The interaction of ambient ozone and personal temperature variability on blood markers of inflammation, oxidative stress, coagulation, endothelial function, and stress hormones

The interaction between ozone and temperature on cardiovascular biomarkers has not been thoroughly examined. A panel study was conducted among 40 college students with four equal interval follow-ups in Hefei, Anhui Province, China between August and October 2021. Real-time concentrations of ozone were collected from a nearby monitoring device. Temperature variability parameters included diurnal temperature range (DTR), the standard-deviation of temperature (SDT), and temperature variability (TV). A set of cardiovascular biomarkers were measured, including markers of inflammation (Granulocyte-macrophage colony-stimulating factor, GM-CSF and serum amyloid A, SAA), coagulation (D-dimer and ADAMTS13), oxidative stress (Myeloperoxidase, MPO and Growth differentiation factor-15, GDF-15), endothelial function (vascular endothelial growth factor A, VEGFA), and stress hormone (5-hydroxytryptamine, 5-HT). Linear mixed-effect models were conducted to analyze the associations between ozone, temperature variability, and all blood markers. The results showed significant associations among ozone, DTR, SDT, TV, and blood markers, suggesting harmful effects on markers. For instance, a 10-μg/m3 increase in ozone at lag 2d was associated with higher levels of SAA by 19.65% (95%CI: 13.70, 25.60), VEGFA by 10.90% (95%CI: 4.57, 17.22), GDF-15 by 5.33% (95%CI: 0.59, 10.06), and GM-CSF by 2.52% (95%CI: 1.70, 3.34), but 13.09% lower D-dimer (95%CI: 6.99, 19.19). We also found statistically significant interaction between ozone and TV exposures for GM-CSF and SAA. This study shows that ambient ozone and personal TV exposures may independently have acute effects on markers of inflammation, oxidative stress, coagulation, endothelial function, and neuroendocrine stress response. Simultaneous exposure to these factors may also lead to interactive effects on inflammation markers. These findings offer valuable insights for developing comprehensive strategies in cardiovascular disease control and prevention. [Display omitted] •O3 and temperature variability had a synergistic effect on blood markers.•The joint effect of O3 and temperature variability varied in direction and magnitude across inflammation markers.•O3 was associated with inflammation, oxidative stress and endothelial function markers.•Temperature variability perturbed blood markers that are involved in numerous different downstream outcomes.