Joint impact of heat and ozone exposure on mortality in Henan, central China

IF 3.8 2区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES

Atmospheric Environment Pub Date : 2026-03-15 Epub Date: 2026-01-19 DOI:10.1016/j.atmosenv.2026.121800

Dong Ding , Kai Kang , Shaofang Li , Tianfang Xing , Wenjie Yang , Liuqiao Sun , Xinxin Liu , Yao Chen , Mingyi Xue , Zengli Yu , Zhan Gao

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引用次数: 0

Abstract

Background

Globally, the increasing frequency of extreme heat events and ozone pollution incidents has significantly intensified public health risks. However, empirical evidence regarding their synergistic impacts remains limited in central China.

Methods

A two-stage analysis was conducted using data from 121 counties in Henan (2013–2019). Quasi-Poisson generalized additive models were used to assess county-specific associations, adjusting for PM₂.₅, RH, and temporal trends. The combined effect of air temperature (non-linear) and ozone (linear) was captured through multiplicative interaction terms. Random-effects meta-analyses were applied to pool the results. Subgroup analyses examined differences by age, sex, marital status, and cause of death.

Results

During the study period, 1,280,429 deaths were recorded. Both high temperatures and elevated ozone levels were associated with increased mortality. Their joint effects were stronger than individual exposures. At high ozone levels, mortality risk increased by 2 percentage points (from 9.3 % to 11.3 %) between temperature distribution percentiles 75th and 99th. Under high-temperature conditions (31.4 °C, 90th percentile), a 10 μg/m³ elevation in ozone was associated with a 0.94 % (95 % CI: 0.49 %–1.38 %) increase in mortality. Older adults, females, other marital statuses (including unmarried, divorced, or widowed), and those with cardiovascular or respiratory diseases were more susceptible to its effects.

Conclusion

High temperature and ozone synergistically increase mortality risk. Targeted interventions are needed to protect vulnerable groups under climate change.

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高温和臭氧暴露对河南省死亡率的共同影响

在全球范围内，极端高温事件和臭氧污染事件的频率日益增加，大大加剧了公共卫生风险。然而，关于其协同效应的经验证据在中国中部地区仍然有限。方法采用2013-2019年河南省121个县的数据进行两阶段分析。准泊松广义加性模型用于评估特定国家的关联，调整PM2.5、相对湿度和时间趋势。气温（非线性）和臭氧（线性）的综合效应通过乘法相互作用项被捕获。随机效应荟萃分析用于汇总结果。亚组分析检查了年龄、性别、婚姻状况和死亡原因的差异。结果在研究期间，记录了1,280,429例死亡。高温和臭氧浓度升高都与死亡率增加有关。它们的联合效应比单独接触更强。在高臭氧水平下，死亡风险在温度分布百分位数第75和99之间增加了2个百分点（从9.3%增加到11.3%）。在高温条件下（31.4°C， 90百分位），臭氧浓度每升高10 μg/m3，死亡率就会增加0.94% （95% CI: 0.49% - 1.38%）。老年人、女性、其他婚姻状况（包括未婚、离婚或丧偶）以及患有心血管或呼吸系统疾病的人更容易受到其影响。结论高温和臭氧协同增加死亡风险。需要有针对性的干预措施来保护气候变化下的弱势群体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atmospheric Environment 环境科学-环境科学

CiteScore

9.40

自引率

8.00%

发文量

458

审稿时长

53 days

期刊介绍： Atmospheric Environment has an open access mirror journal Atmospheric Environment: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atmospheric Environment is the international journal for scientists in different disciplines related to atmospheric composition and its impacts. The journal publishes scientific articles with atmospheric relevance of emissions and depositions of gaseous and particulate compounds, chemical processes and physical effects in the atmosphere, as well as impacts of the changing atmospheric composition on human health, air quality, climate change, and ecosystems.