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International Journal of Environmental... Jun 2016The objective was to assess the transient association between air pollution and cardiac arrhythmia. Five databases were searched for studies investigating the... (Meta-Analysis)
Meta-Analysis Review
The objective was to assess the transient association between air pollution and cardiac arrhythmia. Five databases were searched for studies investigating the association between daily increases in air pollutants (PM2.5, PM10, carbon monoxide, nitrogen dioxide, sulfur dioxide and ozone) and arrhythmia hospitalization or arrhythmia mortality. Two reviewers independently selected studies, extracted data, and assessed risk of bias. Outcomes were analyzed via a random-effects model and reported as relative risk and 95% confidence interval. 25 studies satisfied our inclusion criteria and 23 contributed to the meta-analysis. Arrhythmia hospitalization or mortality were associated with increases in PM2.5 (RR = 1.015 per 10 μg/m³, 95% CI: 1.006-1.024), PM10 (RR = 1.009 per 10 μg/m³, 95% CI: 1.004-1.014), carbon monoxide (RR = 1.041 per 1 ppm, 95% CI: 1.017-1.065), nitrogen dioxide (RR = 1.036 per 10 ppb, 95% CI: 1.020-1.053), and sulfur dioxide (RR = 1.021 per 10 ppb, 95% CI: 1.003-1.039), but not ozone (RR = 1.012 per 10 ppb, 95% CI: 0.997-1.027). Both particulate and gaseous components, with the exception of ozone, have a temporal association with arrhythmia hospitalization or mortality. Compared with Europe and North America, a stronger association was noted in Asia.
Topics: Air Pollutants; Air Pollution; Arrhythmias, Cardiac; Humans; Particulate Matter; Risk Assessment
PubMed: 27367707
DOI: 10.3390/ijerph13070642 -
BMJ Open Feb 2016While there is good evidence for associations between short-term exposure to ozone and a range of adverse health outcomes, the evidence from narrative reviews for... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
While there is good evidence for associations between short-term exposure to ozone and a range of adverse health outcomes, the evidence from narrative reviews for long-term exposure is suggestive of associations with respiratory mortality only. We conducted a systematic, quantitative evaluation of the evidence from cohort studies, reporting associations between long-term exposure to ozone and mortality.
METHODS
Cohort studies published in peer-reviewed journals indexed in EMBASE and MEDLINE to September 2015 and PubMed to October 2015 and cited in reviews/key publications were identified via search strings using terms relating to study design, pollutant and health outcome. Study details and estimate information were extracted and used to calculate standardised effect estimates expressed as HRs per 10 ppb increment in long-term ozone concentrations.
RESULTS
14 publications from 8 cohorts presented results for ozone and all-cause and cause-specific mortality. We found no evidence of associations between long-term annual O3 concentrations and the risk of death from all causes, cardiovascular or respiratory diseases, or lung cancer. 4 cohorts assessed ozone concentrations measured during the warm season. Summary HRs for cardiovascular and respiratory causes of death derived from 3 cohorts were 1.01 (95% CI 1.00 to 1.02) and 1.03 (95% CI 1.01 to 1.05) per 10 ppb, respectively.
CONCLUSIONS
Our quantitative review revealed a paucity of independent studies regarding the associations between long-term exposure to ozone and mortality. The potential impact of climate change and increasing anthropogenic emissions of ozone precursors on ozone levels worldwide suggests further studies of the long-term effects of exposure to high ozone levels are warranted.
Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; Cohort Studies; Humans; Mortality; Ozone; Respiratory Tract Diseases; Risk Factors; Seasons; Time Factors
PubMed: 26908518
DOI: 10.1136/bmjopen-2015-009493 -
Complementary Therapies in Medicine Mar 2023The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. Ozone therapy has long been used in the treatment of a variety of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. Ozone therapy has long been used in the treatment of a variety of infectious diseases, probably through its antioxidant properties and the supply of oxygen to hypoxic tissues. This systematic review and meta-analysis aimed to determine the efficacy of ozone on mortality in patients with COVID-19.
