Environ. Health Perspec. http://doi.org/c6w8 (2019).

Although there is strong evidence for negative respiratory effects from long-term ground-level ozone (O3) exposure, evidence for a relationship between exposure and cardiovascular disease remains uncertain, and the physiological mechanisms underlying a potential link remain underexplored.

figure a

FrankRamspott/E+/Getty

Meng Wang, of the University of Buffalo, and colleagues at the University of Washington and University of Wisconsin, use the Multi-Ethnic Study of Atherosclerosis to assess the longitudinal relationship between exposure to residence-specific O3 concentrations and indicators of coronary heart disease and stroke risk in adults. They show that cumulative exposure to O3 is associated with the progression of intima-media thickness of the common carotid artery and carotid plaque burden, independent of exposure to other air pollutants (such as PM2.5 and NO2). The results are robust to a range of controls for cardiovascular disease risk and suggest different pathways and relative potencies for ozone and particulate matter on cardiovascular disease.

While ground-level ozone has declined in some places, it is anticipated to continue its overall increase with climate change and to continue to impact human health into the future.