The adverse health effects of ambient ozone are well established. Given the high sensitivity of ambient ozone concentrations to meteorological conditions, the impacts of future climate change on ozone concentrations and its associated health effects are of concern. We describe a statistical modeling framework for projecting future ozone levels and its health impacts under a changing climate. This is motivated by the continual effort to evaluate projection uncertainties to inform public health risk assessment. The proposed approach was applied to the 20-county Atlanta metropolitan area using regional climate model (RCM) simulations from the North American Regional Climate Change Assessment Program. Future ozone levels and ozone-related excesses in asthma emergency department (ED) visits were examined for the period 2041-2070. The computationally efficient approach allowed us to consider 8 sets of climate model outputs based on different combinations of 4 RCMs and 4 general circulation models. Compared to the historical period of 1999-2004, we found consistent projections across climate models of an average 11.5% higher ozone levels (range: 4.8%, 16.2%), and an average 8.3% (range: -7% to 24%) higher number of ozone exceedance days. Assuming no change in the at-risk population, this corresponds to excess ozone-related ED visits ranging from 267 to 466 visits per year. Health impact projection uncertainty was driven predominantly by uncertainty in the health effect association and climate model variability. Calibrating climate simulations with historical observations reduced differences in projections across climate models.
Keywords: Air pollution; Climate Change; Emergency Department Visit; Health Impact; Ozone; Statistical Model; Uncertainty Quantification.