Temperature-dependent association between ambient ozone exposure and allergic rhinitis-related outpatient visits: a time-stratified case-crossover study in Henan Province, China
4 affiliations
- 1College of Public Health, Zhengzhou University
- 2Department of Public Health, The First Affiliated Hospital of Zhengzhou University
- 3School of Public Health, Cheeloo College of Medicine, Shandong University
- 4College of Arts and Sciences, Boston University
Abstract
Background: Ambient ozone (O ₃ ) may adversely affect the upper airway, but whether temperature modifies its short-term association with outpatient visits for allergic rhinitis remains unclear.
Methods: We conducted a time-stratified case-crossover study of 43,418 outpatient visits for allergic rhinitis at a tertiary hospital in Henan, China, during April–October of 2013–2023. Daily O ₃ , PM 2.5 , temperature, and relative humidity (RH) were assigned by residential address using gridded datasets and averaged over lag 0–1 day. Conditional logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) per 10 μg/m ³ increase in O ₃ across the observed exposure distribution, adjusting for temperature, RH, and PM 2.5 . Temperature modification was assessed using an interaction term between O ₃ and a natural cubic spline function of temperature.
Results: Each 10 μg/m ³ increase in O ₃ was associated with a 1.2% increase in the odds of an outpatient visit for allergic rhinitis (OR = 1.012, 95% CI: 1.006–1.017). The largest age-specific estimate was observed among patients aged <18 years (OR = 1.030, 95% CI: 1.017–1.044). Temperature significantly modified the association (χ ² = 31.2, P < 0.001), the OR for O ₃ increased from 1.000 at the 25th percentile of temperature to 1.021 at the 75th percentile.
Conclusion: Short-term O ₃ exposure was associated with higher odds of outpatient visits for allergic rhinitis, with larger estimates at higher temperatures and among patients aged <18 years.
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BibTeX
@article{ding2026temperaturedependent,
title = {{Temperature-dependent association between ambient ozone exposure and allergic rhinitis-related outpatient visits: a time-stratified case-crossover study in Henan Province, China}},
author = {Dong Ding and Wei Lu and Huina Wang and Leiyu Wang and Jinghong Gao and Tengda Wei and Haohao Liu},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1952329},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1952329/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Temperature-dependent association between ambient ozone exposure and allergic rhinitis-related outpatient visits: a time-stratified case-crossover study in Henan Province, China
AU - Dong Ding
AU - Wei Lu
AU - Huina Wang
AU - Leiyu Wang
AU - Jinghong Gao
AU - Tengda Wei
AU - Haohao Liu
PY - 2026
DA - 2026/10/20
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1952329
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1952329/full
AB - Background: Ambient ozone (O ₃ ) may adversely affect the upper airway, but whether temperature modifies its short-term association with outpatient visits for allergic rhinitis remains unclear. Methods: We conducted a time-stratified case-crossover study of 43,418 outpatient visits for allergic rhinitis at a tertiary hospital in Henan, China, during April–October of 2013–2023. Daily O ₃ , PM 2.5 , temperature, and relative humidity (RH) were assigned by residential address using gridded datasets and averaged over lag 0–1 day. Conditional logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) per 10 μg/m ³ increase in O ₃ across the observed exposure distribution, adjusting for temperature, RH, and PM 2.5 . Temperature modification was assessed using an interaction term between O ₃ and a natural cubic spline function of temperature. Results: Each 10 μg/m ³ increase in O ₃ was associated with a 1.2% increase in the odds of an outpatient visit for allergic rhinitis (OR = 1.012, 95% CI: 1.006–1.017). The largest age-specific estimate was observed among patients aged <18 years (OR = 1.030, 95% CI: 1.017–1.044). Temperature significantly modified the association (χ ² = 31.2, P < 0.001), the OR for O ₃ increased from 1.000 at the 25th percentile of temperature to 1.021 at the 75th percentile. Conclusion: Short-term O ₃ exposure was associated with higher odds of outpatient visits for allergic rhinitis, with larger estimates at higher temperatures and among patients aged <18 years.
SN - 2296-2565
ER -