Summary
- Ozone (O3) is gas generally considered to be damaging to human and animal health.
- Ozone interacts with the body, causing oxidative stress and inflammation
- Ozone therapy is classified as alternative medicine
- It is not approved by FDA (USA) or NICE (UK) for human use
- Despite widespread claims by those providing ozone treatments for horses, there are virtually no scientific studies demonstrating efficacy in horses
As someone who has researched and published on the effects of ozone and free radicals and oxidative stress, I was somewhat disturbed to see the latest non-validated treatment or cure-all for horses is ozone therapy.
What is Ozone?
Ozone (O3) is a gas which is damaging to human and animal health, causing irritation of the respiratory tract, eyes, nose and throat, as well as asthma attacks. Ozone can damage wild plants, crops, forests and some materials. Ozone can also react with other chemicals in the air to form particulate matter, or smog, which is also harmful to health.
Ozone is found both at ground level and in the stratosphere (10 and 50 kilometres above ground level). Ozone is naturally occurring at these altitudes, where it forms a protective layer shielding us from the sun’s UV radiation. However, at ground level, ozone has adverse effects on human health and the environment.
In contrast to many air pollutants measured in the UK (such as particulate matter (e.g.) PM10, nitrogen dioxide (NO2) and sulphur dioxide (SO2)), there are no major emission sources of ozone itself. Ozone is formed and removed from the atmosphere through a wide range of chemical reactions and physical processes. For example, sunlight (UV) can trigger a complex series of chemical reactions between nitrogen dioxide and volatile organic compounds (VOCs), which can result in the formation of ozone; ozone is usually low in the morning and increases during the day in summer.
The pollutants involved in the formation of ozone are known as precursor pollutants, and these can be both man-made and naturally occurring. Most of the ozone experienced in the UK is a consequence of emissions of methane and of ozone generated from NOx and VOC emissions outside the UK. Thus, ozone is seen as harmful in the atmosphere when uncontrolled.
What effect does ozone have on or in the body?
At higher concentrations, ozone can cause skin irritation, leading to redness, itching, or a burning sensation. Ozone exposure can induce oxidative stress, which may damage skin cells and accelerate aging, resulting in increased wrinkle formation and loss of skin elasticity over time. Ozone can also enhance the skin’s sensitivity to sunlight (UV), increasing the risk of sunburn and related skin damage. In controlled therapeutic settings, ozone is sometimes used in ozone therapy for skin conditions, including infections or wounds. Some individuals are more sensitive to ozone, experiencing adverse effects even at lower concentrations.
Inhaled ozone can irritate the airways, leading to symptoms such as coughing, throat irritation, and shortness of breath. For people with asthma or other respiratory conditions, inhaling ozone can trigger asthma attacks and worsen overall symptoms. Prolonged exposure to elevated levels of ozone may contribute to chronic respiratory diseases and could have negative impacts on overall lung health. Children, the elderly, and individuals with pre-existing health conditions are particularly vulnerable to the harmful effects of inhaled ozone. Ozone itself is not formed within the body.
Ozone as a disinfectant
Ozone is increasingly used as a disinfectant due to its strong oxidative properties. Ozone can kill bacteria, viruses, and fungi more effectively than traditional disinfectants. It disrupts the cell walls of pathogens, leading to their destruction. Ozone is used in various settings, including water treatment facilities, food processing, hospitals, and HVAC systems, to sanitize surfaces and improve air quality.
While ozone is effective as a disinfectant, it can be harmful to human health at high concentrations.
Ozone and horses
Below are the results of an AI-based search using “ozone treatment for horses” as the key phrase. AI clearly hasn’t yet evolved to evidence-based medicine. The issue is that AI selects what is commonly circulating on the web.
AI Overview
Ozone therapy is a drug-free treatment that can help horses with a variety of conditions, including:
Pain relief: Ozone can be injected into joints to reduce pain
Wound healing: Ozone can speed up the healing process
Inflammation: Ozone can decrease inflammation
Immunity: Ozone can increase immunity
Circulation: Ozone can enhance circulation
Plaque removal: Ozone can help remove plaque from arteries
Muscle, tendon, and ligament damage: Ozone can treat damage and inflammation to these tissues
Laminitis: Ozone can be used to treat laminitis
Wellness: Ozone can help maintain a horse’s condition after hard work or transport
Ozone is a special type of oxygen that can kill viruses, bacteria, fungus, and cancer cells. When used properly, ozone therapy has few risks and many benefits for horses.”
What does the science say about ozone and horses?
