1.017), 1.004 (0.999, 1.010), 1.035 (1.022, 1.048), 1.221 (1.174, 1.271), 0.999 (0.981, 1.017), and 1.382 (1.230, 1.552), respectively. The strongest effects occur in lag 1, lag 7, lag 07, lag 07, lag 3, and lag 05, respectively. Our study identifies significant gender- and age-specific susceptibilities to air pollution in Qingyang. Men were more vulnerable to SO2, whereas women were more affected by CO. Children aged ≤14 years constituted a high-risk group. Furthermore, we observed a distinct seasonal pattern: SO2, NO2, and CO were key drivers of pneumonia admissions with stronger effects in the cold season, in contrast to O3, which exhibited adverse effects only during the warm season.
Lisha Zhu, Jiyuan Dong, Jianhua You et al.· Medicine· 0 citations
This study quantifies the annual health and economic burden caused by exposure to local emissions of fine particulate matter (PM2.5), ozone, nitrogen dioxide (NO2) and benzene in the Haifa Bay Area, Israel.
A spatial health impact assessment was conducted using high-resolution pollution modeling and fine-scale population data. National disease rates and local concentrations were combined to estimate mortality and morbidity across statistical areas. Economic costs were evaluated using cost-of-illness and Value of a Statistical Life (VSL) and the Value of a Life Year (VOLY).
Significant spatial differences were found in both exposure levels and attributable health outcomes, with specific neighborhoods facing higher risks of mortality and chronic diseases, including cardiovascular disease, cancer, Diabetes, asthma and low birthweight. The total annual economic burden was estimated at 0.56–1.36 billion ILS (approximately 150–366 million USD).
Results provide essential data for local policymakers to target high-risk areas and inform cost-effective pollution-reduction strategies in complex urban zones.
This research offers a novel, spatially resolved quantification of the health and economic burden of local air pollution in Israel, combining advanced epidemiological methods and economic analysis to support integrated environmental management.
Asael Greenfeld, Yossi Erel, Gad Schaffer et al.· Management of environmental...· 0 citations
Evidence regarding the short-term effects of ambient air pollution on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) across multiple cities in northern China remains limited. This study aimed to evaluate the associations between major ambient air pollutants and AECOPD hospitalizations, as well as their lagged effects. We conducted an ecological time-series study of 14,786 AECOPD hospitalizations recorded at 49 hospitals in Shijiazhuang, Handan, and Chengde, Hebei Province, from January 1, 2018, to December 31, 2020. City-specific associations between daily concentrations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and 8-hour ozone and AECOPD hospitalizations were estimated using distributed lag nonlinear models, with adjustment for long-term trends, temperature, relative humidity, day of the week, public holidays, and stages of the coronavirus disease 2019 pandemic. Single-day lag effects from lag 0 to lag 5, cumulative lag effects from lag 0–1 to lag 0–5, effects of extreme pollutant concentrations, and associations stratified by age and sex were evaluated. City-specific estimates were subsequently pooled using random-effects multivariate meta-analysis. Associations were expressed as relative risks with 95% confidence intervals. During the 1096-day study period, 14,786 AECOPD hospitalizations were recorded. Compared with the 25th-percentile concentrations, the 75th-percentile concentrations of PM2.5, PM10, SO2, NO2, and CO generally showed stronger cumulative associations with longer lag periods, with the largest estimates usually observed at lag 0–5 days, whereas single-day effects were weak. All 6 pollutants exhibited nonlinear cumulative exposure–response relationships. Compared with median concentrations, the 99th-percentile concentrations of PM2.5, PM10, SO2, NO2, and CO were associated with higher hospitalization risks. High PM2.5 reached its maximum effect at lag 0–5 days (relative risk, 1.391; 95% confidence interval, 1.169–1.658). Higher 8-hour ozone concentrations were generally associated with lower hospitalization risk. Associations were more pronounced among adults aged ≥65 years and males. Short-term exposure to PM2.5, PM10, SO2, NO2, and CO was associated with increased AECOPD hospitalization risk, with nonlinear, lagged, and cumulative effects. Older adults and females may be more susceptible to ambient air pollution.
