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A Systematic Review and Meta-Analysis of Short-Term Ambient Ozone Exposure and COPD Hospitalizations
- Source :
- International Journal of Environmental Research and Public Health, 17(6):2130. Multidisciplinary Digital Publishing Institute (MDPI), International Journal of Environmental Research and Public Health, Vol 17, Iss 6, p 2130 (2020), International Journal of Environmental Research and Public Health
- Publication Year :
- 2020
-
Abstract
- Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally and ozone exposure is a main cause of its disease burden. However, studies on COPD hospitalizations from short-term ambient level ozone exposure have not generated consensus results. To address the knowledge gap, comprehensive and systematic searches in several databases were conducted using specific keywords for publications up to February 14, 2020. Random-effect models were used to derive overall excess risk estimates between short-term ambient-level ozone exposure and COPD hospitalizations. The influence analyses were used to test the robustness of the results. Both meta-regression and subgroup analyses were used to explore the sources of heterogeneity and potential modifying factors. Based on the results from 26 eligible studies, the random-effect model analyses show that a 10 µg/m3 increase in maximum 8-h ozone concentration was associated with 0.84% (95% CI: 0.09%, 1.59%) higher COPD hospitalizations. The estimates were higher for warm season and multiple-day lag but lower for old populations. Results from subgroup analyses also indicate a multiple-day lag trend and bigger significant health effects during longer day intervals. Although characteristics of individual studies added modest heterogeneity to the overall estimates, the results remained robust during further analyses and exhibited no evidence of publication bias. Our systematic review and meta-analysis indicate that short-term ambient level ozone exposure was associated with increased risk of COPD hospitalizations. The significant association with multiple-day lag trend indicates that a multiple-day exposure metric should be considered for establishing ambient ozone quality and exposure standards for improvement of population health. Future investigations and meta-analysis studies should include clinical studies as well as more careful lag selection protocol.
- Subjects :
- Health, Toxicology and Mutagenesis
environmental health
lcsh:Medicine
Review
Population health
010501 environmental sciences
01 natural sciences
chronic obstructive pulmonary disease
Ambient ozone
Pulmonary Disease, Chronic Obstructive
03 medical and health sciences
0302 clinical medicine
Environmental health
medicine
Humans
Disease burden
0105 earth and related environmental sciences
Cause of death
Air Pollutants
COPD
business.industry
lcsh:R
Public Health, Environmental and Occupational Health
Absolute risk reduction
Environmental Exposure
Publication bias
medicine.disease
Hospitalization
meta-analysis
ozone
030228 respiratory system
Meta-analysis
Seasons
business
Subjects
Details
- Language :
- English
- ISSN :
- 16617827
- Database :
- OpenAIRE
- Journal :
- International Journal of Environmental Research and Public Health, 17(6):2130. Multidisciplinary Digital Publishing Institute (MDPI), International Journal of Environmental Research and Public Health, Vol 17, Iss 6, p 2130 (2020), International Journal of Environmental Research and Public Health
- Accession number :
- edsair.doi.dedup.....e28e64e35a2509bc9c867326a25bb863