A PUBMED search for the keywords “ozone and horses” yielded 39 references. Of these papers
- Fertility/uterine health – 7 papers
- Semen preservation – 3 papers
- Injection in healthy joints – 1 paper
- Respiratory effect – 4 papers
- Autohemotherapy – 1 paper
- Review – 1 paper
- Total – 17 papers referring directly to ozone and horses
The remaining 22 papers were irrelevant
NO SCIENTIFIC PAPERS ON THE FOLLOWING IN HORSES
- Pain relief
- Wound healing
- Decreasing inflammation
- Increasing immunity
- Enhancing circulation
- Removing plaque from arteries
- Muscle, tendon, and ligament damage
- Treating laminitis
- Wellness – help maintain a horse’s condition after hard work or transport
Ozone therapy in human medicine
The US Food and Drug Administration (FDA) currently classes OZONE THERAPY as an alternative therapy.
“Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals.”
Full details of the FDA position can be found hee – LINK
This is a good summary of the position in human medicine.
“Ozone therapy is a controversial alternative medicine practice that uses ozone gas to fight disease. Currently, there is not enough evidence to conclude that it is effective or safe for medical use.” LINK
As far as I am aware, ozone therapy is not used by the NHS in the UK and is also considered as an alternative form of therapy.
Claims for the benefits of ozone therapy in horses from companies/individuals offering it.
The following are claims from a variety of websites offering ozone therapy for horses:
- “Help your horse in injuries such as damage to the tendons, muscles, or ligaments
- Speed up the rehabilitation process after the injury
- Allows full reactivation of the blood circulation
- Keep your horse in the best condition after hard work”
- “Below is a list of some of the problems that we use ozone to treat:
- Skin issues, all types of dermatitis
- Pain relief, anywhere in the body
- Neurological issues
- Oral disease
- Eye issues
- GI problems
- Cancer and autoimmune disease
- Reproductive issues
- Wound treatment”
- “I have treated cases of laminitis, septic arthritis and tenosynovitis, lymphosarcoma, endocarditis, myocarditis, C.O.P.D., allergies, colic, lymphangitis, abscesses, osteomyelitis, fistulas (poll and wither), candidiasis, periodic opthalmia, melanoma, Rocky Mountain Spotted Fever, Lyme disease, Babesiosis, West Nile, EPM, herpes myelitis, sinusitis, tooth abscesses, soft tissue infections, bladder and kidney infections and chronic liver and kidney disease all with successful outcomes.” (from a US based DVM)
- “One of these methods we have experimented with is the use of ozone as a treatment for horses with muscle diseases like tying-up exertional rhabdomyolysis, bacterial infections and more. After coming across a doctor in Florida that was using ozone for tendon and joint healing in people, we asked why couldn’t we also use the same method in horses? Ozone is an amazing anti-inflammatory for any and all joint issues from the back, to stifles, knees, etc.” ……..”It is not yet FDA approved, but we stand by this as a 100% natural option for horses that doesn’t promote harm or doping.”
NONE OF THESE CLAIMS ARE SUPPORTED BY ANY SCIENCE IN HORSES!
Conclusion
At this time I would strongly caution against allowing your horse to be subjected to any form of ozone therapy!
Further reading
This document explains in more detail about oxidative stress, free radicals and protection by antioxidants – LINK TO Oxidative Stress, Free Radicals, and Antioxidants
References
Christopher M. Deaton, David J. Marlin, Exercise-associated oxidative stress, Clinical Techniques in Equine Practice, Volume 2, Issue 3, 2003, Pages 278-291, https://doi.org/10.1053/S1534-7516(03)00070-2
