• Yue Niu, Ting Yang, Xiaoying Gu, Renjie Chen, Xia Meng, Jianying Xu, Lan Yang, Jianping Zhao, Xiangyan Zhang, Chunxue Bai, Jian Kang, Pixin Ran, Huahao Shen, Fuqiang Wen, Kewu Huang, Yahong Chen, Tieying Sun, Guangliang Shan, Yingxiang Lin, Sinan Wu, Jianguo Zhu, Ruiying Wang, Zhihong Shi, Yongjian Xu, Xianwei Ye, Yuanlin Song, Qiuyue Wang, Yumin Zhou, Liren Ding, Wanzhen Yao, Yanfei Guo, Fei Xiao, Yong Lu, Xiaoxia Peng, Biao Zhang, Dan Xiao, Zuomin Wang, Hong Zhang, Xiaoning Bu, Xiaolei Zhang, Li An, Shu Zhang, Zhixin Cao, Qingyuan Zhan, Yuanhua Yang, Lirong Liang, Bin Cao, Huaping Dai, Tangchun Wu, Jiang He, Huichu Li, Haidong Kan, Chen Wang, and China Pulmonary Health Study Group.
• School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, National Health Commission Key Lab of Health Technology Assessment, and.
• Am. J. Respir. Crit. Care Med. 2022 Feb 15; 205 (4): 450-458.

AbstractRationale: It remains unknown whether long-term ozone exposure can impair lung function. Objectives: To investigate the associations between long-term ozone exposure and adult lung function in China. Methods: Lung function results and diagnosis of small airway dysfunction (SAD) were collected from a cross-sectional study, the China Pulmonary Health Study (N = 50,991). We used multivariable linear and logistic regression models to examine the associations of long-term ozone exposure with lung function parameters and SAD, respectively, adjusting for demographic characteristics, individual risk factors, and longitudinal trends. We then performed a stratification analysis by chronic obstructive pulmonary disease (COPD). Measurements and Main Results: We observed that each 1 SD (4.9 ppb) increase in warm-season ozone concentrations was associated with a 14.2 ml/s (95% confidence interval [CI], 8.8-19.6 ml/s] decrease in forced expiratory flow at the 75th percentile of vital capacity and a 29.5 ml/s (95% CI, 19.6-39.5 ml/s) decrease in mean forced expiratory flow between the 25th and 75th percentile of vital capacity. The odds ratio of SAD was 1.09 (95% CI, 1.06-1.11) for a 1 SD increase in warm-season ozone concentrations. Meanwhile, we observed a significant association with decreased FEV1/FVC but not with FEV1 or FVC. The association estimates were greater in the COPD group than in the non-COPD group. Conclusions: We found independent associations of long-term ozone exposure with impaired small airway function and higher SAD risks, while the associations with airflow obstruction were weak. Patients with COPD appear to be more vulnerable.

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