While you  may exercise, eat well, and never smoke, your heart health can be greatly impacted  by air pollution. According to The American Heart Association, someone dies from cardiovascular disease every 40 seconds in the United States (1). Ozone may be a contributing factor to heart disease. 

Researchers from China and Duke University wanted to learn whether ozone affects other aspects of human health, specifically the cardiovascular system. Ozone is a difficult pollutant to control because its creation in the atmosphere is complex. Even with a reduction in nitrogen oxides ozone levels don’t automatically decrease. 

The team followed 89 healthy adults living in Changsha City, China, for once a year. They monitored indoor and outdoor ozone levels, along with other pollutants. At four intervals, the researchers took participant blood and urine samples and used a breathing test to examine a set of factors that could contribute to cardiovascular and respiratory disease. They found blood platelet activation (a risk factor for clotting) and an increase in blood pressure. The study suggests that ozone may affect cardiovascular health. 

The study is published in JAMA Internal Medicine (2).

Ozone is not emitted directly into the air, but created by chemical reactions between oxides of nitrogen (NOx) and volatile organic compounds (VOC) in the presence of sunlight (3,5).

The EPA funded the Multi-Ethnic Study of Atherosclerosis Air Pollution Study (MESA Air) that also linked air pollution to poor cardiovascular health.  The decade-long study found a direct link between air pollution and atherosclerosis, which is a buildup of plaque in the coronary artery that can affect heart health.

Installing air filters is helpful, but may not be enough for your home. The EPA has a guide on decreasing ozone pollutants in the home that includes outdoor air ventilation and source control methods (4). Ozone is produced by automobiles, chemical plants, power plants, refineries, brush fires and burning, lawn mowing, aviation, trains, construction equipment, and more. It’s important that we become aware and do our part in reducing ozone production. 



  1. https://www.epa.gov/sciencematters/linking-air-pollution-and-heart-disease
  2. http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2643779
  3. https://www.epa.gov/ozone-pollution
  4. https://www.epa.gov/indoor-air-quality-iaq/ozone-generators-are-sold-air-cleaners#difficult-exposure
  5. https://www.climatecentral.org/gallery/graphics/explainer-how-ground-level-ozone-is-formed