Deaton, C.M., Marlin, D.J., Smith, N.C., Roberts, C.A., Harris, P.A., Schroter, R.C. And Kelly, F.J. (2005), Antioxidant and inflammatory responses of healthy horses and horses affected by recurrent airway obstruction to inhaled ozone. Equine Veterinary Journal, 37: 243-249. https://doi.org/10.2746/0425164054530605
Deaton, C. M., Marlin, D. J., Smith, N. C., Harris, P. A., Dagleish, M. P., Schroter, R. C., & Kelly, F. J. (2005). EFFECT OF ACUTE AIRWAY INFLAMMATION ON THE PULMONARY ANTIOXIDANT STATUS. Experimental Lung Research, 31(7), 653–670. https://doi.org/10.1080/01902140591007092
Deaton C, Marlin D. A review of the effects of environmental pollution on the equine respiratory tract: considerations for the 2004 Athens Olympic Games. Equine and Comparative Exercise Physiology. 2004;1(3):171-176. https://doi:10.1079/ECEP200425
David J. Marlin, Katie Fenn, Nicola Smith, Chris D. Deaton, Colin A. Roberts, Patricia A. Harris, Christina Dunster, Frank J. Kelly, Changes in Circulatory Antioxidant Status in Horses during Prolonged Exercise, The Journal of Nutrition, Volume 132, Issue 6, 2002, Pages 1622S-1627S, https://doi.org/10.1093/jn/132.6.1622S
David J. Marlin, Lucy Johnson, Demelza A. Kingston, Nicola C. Smith, Chris M. Deaton, Sarah Mann, Paul Heaton, Fenneke Van Vugt, Kelly Saunders, Julia Kydd, Pat A. Harris, Application of the Comet Assay for Investigation of Oxidative DNA Damage in Equine Peripheral Blood Mononuclear Cells,
The Journal of Nutrition, Volume 134, Issue 8, 2004, Pages 2133S-2140S, https://doi.org/10.1093/jn/134.8.2133S
PUBMED Search Results:
Items 1-39 of 39 (Display the 39 citations in PubMed)
| Ozone therapy in veterinary medicine: A review. Sciorsci RL, Lillo E, Occhiogrosso L, Rizzo A. Res Vet Sci. 2020 Jun;130:240-246. doi: 10.1016/j.rvsc.2020.03.026. Epub 2020 Mar 25. PMID: 32234614 Review. |
| Safety and Effects of a Commercial Ozone Foam Preparation on Endometrial Environment and Fertility of Mares. Donato GG, Appino S, Bertero A, Poletto ML, Nebbia P, Robino P, Varello K, Bozzetta E, Vincenti L, Nervo T. J Equine Vet Sci. 2023 Feb;121:104222. doi: 10.1016/j.jevs.2023.104222. Epub 2023 Jan 6. PMID: 36623580 |
| Effect of uterine ozone therapy and anticoagulant sampling on oxidative stress parameters in mares. Almeida BFM, Amatti LZ, de Souza GG, Garcia LV, Montechiesi DF, Ignácio FS, de Oliveira PL, Costa LR, Floriano BP, Bosculo MRM, Joaquim JGF, Rubio CP. Res Vet Sci. 2021 May;136:503-511. doi: 10.1016/j.rvsc.2021.04.002. Epub 2021 Apr 13. PMID: 33878612 |
| Impact of low-dose ozone supplementation on motility parameters and bacterial growth in horse cryopreserved semen. Fanelli D, Moroni R, Sala G, Melanie P, Tarabella I, Telleschi N, Maltinti S, Giorgi M, Barsotti G, Passamonti F, Marmorini P, Rota A, Camillo F, Panzani D. Vet Anim Sci. 2024 Jul 21;25:100380. doi: 10.1016/j.vas.2024.100380. eCollection 2024 Sep. PMID: 39135617 Free PMC article. |
| Comparison of systemic trimethoprim-sulfadimethoxine treatment and intrauterine ozone application as possible therapies for bacterial endometritis in equine practice. Köhne M, Hofbauer L, Böttcher D, Tönissen A, Hegger A, Görgens A, Ulrich R, Sieme H. Front Vet Sci. 2023 Jan 27;10:1102149. doi: 10.3389/fvets.2023.1102149. eCollection 2023. PMID: 36777673 Free PMC article. |
| The interference of ozone gas in kinects and mitochondrial potential of equine sperm submitted on cryopreservation. Macêdo IN, Arruda LCP, de Santana BB, de Moura TCM, Guerra MMP, Bezerra DG, Carneiro GF, Silva SV. Anim Reprod. 2021 Dec 17;18(4):e20210075. doi: 10.1590/1984-3143-AR2021-0075. eCollection 2021. PMID: 34956402 Free PMC article. |
