Comparison of the association between different ozone indicators and daily respiratory hospitalization in Guangzhou, China

Abstract

BackgroundEpidemiological studies have widely proven the impact of ozone (O3) on respiratory mortality, while only a few studies compared the association between different O3 indicators and health.MethodsThis study explores the relationship between daily respiratory hospitalization and multiple ozone indicators in Guangzhou, China, from 2014 to 2018. It uses a time-stratified case–crossover design. Sensitivities of different age and gender groups were analyzed for the whole year, the warm and the cold periods. We compared the results from the single-day lag model and the moving average lag model.ResultsThe results showed that the maximum daily 8 h average ozone concentration (MDA8 O3) had a significant effect on the daily respiratory hospitalization. This effect was stronger than for the maximum daily 1 h average ozone concentration (MDA1 O3). The results further showed that O3 was positively associated with daily respiratory hospitalization in the warm season, while there was a significantly negative association in the cold season. Specifically, in the warm season, O3 has the most significant effect at lag 4 day, with the odds ratio (OR) equal to 1.0096 [95% confidence intervals (CI): 1.0032, 1.0161]. Moreover, at the lag 5 day, the effect of O3 on the 15–60 age group was less than that on people older than 60 years, with the OR value of 1.0135 (95% CI: 1.0041, 1.0231) for the 60+ age group; women were more sensitive than men to O3 exposure, with an OR value equal to 1.0094 (95% CI: 0.9992, 1.0196) for the female group.ConclusionThese results show that different O3 indicators measure different impacts on respiratory hospitalization admission. Their comparative analysis provided a more comprehensive insight into exploring associations between O3 exposure and respiratory health.