Abstract
BACKGROUND: Tropospheric ozone (O₃) is increasingly becoming the dominant urban air pollutant in China, posing significant public health risks that are exacerbated by meteorological conditions. A clear understanding of how O₃-related health effects are modified by atmospheric factors is crucial for targeted risk mitigation. METHODS: This ten-year time-series study (2013-2022) was conducted in Taiyuan, China. We analyzed data on daily O₃ concentrations, meteorological factors, and all-cause and cause-specific mortality. The analysis employed Generalized Additive Models (GAMs) to assess the lagged effects of O₃ exposure on mortality and to investigate the interactions between O₃ and key atmospheric determinants, including temperature, sunshine duration, and season. RESULTS: The study revealed distinct patterns of O₃-related mortality risk modified by meteorological conditions. The 10-year average daily O₃ concentration was 92.92 μg/m(3). O₃ exposure significantly contributed to all-cause, respiratory, and circulatory mortality with lagged effects. While atmospheric pressure, sunshine duration, temperature, and season all influenced the O₃-mortality relationship, the effect was primarily modified through significant interactions with sunshine duration, season, and temperature. These interactive health risks were more pronounced among females and the older adults. CONCLUSION: Our study provides strong evidence that O(3) increases the risk of all-cause, respiratory and circulatory mortality in the population. In addition, there were interactions between meteorological factors and O(3), primarily involving sunshine duration, season and temperature.