Abstract
The impact of O(3) on the respiratory system is a significant global problem. Nevertheless, there is insufficient information about its impact on respiratory disorders in northeast China. In this study, we used a generalized additive model (GAM) to determine the correlation between O(3) concentrations and respiratory deaths based on the daily meteorological data, pollutant concentrations, and respiratory deaths from 2014 to 2016 in Shenyang, a typical city in northeast China. Single and cumulative lag structures and seasonal modification were considered to investigate the link between O(3) exposure and respiratory mortality in Shenyang, northeast China. Synergic effects of O(3) and meteorological factors were also evaluated. Results indicated that there was a significant correlation between O(3) and the number of deaths caused by respiratory diseases on a daily basis, regardless of the time delay between exposure and the occurrence of the deaths. A 10 µg/m(3) rise in O(3) concentration was associated with a 0.85% (95% CI 0.18-1.52%) increase in respiratory death at a lag of 1 day and a 1.43% (95% CI 0.40-2.48%) increase at a cumulative lag of 3 days. Stratified analyses revealed that O(3) had a greater impact on health under warm conditions compared to cold settings. Additionally, O(3) had a more pronounced effect on females than on males. The results for this study could provide some scientific guidance for local environment and health departments.