Exposure to surface ozone and its associated health effects and economic burden in India

Surface ozone is a secondary air pollutant and when its exposure exceeds the threshold of 70 μg/m 3 for 8 h, it can make adverse health effects. This study assesses surface ozone pollution in India using satellite and ground-based measurements. The exposure to surface ozone varies between seasons, from a pre-monsoon (March, April, and May) maximum (30–50 μg/m 3 ) to a monsoon (June, July, August, and September) minimum (<25 μg/m 3 ). However, there are many regions with ozone exceeding an exposure threshold of 70 μg/m 3 . This results in about 29000 mortalities in 45 out of 220 Indian cities based on the ground-based measurements considered. Estimates of mortality related to Chronic Obstructive Pulmonary Disease (COPD) and Ischemic Heart Disease (IHD) show a total of about 51154 deaths for the year 2022 as deduced from the satellite measurements. Also, the economic burden of premature mortality from ozone exposure is 16.83 billion USD, which is about 1.5 times the health budget of India in 2022. Therefore, it is imperative to address surface ozone pollution to ensure economic stability, protect public health and mitigate climate change. • Annual ozone varies between 20 and 30 μg/m 3 , but in pre-monsoon it often exceeds 70 μg/m 3 . • Populated areas have high ozone exposure, above 70 μg/m 3 , about 10–15 days in 2022. • Mortality due to ozone exposure in India exceeds 50000 in the year 2022 alone. • It costs an economic burden of US $16.83 Bn in 2022; 1.5 times the health budget of India. • Uttar Pradesh, Maharashtra and Madhya Pradesh have the highest exposure risks.