A new study suggests that exposure to ozone, long associated with impaired lung function, can also cause cardiovascular disease such as heart attack, high blood pressure and stroke. The study involving 89 healthy adults living in Changsha City of China for one year showed blood platelet activation and an increase in blood pressure, suggesting a possible mechanism by which ozone may affect cardiovascular health. Exposure to ozone, a powerful greenhouse gas and a widespread air pollutant in many major cities, has long been associated with adverse health effects in children and adults. Ozone is a pollutant formed through a chemical reaction that occurs when sunlight interacts with nitrogen oxides and other organic compounds that are generated by coal-burning, vehicle exhaust and some natural sources. “We know that ozone can damage the respiratory system, reduce lung function and cause asthma attacks,” said study author Junfeng Zhang, from Duke and Duke Kunshan University. “Here, we wanted to learn whether ozone affects other aspects of human health, specifically the cardiovascular system.” In the study, Zhang and colleagues monitored indoor and outdoor ozone levels, along with other pollutants. At four intervals, the study team took participant blood and urine samples and used a breathing test called spirometry to examine a set of factors that could contribute to cardiovascular and respiratory disease. The team examined inflammation and oxidative stress, arterial stiffness, blood pressure, clotting factors and lung function in participants. They noted blood platelet activation, which is a risk factor for clotting, and an increase in blood pressure, suggesting a possible mechanism by which ozone may affect cardiovascular health. These effects were found with ozone exposure lower than that which affects respiratory health, and lower than current US Environmental Protection Agency (EPA) air quality standards.