| Effects of medical ozone upon healthy equine joints: Clinical and laboratorial aspects. Vendruscolo CDP, Moreira JJ, Seidel SRT, Fülber J, Neuenschwander HM, Bonagura G, Agreste FR, Baccarin RYA. PLoS One. 2018 May 29;13(5):e0197736. doi: 10.1371/journal.pone.0197736. eCollection 2018. PMID: 29813093 Free PMC article. |
| Use Low Ozone Dosages has Positive Effects on the Cooling and Cryopreservation of Equine Semen. Pereira RR, Nogueira BG, Milan B, Acacio BR, Freitas-Dell’Aqua CP, Souza MI, Sampaio BF. J Equine Vet Sci. 2022 Jan;108:103800. doi: 10.1016/j.jevs.2021.103800. Epub 2021 Oct 29. PMID: 34844202 |
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| Effects of ozone and airway inflammation on glutathione status and iron homeostasis in the lungs of horses. Mills PC, Roberts CA, Smith NC. Am J Vet Res. 1996 Sep;57(9):1359-63. PMID: 8874733 |
| Does the Uterine Ozone Therapy Alter the Transcript Profile of Anti- and Proinflammatory Genes in Mares With Endometritis? Botelho JHV, Pessoa GO, Caixeta ES, Sales G, de Oliveira KR, Nascimento Neto JDP, Ferreira RD, Palhão MP. Reprod Domest Anim. 2024 Sep;59(9):e14718. doi: 10.1111/rda.14718. PMID: 39253801 |
| Effectiveness of Ozone Therapy in The Treatment of Endometritis in Mares. Ávila ACA, Diniz NC, Serpa RT, Chaves MMBC, Viu MAO, de Oliveira RA. J Equine Vet Sci. 2022 May;112:103900. doi: 10.1016/j.jevs.2022.103900. Epub 2022 Feb 18. PMID: 35183680 |
| Ozone-induced inactivation of antioxidant enzymes. Lee YK, Mok Kim S, Han S. Biochimie. 2003 Oct;85(10):947-52. doi: 10.1016/j.biochi.2003.09.012. PMID: 14644549 |
| Stratospheric ozone depletion and animal health. Mayer SJ. Vet Rec. 1992 Aug 8;131(6):120-2. doi: 10.1136/vr.131.6.120. PMID: 1529513 |
| Antioxidant and inflammatory responses of healthy horses and horses affected by recurrent airway obstruction to inhaled ozone. Deaton CM, Marlin DJ, Smith NC, Roberts CA, Harris PA, Schroter RC, Kelly FJ. Equine Vet J. 2005 May;37(3):243-9. doi: 10.2746/0425164054530605. PMID: 15892234 |
| Removal of Particulate Matter by a Non-Powered Brush Filter Using Electrostatic Forces. Heo J, Lee J, Yoon M, Park D. Toxics. 2023 Oct 30;11(11):891. doi: 10.3390/toxics11110891. PMID: 37999543 Free PMC article. |
| Effectiveness of photo-ozone therapy against equine Pythium insidiosum. Rodrigues VS, Trevisan LAC, Cintra BS, Pires RH, Ribeiro AB, Tavares DC, Oberhaus E, Ferreira JC. J Equine Vet Sci. 2024 Mar;134:105030. doi: 10.1016/j.jevs.2024.105030. Epub 2024 Feb 9. PMID: 38342358 |
| Reaction of ozone with protein tryptophans: band III, serum albumin, and cytochrome C. Mudd JB, Dawson PJ, Tseng S, Liu FP. Arch Biochem Biophys. 1997 Feb 15;338(2):143-9. doi: 10.1006/abbi.1996.9848. PMID: 9028865 |
| The characterization and properties of castaprenol-11, -12 and -13 from the leaves of Aesculus hippocastanum (horse chestnut). Wellburn AR, Stevenson J, Hemming FW, Morton RA. Biochem J. 1967 Jan;102(1):313-24. doi: 10.1042/bj1020313. PMID: 6067665 Free PMC article. |
| In vitro effects of different ozone preparations on microorganisms responsible for endometritis in the mare. Donato GG, Nebbia P, Stella MC, Scalas D, Necchi D, Bertero A, Romano G, Bergamini L, Poletto ML, Peano A, Robino P, Nervo T. Theriogenology. 2024 Apr 15;219:132-137. doi: 10.1016/j.theriogenology.2024.02.011. Epub 2024 Feb 15. PMID: 38430797 |
| The effects of short- and long-term air pollutants on plant phenology and leaf characteristics. Jochner S, Markevych I, Beck I, Traidl-Hoffmann C, Heinrich J, Menzel A. Environ Pollut. 2015 Nov;206:382-9. doi: 10.1016/j.envpol.2015.07.040. Epub 2015 Aug 4. PMID: 26253312 |