METHODS
A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Prospective controlled trials on treatment of COVID-19 with ozone, compared with placebo or blank, were reviewed. Studies were pooled to risk ratios (RRs) and weighted mean differences (WMDs), with 95% confidence intervals (CIs).
RESULTS
Eight trials (enrolling 371 participants) met the inclusion criteria. Ozone therapy showed significant effects on mortality (RR 0.38, 95% CI 0.17-0.85; P = 0.02), length of hospital stay (WMD -1.63 days, 95% CI -3.05 to -0.22 days; P = 0.02), and polymerase chain reaction (PCR) positivity (RR 0.07, 95% CI 0.01-0.34; P = 0.001).
CONCLUSIONS
Ozone therapy significantly reduced mortality, PCR positivity, and length of stay in hospitalized patients with COVID-19. Ozone therapy should be considered for COVID-19 patients.
Topics: Humans; COVID-19; Ozone; Prospective Studies; Antioxidants
PubMed: 36513208
DOI: 10.1016/j.ctim.2022.102907 -
The Archives of Bone and Joint Surgery May 2020Of the pharmacological modalities for knee osteoarthritis (OA), intra-articular injections including ozone (O3) and hyaluronic acid (HA) are commonly used for reducing... (Review)
Review
BACKGROUND
Of the pharmacological modalities for knee osteoarthritis (OA), intra-articular injections including ozone (O3) and hyaluronic acid (HA) are commonly used for reducing pain and improving function. In this systematic review and meta-analysis, we aimed to compare the effect of O3 versus HA in reducing pain and increasing function in patients with knee OA.
METHODS
After searching databases, we included 6 randomized controlled trials on patients with knee OA that compared the effects of intra-articular injection of ozone versus HA. The primary outcome was visual analogue scale (VAS) of pain. The secondary outcome was Western Ontario and McMaster Universities Arthritis Index (WOMAC) score.
RESULTS
There was a total of 237 patients in the HA group and 230 patients in the Ozone group. Of 6 studies, 4 were in English, 1 was in Persian, and 1 was in German language. The overall Standardized Mean Difference (SMD) for VAS pain did not show a significant difference between the groups although it favored HA injection (1.27 [95%CI: (-0.12)-2.66]). Total WOMAC score showed a significant difference over the time favoring HA injection (4.5 [95%CI: 1.1-8]). However, no single time point showed any significant difference between groups.
CONCLUSION
This meta-analysis showed no significant difference between HA and ozone in reducing pain and improving function in patients with knee OA, although the overall results favored HA over ozone. Since previous studies have shown comparable results between HA and placebo, ozone seems to fall in the same category with more placebo effect rather than a real disease-modifier.
PubMed: 32766391
DOI: 10.22038/abjs.2020.46925.2292 -
BMJ Open Diabetes Research & Care Mar 2020Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes... (Review)
Review
Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case-control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM, significant association between GDM and nitrogen dioxide (NO) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NO) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO, NO, and SO, and the second trimester exposure of PM with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.
Topics: Air Pollution; Case-Control Studies; Cohort Studies; Diabetes Mellitus, Type 2; Diabetes, Gestational; Female; Humans; Pregnancy; Prospective Studies; Retrospective Studies
PubMed: 32193198
DOI: 10.1136/bmjdrc-2019-000937 -
Healthcare (Basel, Switzerland) Oct 2023The potential influence of environmental factors, particularly air pollutants such as ozone (O), on the dynamics and progression of COVID-19 remains a significant... (Review)
Review
The potential influence of environmental factors, particularly air pollutants such as ozone (O), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00-1.13) compared to the general population (OR: 1.00, 95% CI: 0.98-1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: -0.187) and mortality (coefficient: -0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics.
