近年来中国的近地面臭氧（O3）污染问题日益突出，但多数研究集中关注于PM2.5污染，对近地面臭氧污染及健康风险研究相对较少。而要制定合理的臭氧大气健康基准和标准，关键就是要全面摸清中国的臭氧污染现状及对臭氧健康风险进行评价。本文旨在通过详细分析中国的臭氧时空变化特征与暴露情况，评估臭氧导致的健康风险与经济损失，为政策部门在制定臭氧基准和标准时提供科学依据。本文主要针对我国的近地面臭氧进行系统性风险评估，包括污染现状分析与暴露评估、暴露反应系数研究和健康风险与价值评估。首先，以我国2014 -2016年国控站点臭氧浓度监测数据为基础，利用ArcGIS空间插值方法，分析三年的臭氧浓度时空变化特征，并结合第六次人口普查分县数据，确定我国的人群臭氧暴露水平。然后，采用循证医学的Meta分析方法综合大量短期臭氧暴露时间序列研究结果，并进行Meta回归分析、敏感性分析、发表偏倚分析与质量评价最终确定符合我国人群特点的臭氧短期暴露反应系数与相对风险度。最后，根据前两部分研究结果计算出2014-2016年中国臭氧导致的死亡风险与健康价值损失。本研究的主要结果表明：（1）2014-2016年中国臭氧年均浓度总体呈先降后升的趋势，月均浓度呈现倒“U”形起伏的变化规律，6月份三年浓度平均值最高，为109.66 μg/m3。（2）2014年臭氧年均浓度高值区主要有新疆、西藏、京津冀地区，长三角地区，珠三角部分地区、山东全境和内蒙古西部地区。2015年全国臭氧浓度高值区范围明显缩小，而2016年全国臭氧污染表现为整个华北地区、江苏和辽东半岛浓度较高。（3）2014-2016年臭氧浓度在100 μg/m3（臭氧国家空气质量一级标准）以上的暴露人数分别为37041、13231和31550万人。（4）臭氧短期暴露与人群健康效应的关系为日最大8小时臭氧浓度每增加10 μg/m3，人群非事故总死亡率、心血管疾病死亡率和呼吸系统疾病死亡率分别增加0.34%（95%CI：0.28%~0.40%）、0.31%（95%CI：0.18%~0.43%）和0.35%（95%CI：0.15%~0.55%），计算后的相对风险RR分别为1.0346、1.0315和1.0356。（5）臭氧短期暴露三年共导致约100236~143002人的超额死亡，主要分布于北京市、山东省、河南省、湖北省、长三角地区和珠三角地区，2014-2016年全国因臭氧早逝导致经济损失分别为218.40、232.35和276.61亿元。
In recent years, ground-level ozone pollution in China has become an increasingly prominent problem. However, there is only few researches analyzing O3 pollution and associated mortality, compare to PM2.5. The key to establishing a reasonable air quality criteria and standard for ozone is to fully understand the current situation of ozone pollution in China and evaluate the health risk of ozone. In this study, the spatiotemporal characteristics and exposure level of ozone in China are analyzed in detail, and the health risks and economic losses caused by ozone are evaluated, which would be further used by policy-makers as the basis of developing scientific criteria and standard.This study focuses on the systematic risk assessment of ground-level ozone in China, including pollution status and exposure level, exposure reaction coefficient and health risk and value assessment. First, this study is based on the monitoring data of national control sites in China during 2014-2016, simulating the spatiotemporal distribution of ozone and exposure level by interpolation method combined with the sixth census data. Then the Meta-analysis method of evidence-based medicine is used to combine the results of a large number of short-term ozone exposure time series study. Meta regression analysis, sensitivity analysis, publication bias analysis and quality evaluation are used to determine the short-term exposure coefficient and relative risk of ozone in accordance with the characteristics of the population in China. Finally, we calculate the death risk and health value of ozone during 2014-2016 based on the results of the first two parts.It was found that nationwide maximum daily 8-hour average of ground-level ozone was 87.06, 83.58 and 87.53 μg/m3 from 2014 to 2016. The monthly mean concentrations showed an inverted "U" shape and nationwide 3-year concentration average exhibited peaking in June, 109.66 μg/m3. The simulation results showed that the high value of ozone concentration is mainly in the Beijing-Tianjin-Hebei region, Xinjiang, the Yangtze River Delta region, Tibet, the Pearl River Delta region, the whole territory of Shandong and the western part of Inner Mongolia in 2014. The range of the high value area in 2015 was obviously narrowed. The concentration of the whole North China, Jiangsu and Liaodong peninsula was relatively high in 2016. The number of people exposed to annual 8-h average concentration above 100 μg/m3 was about 370.41、132.31 and 315.50 million from 2014 to 2016. The relationship between the short-term exposure of ozone and the health effect of the population was that an increase of 10 μg/m3 of ozone corresponds to 0.34% (95%CI, 0.28~0.40%), 0.31% (95% CI, 0.18~0.43%), and 0.35% (95% CI, 0.15~ 0.55%) increase of total non-accidental, cardiovascular, and respiratory mortality, respectively. The estimated 3-year mortality caused by ozone in China was 100236~143002, which mainly distributed in Beijing, Shandong, the Yangtze River Delta region, Henan, Hubei and the Pearl River Delta region, the economic loss due to premature death was 21839.883, 23234.741 and 27660.877 million yuan from 2014 to 2016.
