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Your Environment. Your Health.

Ozone Exposure, Worse Respiratory Outcomes in Smokers

Laura Paulin, M.D.
Johns Hopkins University
R01ES023500, K23ES025781

Higher long-term ozone exposure was associated with lower lung function and increased emphysema in current and former smokers, according to an NIEHS-funded study. The study suggested that exposure to higher concentrations of ozone might also contribute to worse respiratory outcomes in adults already at higher risk for chronic lung disease because of their smoking status.

The researchers analyzed lung function data from 1,874 current and former smokers from seven cities across the U.S. They also estimated 10-year historical ambient ozone exposure for each study participant based on their residence. The researchers found that higher 10-year historical ambient ozone exposure was associated with reduced lung function, worse patient-reported respiratory outcomes, increased respiratory symptoms, and higher levels of emphysema and gas trapping, which is an abnormal retention of air in the lungs. Looking at data on quality of life from the cohort study, the researchers also linked living in areas in the U.S. with higher 10-year historical ozone to worse quality of life and health status for study participants.

The adverse outcomes were consistent across people with different levels of smoking history, which suggested that the effects of ozone exposure might be independent of smoking intensity. According to the authors, these findings support continued re-examination of ambient pollution standards designed to protect the most vulnerable members of the U.S. population.

Citation: Paulin LM, Gassett AJ, Alexis NE, Kirwa K, Kanner RE, Peters S, Krishnan JA, Paine R, Dransfield M, Woodruff PG, Cooper CB, Barr RG, Comellas AP, Pirozzi CS, Han M, Hoffman EA, Martinez FJ, Woo H, Peng RD, Fawzy A, Putcha N, Breysse PN, Kaufman JD, Hansel NN. 2019. Association of long-term ambient ozone exposure with respiratory morbidity in smokers. JAMA Intern Med 180(1):106–115.


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