PubMed: 37830707
DOI: 10.3390/healthcare11192670 -
The Saudi Dental Journal May 2020The objective of this systematic review and meta-analysis study was to identify the different disinfection methods and materials and the existing evidence on their... (Review)
Review
Effect of chemical, microwave irradiation, steam autoclave, ultraviolet light radiation, ozone and electrolyzed oxidizing water disinfection on properties of impression materials: A systematic review and meta-analysis study.
OBJECTIVES
The objective of this systematic review and meta-analysis study was to identify the different disinfection methods and materials and the existing evidence on their effect on properties of the different impression materials.
MATERIAL AND METHODS
An electronic search of MEDLINE (PubMed), Science Direct, and Google Scholar databases was performed to retrieve related English-language articles published between January 2000 and July 2019. Available studies with search terms such as: Impression disinfection, disinfection method, impression dimensional stability and impression wettability were used. The selected articles were reviewed by screening their titles and abstracts and full text. Finally, a total of 70 articles were considered relevant and were included in this study.
RESULTS
Extensive studies were conducted to determine the effect of the different disinfection methods and materials on the properties of the different impression materials such as dimensional stability, wettability and surface roughness. While some studies reported significant changes in the properties of the impression materials, others reported either no changes or minor insignificant effects.
CONCLUSIONS
Some studies reported significant changes in the properties of the impression materials as a result of using different disinfection methods, whereas others reported either minor insignificant or no changes. Although the findings of the studies were controversial, care should be taken to avoid distortion of impressions and loss of their surface details that can adversely affect the fitting accuracy of the restorations. Therefore, better designed and standardized studies are needed to evaluate the effect of different commonly used disinfectants on properties of impression materials. Moreover, manufacturers should be encouraged to recommend specific disinfection methods and materials for disinfecting the impression materials to ensure their optimal accuracy.
PubMed: 32405219
DOI: 10.1016/j.sdentj.2019.12.003 -
Journal of Pain Research 2018This study aimed to review and pool the current literature on intra-articular ozone injection in knee osteoarthritis (OA) patients. (Review)
Review
PURPOSE
This study aimed to review and pool the current literature on intra-articular ozone injection in knee osteoarthritis (OA) patients.
METHODS
A systematic review of three big databases was performed to identify all English-language randomized clinical trials (RCTs) that evaluated the efficacy of intra-articular ozone injection vs a control injection for knee OA sufferers, using the following two measuring tools: pain VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC).
RESULTS
A total of 428 patients in five RCTs were included, from which 53% (n=225) were in the ozone group and 47% in the control (hyaluronic acid [HA], dextrose, and air injection) group (n=203). The mean age of the patients in both groups was 64 years. Females were the majority. All studies had at least 2 months of follow-up (F/U). Mean difference (MD) between the groups for VAS in the first month was -0.23 with a -value of 0.71 (negative value was in favor of ozone), whereas this difference in the third and sixth months reached 1.04 and 1.31, respectively, favoring the control group. These data demonstrated that control injection had a more prolonged pain relief period. A similar trend was seen regarding WOMAC scores; pooled results showed that ozone was slightly better than the control injections during the first month (MD =-7.84 [=0.15]), but it declined to MD=2.55 and 8.23 at 2- to 3- and 4- to 6-month F/U, respectively, again in favor of control injections. Also, adverse events occurred homogeneously in both ozone (6/150 cases, 4%) and control groups (7/129 cases, 5.4%; -value=0.31).
CONCLUSION
Based on the current meta-analysis, intra-articular ozone injection efficacy was significantly superior to placebo and slightly lower to other control injections with non-significant difference. Therefore, ozone could be recommended as an efficient non-surgical treatment, durable for at least 3-6 months, in mild or moderate knee OA management.
PubMed: 30498370
DOI: 10.2147/JPR.S175441 -
Journal of Oral & Maxillofacial Research 2016The authors performed a systematic review and meta-analysis to investigate the possible correlation between ambient air pollution and orofacial cleft anomalies in... (Review)
Review
OBJECTIVES
The authors performed a systematic review and meta-analysis to investigate the possible correlation between ambient air pollution and orofacial cleft anomalies in newborns.
