Abstract Background Studies that seek to link the impact of ozone with mortality display a number of uncertainties. This study sought to ascertain the functional relationship between ozone and mortality, and analyse its short-term impact on daily natural-, respiratory- and circulatory-cause mortality in Spain. Methods We analysed data on daily natural- (ICD 10: A00-R99), respiratory- (ICD 10: J00-J99) and circulatory-cause mortality (ICD 10: I00-I99) for each of Spain's 52 provinces across the period 2000–2009. We calculated the impact of ozone on mortality by reference to relative risks (RRs) using generalised linear models, and performed an overall meta-analysis. Attributable mortality was calculated on the basis of RRs. Results A quadratic relationship was observed and the existence of a threshold value identified in 33 of the 46 monitoring stations judged to be valid for ozone data, this threshold value was located above the 80th percentile. The overall RRs for 10 μg/m3 increases in concentrations of the O3 threshold value were as follows: 1.033 (95%CI: 1.023–1.044) for natural causes; 1.089 (95%CI: 1.058–1.120) for respiratory causes; and 1.025 (95%CI: 1.018–1.033) for mortality circulatory causes. The annual total of natural-cause ozone-attributable deaths was 499 (95%CI: 277–717), 126 of which (95%CI: 54–194) were due to respiratory causes and 167 (95%CI: 39–293) to circulatory causes. Conclusions High ozone concentrations display a quadratic relationship with daily mortality. While this effect is more pronounced in respiratory causes, there is also a short-term effect on natural- and circulatory-cause mortality.

中文翻译：

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西班牙对流层臭氧对每日死亡率的短期影响

摘要 背景 试图将臭氧的影响与死亡率联系起来的研究显示出许多不确定性。本研究旨在确定臭氧与死亡率之间的功能关系，并分析其对西班牙日常自然、呼吸和循环原因死亡率的短期影响。方法 我们分析了 2000 年西班牙 52 个省中每个省的每日自然死亡率（ICD 10：A00-R99）、呼吸系统死亡率（ICD 10：J00-J99）和循环系统死亡率（ICD 10：I00-I99）的数据–2009。我们使用广义线性模型通过参考相对风险 (RR) 计算了臭氧对死亡率的影响，并进行了整体荟萃分析。可归因死亡率是根据 RR 计算的。结果 观察到二次关系，并且在 46 个监测站中的 33 个被确定为对臭氧数据有效的阈值的存在，该阈值位于第 80 个百分点以上。O3 阈值浓度增加 10 μg/m3 的总体 RR 如下： 1.033 (95% CI: 1.023–1.044) 自然原因；1.089 (95% CI: 1.058–1.120) 呼吸原因；和 1.025 (95% CI: 1.018–1.033) 用于死亡循环原因。每年因臭氧引起的自然原因死亡总数为 499 人（95%CI：277-717），其中 126 人（95%CI：54-194）是由呼吸系统原因引起的，167 人（95%CI：39-293） ) 循环原因。结论 高臭氧浓度与每日死亡率呈二次方关系。虽然这种影响在呼吸系统疾病中更为明显，