暴露于环境臭氧 (O3) 与各种疾病导致的死亡风险增加有关，但深入探讨其对癌症死亡率潜在影响的流行病学调查有限。我们的目的是研究短期 O3 暴露与特定地点癌症死亡率之间的关联，并调查巴西的弱势亚群。 2000 年至 2019 年间，巴西 5570 个城市总共有 3,459,826 条癌症死亡记录。城市平均每日 O3 浓度是根据 0.25°×0.25° 空间分辨率的全球估计计算得出的。应用时间分层病例交叉设计来评估 O3 与癌症死亡率的关联。按年龄、性别、季节、时间段、地区、城市等级、气候分类、人均国内生产总值分位数和文盲率进行亚组分析。观察到短期暴露于 O3 与癌症死亡率之间存在线性和非阈值暴露-反应关系，每 10 μg，所有癌症死亡风险增加 1.00%（95% CI：0.79%-1.20%） /m3 三天平均 O3 增量。接触 O3 后肾癌的发病率最高，其次是前列腺癌、胃癌、乳腺癌、淋巴瘤、脑癌和肺癌。在温暖的季节和巴西南部，相关的癌症风险相对较高，并且随着时间的推移呈下降趋势。当2000年至2019年期间将O3浓度限制在全国最低值时，巴西总共可以避免147,074人（116,690-177,451人）癌症死亡，其中包括17,836人（7014-28,653人）肺癌死亡。值得注意的是，尽管在巴西人群中观察到了适应情况，但这些关联仍然存在，这凸显了需要重点关注将减少 O3 暴露的具体措施纳入癌症护理建议中。© 2024 作者。约翰·威利出版的《国际癌症杂志》

Exposure to ambient ozone (O3) is linked to increased mortality risks from various diseases, but epidemiological investigations delving into its potential implications for cancer mortality are limited. We aimed to examine the association between short-term O3 exposure and site-specific cancer mortality and investigate vulnerable subgroups in Brazil. In total 3,459,826 cancer death records from 5570 Brazilian municipalities between 2000 and 2019, were included. Municipal average daily O3 concentration was calculated from a global estimation at 0.25°×0.25° spatial resolution. The time-stratified case-crossover design was applied to assess the O3-cancer mortality association. Subgroup analyses by age, sex, season, time-period, region, urban hierarchy, climate classification, quantiles of GDP per capita and illiteracy rates were performed. A linear and non-threshold exposure-response relationship was observed for short-term exposure to O3 with cancer mortality, with a 1.00% (95% CI: 0.79%-1.20%) increase in all-cancer mortality risks for each 10-μg/m3 increment of three-day average O3. Kidney cancer was most strongly with O3 exposure, followed by cancers of the prostate, stomach, breast, lymphoma, brain and lung. The associated cancer risks were relatively higher in the warm season and in southern Brazil, with a decreasing trend over time. When restricting O3 concentration to the national minimum value during 2000-2019, a total of 147,074 (116,690-177,451) cancer deaths could be avoided in Brazil, which included 17,836 (7014-28,653) lung cancer deaths. Notably, these associations persisted despite observed adaptation within the Brazilian population, highlighting the need for a focus on incorporating specific measures to mitigate O3 exposure into cancer care recommendations.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.