MATERIAL AND METHODS
A literature search was performed using the PubMed and Google Scholar, using the keywords "air pollution", "cleft lip", "cleft palate", "carbon monoxide", "ozone", "sulfur dioxide", "nitrogen oxide", "nitrogen dioxide", and "aerodynamic diameter". Eight epidemiologic articles met the criteria of correlating either carbon monoxide (CO), ozone (O3), nitrogen oxides (NOx), airborne particulate matter of less than 10 µm in diameter (PM10), or sulfur dioxide (SO2) exposures with clefting of the palate alone, clefting of the lip alone, or clefting of the lip and palate. Odds ratios were extracted from the eight studies and tabulated in this meta-analysis. Quality analysis showed six high quality, one medium quality, and one low quality study.
RESULTS
Meta-analysis of the combined data confirmed the association of O3 exposure and risk of orofacial cleft anomalies (OR = 1.08; P = 0.02). NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate.
CONCLUSIONS
Ozone showed the strongest correlation with cleft lip and cleft palate anomalies. However, the studies overall showed an inconsistent correlation between orofacial clefts and air pollutants.
PubMed: 27099696
DOI: 10.5037/jomr.2016.7102 -
The Cochrane Database of Systematic... Oct 2015It has been reported that ozone therapy might be helpful in treating foot ulcers in people with diabetes mellitus (DM). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It has been reported that ozone therapy might be helpful in treating foot ulcers in people with diabetes mellitus (DM).
OBJECTIVES
To assess the effects of ozone therapy on the healing of foot ulcers in people with DM.
SEARCH METHODS
In March 2015 we searched: The Cochrane Wounds Group Specialised Register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid EMBASE, EBSCO CINAHL, Science Citation Index, Chinese Biomedical Literature Database and The Chinese Clinical Registry. There were no restrictions based on language, date or study setting.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) that compared ozone therapy with sham ozone therapy or any other interventions for foot ulcers in people with DM, irrespective of publication date or language.
DATA COLLECTION AND ANALYSIS
Two reviewers independently screened all retrieved citations, selected relevant citations and extracted data. Disagreements were resolved by discussion with a third reviewer. The methodological quality of included studies and the evidence level of outcomes were assessed using the Cochrane risk of bias tool and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach respectively. Data were expressed using risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes with their 95% confidence interval (95% CI). Review Manager (RevMan) software was used to analyse the data.
MAIN RESULTS
Three studies (212 participants) were included in this review. The overall risk of bias was high for two trials and unclear for one.One trial (101 participants) compared ozone treatment with antibiotics for foot ulcers in people with DM. The study had a follow-up period of 20 days. This study showed that ozone treatment was associated with a greater reduction in ulcer area from baseline to the end of the study than treatment with antibiotics (MD -20.54 cm(2), 95% CI -20.61 to -20.47), and a shorter duration of hospitalisation (MD -8.00 days, 95% CI -14.17 to -1.83), but did not appear to affect the number of ulcers healed over 20 days (RR 1.10, 95% CI 0.87 to 1.40). No side effects were observed in either group.The other two trials (111 participants) compared ozone treatment plus usual care with usual care for foot ulcers in people with DM. The meta-analysis results did not show evidence of a difference between groups for the outcomes of reduction of ulcer area (MD -2.11 cm(2), 95% CI -5.29 to 1.07), the number of ulcers healed (RR 1.69, 95% CI 0.90 to 3.17), adverse events (RR 2.27, 95% CI 0.48 to 10.79), or amputation rate (RR 2.73, 95%CI 0.12, 64.42).
AUTHORS' CONCLUSIONS
The available evidence was three small RCTs with unclear methodology, so we are unable to draw any firm conclusions regarding the effectiveness of ozone therapy for foot ulcers in people with DM.
Topics: Adult; Anti-Bacterial Agents; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Foot; Humans; Ozone; Randomized Controlled Trials as Topic
PubMed: 26505864
DOI: 10.1002/14651858.CD008474.pub2