Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries.

To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. Two stage time series analysis. 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. Deaths for all causes or for external causes only registered in each city within the study period A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.

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Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from UK Medical Research Council, China Medical Board Collaborating Program, Fundação para a Ciência e a Tecnologia, Spanish Ministry of Economy, Industry and Competitiveness, German Federal Ministry of Education and Research, Czech Science Foundation, Estonian Ministry of Education and Research, Japanese Society for the Promotion of Science, Australian National Health and Medical Research Council, Science and Technology Commission of Shanghai Municipality, Global Research Laboratory, through the National Research Foundation of Korea, Future Planning and Korea Ministry of Environment, CSIR parliamentary grant, and the National Institute of Environmental Health Sciences funded HERCULES Centre; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.