Huixia Shi, Jiajun Li, Boyan Li et al.· Medicine· 0 citations
Ground-level ozone (O3) pollution is a pressing global environmental health threat. In 2021, the World Health Organization (WHO) introduced stringent O3 control strategies. However, their uniform application across regions with various economic conditions has raised concerns about equity and feasibility, particularly in low- and middle-income areas. To develop region-specific O3 control strategies, we adopted a log-linear concentration-response (C-R) model to quantify O3-attributable Chronic Obstructive Pulmonary Disease (COPD) mortality burden and further applied a cost-benefit model to assess the economic costs and health benefits of O3 reduction across different regions in China. Results showed that in 2021, O3 concentrations in all Chinese cities exceeded WHO Air Quality Guidelines (AQG), with 54.78% surpassing the Interim target 1 (IT-1). The health burden of O3-attributable COPD remained severe, with the worst in Eastern China. Based on the cost-benefit model, the O3 control strategies for Eastern, Central, and Western China were determined as 116 μg/m3, 111 μg/m3, and 100 μg/m3, respectively. This regionalized strategy could reduce COPD deaths by 5.44% while lowering emission reduction costs. Our findings provide a scientific basis for targeted O3 mitigation policies in China and offer a "Chinese solution" for developing nations around the world to seek a balance between air quality management and economic development.
Yilan Shu, Huijuan Wang, Zilin Han et al.· Environmental Research· 0 citations
China has invested heavily in air pollution control in recent years, yet comprehensive assessments of the associated health economic benefits remain limited. Prior research on the health economic benefits of air pollution control has mainly focused on mortality outcomes and PM2.5, which may substantially underestimates the true benefits of clean air policies. This study aims to evaluate the health economic benefits and losses associated with air pollution control by incorporating multiple health outcomes, population groups and air pollutants. We integrate daily mortality, hospital admission and outpatient visits and air pollutant (nitrogen dioxide, ozone [O3] and fine particulate matter) data from 18 cities from 2015 to 2022 to assess the health economic benefits. A generalized additive model was used to estimate concentration-response relationships. Health economic benefits were calculated based on the value of statistical life (VSL) and direct medical costs. Between 2015 and 2022, controlling PM2.5 and NO2 yielded significant health economic benefits across all health outcomes. Air pollution control generated significant health economic benefits across multiple outcomes in Guangdong Province. The total health economic benefits associated with PM2.5 and NO2 were 10,305.35 and 1017.00 million CNY, respectively. In contrast, O3 control yielded negative net benefits across all outcomes. Between 2015 and 2022, the multi-outcome health benefits of controlling PM2.5 exceeded mortality-only estimates by 31.79%, respectively For PM2.5 control, the elderly accounted for over 85% of the mortality-related benefits. These findings highlight the need for coordinated PM2.5-O3 control, the integration of multi-outcome evaluations into policy design, and targeted protection for vulnerable populations particularly the elderly.
BACKGROUND
Air pollution is an important environmental factor influencing respiratory and cardiovascular diseases, and growing experimental evidence suggests that exposure to air pollutants can also cause neuroinflammation and neuronal damage. However, epidemiological evidence on the impact of air pollution exposure on neurological disorders remains limited. This study aims to evaluate the impact of short-term air pollution exposure on hospital admissions for neurological disorders.
METHODS
A total of 249,717 hospital admissions for neurological disorders in Harbin, China, from 2014 to 2023, were collected in this registry-based cohort study. Distributed lag nonlinear model (DLNM) was used to evaluate the effects of PM2.5, PM10, NO2, CO, and a composite pollution index on overall neurological disorders, specific ICD disease modules and categories. Stratified analyses by sex, age, pandemic period, and season were further performed to identify high-risk subpopulations and examine variations in susceptibility to air pollution. Attributable risk estimations were further performed to assess the disease burden attributable to air pollution.
RESULTS
Exposure to PM2.5 (RR = 1.23, 95% CI: 1.14-1.32), NO2 (RR = 1.18, 95% CI: 1.10-1.27), PM10 (RR = 1.12, 95% CI: 1.06-1.19), and CO (RR = 1.10, 95% CI: 1.03-1.19) was associated with increased hospital admissions for overall neurological disorders. These associations were stronger in the cold season than in the warm season. Attributable risk analysis suggested that PM2.5 contributed the largest burden, accounting for 8.46% (95% CI: 5.46%-10.76%) of admissions. Different ICD disease modules and categories exhibited varying associations with different air pollutants.
CONCLUSIONS
Short-term exposure to air pollution increases the risk of hospital admissions for neurological disorders, particularly during the cold season, with PM2.5 contributing the largest disease burden.
Yong Cao, Qiang Ma, Lanfang Chen et al.· BMC Public Health· 0 citations