Michelle Etoh

How does long-term exposure to ground-level ozone influence cognitive decline across 10 US States and how might biomedical engineering innovations help vulnerable populations?

Started Mar. 31, 2025

Abstract or project description

Ground-level ozone is a pervasive environmental pollutant and potent oxidative stressor that has been increasingly implicated in neurodegenerative processes. This study investigates the association between long-term ground-level ozone exposure and the prevalence of cognitive decline across 10 U.S. states (Arizona, California, Florida, Illinois, Massachusetts, North Carolina, New York, Ohio, Pennsylvania, and Texas) from 2021 to 2024, while exploring the role of biomedical engineering (BME) in mitigating these risks. An ecological regression analysis was conducted using state-level cognitive decline data from the CDC Behavioral Risk Factor Surveillance System (BRFSS) and daily maximum 8-hour ozone concentrations from EPA air quality datasets. The analysis utilized 39 matched state-year observations, accounting for missing data in Florida for 2021. A statistically significant positive association was observed between ground-level ozone concentrations and cognitive decline prevalence (p = 0.017,R² = 0.236, r = 0.486). The regression model (β1 = 191.73 per ppm; SE = 56.67) indicates that each 10-ppb increase in ground-level exposure is associated with a 1.92 percentage-point increase in cognitive decline prevalence. Arizona exhibited the highest ozone concentrations (0.0480–0.0503 ppm), while both Arizona and Texas reported high cognitive decline prevalence. Biological literature supports these findings, linking ozone to chronic oxidative stress, neuroinflammation, and loss of synaptic plasticity in key regions such as the hippocampus. The results suggest that long-term ozone exposure is a significant environmental correlate of cognitive aging at the population level. Biomedical engineering innovations, including indoor ozone sensing, adaptive ventilation, AI-driven exposure modeling, and neuroprotective pharmacological interventions, offer promising pathways to protect vulnerable populations. Keywords: Ground-level ozone; Cognitive decline; Neurodegeneration; Biomedical engineering; Oxidative stress; Public health.