Ambient Ozone Exposure and Global Child Health: A Systematic Review of Epidemiological Studies.

Acta Paediatr

Heart Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

Published: September 2025


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Article Abstract

Aim: Ozone is a photochemical pollutant, with exposure levels typically peaking during warm seasons in urban areas with intense sunlight and high traffic emissions. The rising annual average tropospheric ozone concentration risks children's health. This paper provided an in-depth overview of research on ambient ozone exposure and child health.

Methods: A meticulous search was conducted within the PubMed database from 1 January 1964 to 4 October 2024 to identify epidemiological studies on the association between ambient ozone exposure and children's health. In addition, this study innovatively compiled the average ozone exposure levels from each epidemiological investigation.

Results: In total, 85 papers were included. Ambient ozone exposure's effects remain controversial in most diseases. Consistent evidence exists that ambient ozone exposure is a risk factor for low birth weight, asthma, respiratory disease and obesity in children, even if ozone concentrations are below the World Health Organization (WHO) standard. Both long-term ozone exposure and short-term spikes in ozone concentrations can harm children's health.

Conclusion: Current ambient ozone air quality standards inadequately protect children's health and urgently require revision. Further research is needed to furnish evidence concerning the contentious aspects of research and to offer guidance to child health practitioners and public health policymakers.

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http://dx.doi.org/10.1111/apa.70293DOI Listing

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