Loss of life expectancy attributed to long-term ozone exposure in Chinese older adults: Cross-cohort analysis from 3 national cohorts
Why this work is in the frame
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Bibliographic record
Abstract
• A cross-cohort analysis of 3 national cohorts to investigate the ozone-mortality association in Chinese older adults. • Per 10-ppb increase in warm-season ozone was associated with a hazard ratio of 1.076 (95% CI: 1.050–1.102) for mortality. • Ozone exposure contributed to 0.88 million deaths and 9.05 million years of life lost, equivalent to a loss of life expectancy of 0.93 years in 2019. Cohort evidence linking ozone (O 3 ) exposure with mortality was sparsely investigated among the elderly in low- and middle-income countries. This study aims to quantify mortality risk and burden attributed to chronic O 3 exposure in Chinese older adults. A total of 30,874 older adults aged ≥65 years were recruited from 3 national dynamic cohorts across 29 provincial regions in China, 2005–2018. Annual warm-season (April–September) O 3 and year-round PM 2.5 concentrations were estimated through well-validated satellite-based spatiotemporal models and were assigned to participants for each survey year. Time-dependent Fragility Cox models with random intercept for study cohort were employed to quantify O 3 -mortality association, adjusting for demographic, behavioral, health, and environmental covariates. A counterfactual causal framework was used for assessment of O 3 -attributable premature deaths in older adults based on exposure–response relationship derived from multi-cohort two-pollutant analysis (+PM 2.5 ). Years of life lost and loss of life expectancy were subsequently evaluated based on the burden estimation model by incorporating the comparative risk assessment method and reference life tables. 16,939 death events occurred during 0.16 million person-years of follow-up surveys. Each 10-ppb increase in O 3 exposure was linked with a hazard ratio of 1.076 (95% confidence interval [CI]: 1.050, 1.102) for all-cause mortality. By achieving the counterfactual target (WHO AQG 2021) of 60 μg/m 3 for warm-season O 3 , 0.88 (95% CI: 0.60, 1.14) million premature deaths could be avoidable among Chinese older population in 2019, yielding an inconspicuous reduction of 0.11 million compared to the estimate in 2011 (0.99 million, 95% CI: 0.68, 1.28). O 3 -attributable deaths amounted to 9.05 (95% CI: 6.19, 11.70) million years of life lost in 2019, equivalent to a loss of life expectancy of 0.93 (95% CI: 0.63, 1.20) years for older population in China. Our multi-cohort analysis suggested that reducing ambient O 3 exposure could increase the life expectancy of Chinese older adults, which may contribute to the development of healthy aging strategies and national cleaning air policies.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it