Short-term exposure to ozone and mortality from AIDS-related diseases: A case-crossover study in the middle Yangtze River region, China

Faxue Zhang; Heng Tang; Dingyuan Zhao; Shijie Zhu; Lianguo Ruan; Wei Zhu

doi:10.1016/j.ypmed.2023.107689

Short-term exposure to ozone and mortality from AIDS-related diseases: A case-crossover study in the middle Yangtze River region, China

Prev Med. 2023 Oct:175:107689. doi: 10.1016/j.ypmed.2023.107689. Epub 2023 Aug 29.

Authors

Faxue Zhang¹, Heng Tang², Dingyuan Zhao², Shijie Zhu¹, Lianguo Ruan³, Wei Zhu⁴

Affiliations

¹ Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
² Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China.
³ Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan 430023, China.
⁴ Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China. Electronic address: weizhu@whu.edu.cn.

PMID: 37652107
DOI: 10.1016/j.ypmed.2023.107689

Abstract

Background: Previous investigations have predominantly concentrated on the influence of ozone (O₃) on general population mortality. However, a noticeable gap exists regarding the attention directed towards susceptible demographics, specifically individuals afflicted by human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS).

Methods: A dataset comprising 1467 AIDS-related fatalities from 2013 to 2020 was amassed from the Hubei Provincial Center for Disease Control and Prevention. Daily maximum 8-h average O₃ levels and meteorological parameters were extracted from the ChinaHighAirPollutants dataset and the National Meteorological Science Data Center, respectively. A time-stratified case-crossover methodology was employed to scrutinize the connection between short-term exposure to O₃ and AIDS-related deaths.

Results: A rise of one interquartile (IQR) in O₃ concentration, lagged by 4 days, was associated with a 15% [95% confidence intervals (CIs): 2, 31] increase in AIDS-related deaths. Notably, males demonstrated heightened susceptibility to the adverse consequences of O₃, marked by an odds ratio of 1.20 (95% CIs: 1.05, 1.37) at lag 4 day. Additionally, patients aged over 65 years exhibited escalated vulnerability to brief O₃ exposure. Marriage status and educational attainment emerged as influential factors modifying the interplay between O₃ and AIDS-related mortality.

Conclusions: Our study presents novel evidence spotlighting the deleterious repercussions of O₃ on mortality in the HIV/AIDS population.

Keywords: AIDS; Case-crossover design; Death; HIV; Middle Yangtze River region; Ozone.