Long-Term Exposure to Ozone and Life Expectancy in the United States, 2002 to 2008

Long-term exposure to ground-level ozone is associated with increased risk of morbidity and mortality. The association remains uncertain between long-term exposure to ozone and life expectancy. We assessed the associations between seasonal mean daily 8-hour maximum (8-hr max) ozone concentrations measured during the ozone monitoring seasons and life expectancy at birth in 3109 counties of the conterminous U.S. during 2002 to 2008. We used latent class growth analysis to identify latent classes of counties that had distinct mean levels and rates of change in ozone concentrations over the 7-year period and used linear regression analysis to determine differences in life expectancy by ozone levels. We identified 3 classes of counties with distinct seasonal mean daily 8-hr max ozone concentrations and rates of change. When compared with the counties with the lowest ozone concentrations, the counties with the highest ozone concentrations had 1.7- and 1.4-year lower mean life expectancy in males and females (both P < 0.0001), respectively. The associations remained statistically significant after controlling for potential confounding effects of seasonal mean PM2.5 concentrations and other selected environmental, demographic, socio-economic, and health-related factors (both P < 0.0001). A 5 ppb higher ozone concentration was associated with 0.25 year lower life expectancy in males (95% CI: -0.30 to -0.19) and 0.21 year in females (95% CI: -0.25 to -0.17). We identified 3 classes of counties with distinct mean levels and rates of change in ozone concentrations. Our findings suggest that long-term exposure to a higher ozone concentration may be associated with a lower life expectancy.