Observational studyAmerican journal of respiratory and critical care medicine2016
Long-Term Ozone Exposure Increases the Risk of Developing the Acute Respiratory Distress Syndrome.
Observational study in American journal of respiratory and critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it, 89 citations in OpenAlex.
- Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review.Environmental health : a global access science source · 2021Pooled it
- Hypoxia Inducible Factor-2 Alpha and Prolinhydroxylase 2 Polymorphisms in Patients with Acute Respiratory Distress Syndrome (ARDS).International journal of molecular sciences · 2017Trial
- Cardiopulmonary hospitalization risks from wildfire-specific and non-wildfire PMNature communications · 2026Article
- Repeated air pollution exposure predisposes to adverse outcomes from acute lung injury.Particle and fibre toxicology · 2026Article
- Impact of air pollution on exacerbations of respiratory and cardiovascular diseases for the intensivist: a narrative review.Intensive care medicine experimental · 2026Review
- Current Insights into Clinical, Molecular, and Therapeutic Approaches to Acute Respiratory Distress Syndrome.Medical sciences (Basel, Switzerland) · 2026Review
- Lung injury, oxidative stress, and impaired functioning in a model of prolonged ozone exposure in female mice are associated with macrophage proinflammatory and profibrotic activation and altered bioenergetics.Toxicological sciences : an official journal of the Society of Toxicology · 2026Article
- Tristetraprolin protects against ozone-induced acute lung injury and inflammation in mice.Journal of immunology (Baltimore, Md. : 1950) · 2026Article
- InNanomaterials (Basel, Switzerland) · 2025Article
- Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies.Signal transduction and targeted therapy · 2025Review
- Long-term air pollution exposure and the risk of primary graft dysfunction after lung transplantation.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025Observational
- Long-term exposure to fine particulate matter, ozone, and greenness and the risk of lung cancer: a retrospective cohort analysis within a national sample cohort.Frontiers in public health · 2025Article
- Environmental Risk Factors for Acute Respiratory Distress Syndrome.Clinics in chest medicine · 2024Review
- Effects of ozone exposure on lung injury, inflammation, and oxidative stress in a murine model of nonpneumonic endotoxemia.Toxicological sciences : an official journal of the Society of Toxicology · 2024Article
- Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study.BMC nephrology · 2024Article
- Ethnoracial Disparities in Nitrogen Dioxide Pollution in the United States: Comparing Data Sets from Satellites, Models, and Monitors.Environmental science & technology · 2023Article
- Effects of ambient air pollutants on ARDS incidence and outcome: a narrative review.Annals of intensive care · 2023Review
- Exposure to ambient air pollutants and acute respiratory distress syndrome risk in sepsis.Intensive care medicine · 2023Article
- The association between air pollution and the severity at diagnosis and progression of systemic sclerosis-associated interstitial lung disease: results from the retrospective ScleroPol study.Respiratory research · 2023Article
- PMEnvironmental geochemistry and health · 2022Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
rationaleThe contribution of air pollution to the risk of acute respiratory distress syndrome (ARDS) is unknown.
methodsWe studied 1,558 critically ill patients enrolled in a prospective observational study at a tertiary medical center who lived less than 50 km from an air quality monitor and had an ARDS risk factor. Pollutant exposures (ozone, NO2, SO2, particulate matter < 2.5 μm, particulate matter < 10 μm) were assessed by weighted average of daily levels from the closest monitors for the prior 3 years. Associations between pollutant exposure and ARDS risk were evaluated by logistic regression controlling for age, race, sex, smoking, alcohol, insurance status, rural versus urban residence, distance to study hospital, and Acute Physiology and Chronic Health Evaluation II. MEASUREMENTS AND MAIN
resultsThe incidence of ARDS increased with increasing ozone exposure: 28% in the lowest exposure quartile versus 32, 40, and 42% in the second, third, and fourth quartiles (P < 0.001). In a logistic regression model controlling for potential confounders, ozone exposure was associated with risk of ARDS in the entire cohort (odds ratio, 1.58 [95% confidence interval, 1.27-1.96]) and more strongly associated in the subgroup with trauma as their ARDS risk factor (odds ratio, 2.26 [95% confidence interval, 1.46-3.50]). There was a strong interaction between ozone exposure and current smoking status (P = 0.007). NO2 exposure was also associated with ARDS but not independently of ozone exposure. SO2, particulate matter less than 2.5 μm, and particulate matter less than 10 μm were not associated with ARDS.
conclusionsLong-term ozone exposure is associated with development of ARDS in at-risk critically ill patients, particularly in trauma patients and current smokers. Ozone exposure may represent a previously unrecognized environmental risk factor for ARDS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.