1. Systematic Review of Ozone Effects on Human Lung Function, 2013 Through 2020
- Author
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Stephanie M. Holm and John R. Balmes
- Subjects
Lung Diseases ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Ozone ,air pollution ,spirometry ,Vital Capacity ,EPA, Environmental Protection Agency ,Air pollution ,Context (language use) ,Critical Care and Intensive Care Medicine ,medicine.disease_cause ,Human lung ,FEV1/FVC ratio ,chemistry.chemical_compound ,Forced Expiratory Volume ,Environmental health ,Epidemiology ,medicine ,Humans ,United States Environmental Protection Agency ,Lung ,child ,ppb, parts per billion ,medicine.diagnostic_test ,ISA, Integrated Science Assessment ,business.industry ,adult ,NAAQS, National Ambient Air Quality Standards ,Age Factors ,Environmental Exposure ,National Ambient Air Quality Standards ,United States ,Education and Clinical Practice: Original Research ,medicine.anatomical_structure ,chemistry ,PEF, peak expiratory flow ,epidemiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Ozone effects on lung function are particularly important to understand in the context of the air pollution-health outcomes epidemiologic literature, given the complex relationships between ozone and other air pollutants with known lung function effects. Research Question What has been learned about the association between ozone exposures and lung function from epidemiology studies published from 2013 through 2020? Study Design and Methods On March 18, 2018, and September 8, 2020, PubMed was searched using the terms health AND ozone, filtering to articles in English and about humans, from 2013 or later. An additional focused review searching for ozone AND (lung function OR FEV1 OR FVC) was performed June 26, 2021. Articles were selected for this review if they reported a specific relationship between a lung function outcome and ozone exposure. Results Of 3,271 articles screened, 53 ultimately met criteria for inclusion. A systematic review with assessment of potential for bias was conducted, but a meta-analysis was not carried out because of differences in exposure duration and outcome quantification. Consistent evidence exists of small decreases in children’s lung function, even associated with very low levels of short-term ozone exposure. The effects on adult lung function from exposure to low-level, short-term ozone are less clear, although ozone-associated decrements may occur in the elderly. Finally, long-term ozone exposure decreases both lung function and lung function growth in children, although few new studies have examined long-term ozone and lung function in adults. Interpretation Much of this literature involves concentrations below the current US Environmental Protection Agency’s National Ambient Air Quality Standard of 70 parts per billion over an 8-h averaging time, suggesting that this current standard may not protect children adequately from ozone-related decrements in lung function.
- Published
- 2022
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