SynthesisBMJ open2016
Long-term exposure to ambient ozone and mortality: a quantitative systematic review and meta-analysis of evidence from cohort studies.
Synthesis in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
68 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Ambient air pollution and urological cancer risk: A systematic review and meta-analysis of epidemiological evidence.Nature communications · 2024Pooled it
- Long-Term Exposure to Fine Particulate Matter and the Risk of Chronic Liver Diseases: A Meta-Analysis of Observational Studies.International journal of environmental research and public health · 2022Pooled it
- Mortality and Morbidity Effects of Long-Term Exposure to Low-Level PMResearch report (Health Effects Institute) · 2021Pooled it
- Individual-level interventions to reduce personal exposure to outdoor air pollution and their effects on people with long-term respiratory conditions.The Cochrane database of systematic reviews · 2021Pooled it
- Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses.International journal of environmental research and public health · 2021Pooled it
- Long-term exposure to NOEnvironment international · 2020Pooled it
- Long-Term Exposure to Air Pollutants and Cancer Mortality: A Meta-Analysis of Cohort Studies.International journal of environmental research and public health · 2018Pooled it
- Breathing in harm: current insights into the effects of air pollution on cardiorespiratory health.Medical gas research · 2027Review
- Investigation of the Association between Long-term Ozone Exposure and Cardiovascular Disease: A Meta-Analysis Addressing Exposure Windows, Vulnerable Populations, and Spatial Variation.China CDC weekly · 2026Review
- Ozone protects against ischemia-reperfusion injury: molecular mechanisms.Frontiers in pharmacology · 2026Review
- Mortality Related to Climate Change and Environmental Hazards in the Mediterranean Region: A Scoping Review.Current environmental health reports · 2025Article
- [Spatial association between air pollutants and diseases of the respiratory and cardiovascular systems in Hamburg].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2025Article
- Effect of Ozone Exposure on Cardiovascular and Cerebrovascular Disease Mortality in the Elderly.Toxics · 2025Article
- Ozone exposure and cardiovascular disease: A narrative review of epidemiology evidence and underlying mechanisms.Fundamental research · 2025Review
- Article
- Divergent trends and regional disparities in PMFrontiers in public health · 2025Article
- Spatial variation, temporal evolution, and source direction apportionment of PMEnvironmental monitoring and assessment · 2024Article
- Air Pollution Increases Risk of Occurrence of Intracerebral Haemorrhage but Not of Subarachnoid Haemorrhage: Time-Series Cross-Sectional Study.Biomedicines · 2024Article
- Assessing long-term effects of gaseous air pollution exposure on mortality in the United States using a variant of difference-in-differences analysis.Scientific reports · 2024Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWhile there is good evidence for associations between short-term exposure to ozone and a range of adverse health outcomes, the evidence from narrative reviews for long-term exposure is suggestive of associations with respiratory mortality only. We conducted a systematic, quantitative evaluation of the evidence from cohort studies, reporting associations between long-term exposure to ozone and mortality.
methodsCohort studies published in peer-reviewed journals indexed in EMBASE and MEDLINE to September 2015 and PubMed to October 2015 and cited in reviews/key publications were identified via search strings using terms relating to study design, pollutant and health outcome. Study details and estimate information were extracted and used to calculate standardised effect estimates expressed as HRs per 10 ppb increment in long-term ozone concentrations.
results14 publications from 8 cohorts presented results for ozone and all-cause and cause-specific mortality. We found no evidence of associations between long-term annual O3 concentrations and the risk of death from all causes, cardiovascular or respiratory diseases, or lung cancer. 4 cohorts assessed ozone concentrations measured during the warm season. Summary HRs for cardiovascular and respiratory causes of death derived from 3 cohorts were 1.01 (95% CI 1.00 to 1.02) and 1.03 (95% CI 1.01 to 1.05) per 10 ppb, respectively.
conclusionsOur quantitative review revealed a paucity of independent studies regarding the associations between long-term exposure to ozone and mortality. The potential impact of climate change and increasing anthropogenic emissions of ozone precursors on ozone levels worldwide suggests further studies of the long-term effects of exposure to high ozone levels are warranted.
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What OpenQuestion holds
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.