| Outbreak of equine pythiosis in a southeastern region of Brazil: Environmental isolation and phylogeny. Paz GSD, Camargo GG, Cury JE, Apolonio EVP, Garces HG, Prado ACD, Chechi JL, Oliveira AL, Watanabe MJ, Bagagli E, Bosco SMG. Transbound Emerg Dis. 2022 May;69(3):1617-1624. doi: 10.1111/tbed.14135. Epub 2021 Jun 10. PMID: 33991402 |
| Oleic acid and derivatives affect human endothelial cell mitochondrial function and vasoactive mediator production. Bass VL, Soukup JM, Ghio AJ, Madden MC. Lipids Health Dis. 2020 Jun 6;19(1):128. doi: 10.1186/s12944-020-01296-6. PMID: 32505182 Free PMC article. |
| The In Vitro Effect of Ozone Therapy Against Equine Pythium insidiosum. Ferreira JC, Pires RH, Costa GBD, Carrijo BN, Guiotto FG, Rodrigues VS. J Equine Vet Sci. 2021 Mar;98:103305. doi: 10.1016/j.jevs.2020.103305. Epub 2020 Dec 30. PMID: 33663716 |
| Beware: transparency rule is a Trojan Horse. Oreskes N. Nature. 2018 May;557(7706):469. doi: 10.1038/d41586-018-05207-9. PMID: 29789751 No abstract available. |
| Endometrial angiogenesis induced by uterine insufflation with an oxygen-ozone gas mixture in mares. Camargo Ferreira J, Silva Amaral R, Mara Cardoso L, Panelli Marchió S, Aldrovani Rodrigues M, Fonseca Alves CE, de Meira C. Reprod Domest Anim. 2021 Sep;56(9):1176-1183. doi: 10.1111/rda.13958. Epub 2021 Jun 3. PMID: 34021934 |
| In vitro and ex vivo anti-Pythium insidiosum potential of ozonated sunflower oil. Braga CQ, Zambrano CG, Dos Santos Bermann C, Milech A, Ianiski LB, Soares MP, Pötter L, de Avila Botton S, Pereira DIB. Braz J Microbiol. 2024 Mar;55(1):867-873. doi: 10.1007/s42770-023-01173-1. Epub 2023 Nov 24. PMID: 37999913 |
| Increased Weekly Mean PM2.5, and NO2 Are Associated With Increased Proportions of Lower Airway Granulocytes in Ontario Horses. Brankston G, Greer AL, Marshall Q, Lang B, Moore K, Hodgins D, Hennessey JTG, Beeler-Marfisi J. Front Vet Sci. 2020 May 5;7:185. doi: 10.3389/fvets.2020.00185. eCollection 2020. PMID: 32432128 Free PMC article. |
| The impact of the 2016 Fort McMurray Horse River Wildfire on ambient air pollution levels in the Athabasca Oil Sands Region, Alberta, Canada. Landis MS, Edgerton ES, White EM, Wentworth GR, Sullivan AP, Dillner AM. Sci Total Environ. 2018 Mar 15;618:1665-1676. doi: 10.1016/j.scitotenv.2017.10.008. Epub 2017 Nov 4. PMID: 29102183 Free PMC article. |
| Multimodal therapy for treatment of equine back pain: a report of 15 cases. de Melo UP, Ferreira C. Braz J Vet Med. 2021 Nov 22;43:e003321. doi: 10.29374/2527-2179.bjvm003321. eCollection 2021. PMID: 35749060 Free PMC article. |
| Success of different therapies for bacterial endometritis in stud farm practice. Köhne M, Hegger A, Tönissen A, Hofbauer L, Görgens A, Sieme H. J Equine Vet Sci. 2024 Feb;133:105009. doi: 10.1016/j.jevs.2024.105009. Epub 2024 Jan 21. PMID: 38262523 |
| Effects of ozonated autohemotherapy on the antioxidant capacity of Thoroughbred horses. Tsuzuki N, Endo Y, Kikkawa L, Korosue K, Kaneko Y, Kitauchi A, Katamoto H, Hidaka Y, Hagio M, Torisu S. J Vet Med Sci. 2016 Jan;77(12):1647-50. doi: 10.1292/jvms.15-0225. Epub 2015 Jul 10. PMID: 26166812 Free PMC article. |
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| Toxicity of ozonated animal manure to the house fly, Musca domestica. Masten SJ, Kim-Yang H, Walker ED, Roman H, Yokoyama MT. J Environ Qual. 2001 Sep-Oct;30(5):1624-30. doi: 10.2134/jeq2001.3051624x. PMID: 11577869 |
| The role of apoptotic regulators in metaplastic mucous cells. Tesfaigzi Y. Novartis Found Symp. 2002;248:221-30; discussion 230-6, 277-82. PMID: 12568497 Review. |
| [The efficacy of water ozonation on the inactivation of oocysts of Cryptosporidium]. Perrine D, Georges P, Langlais B. Bull Acad Natl Med. 1990 Jun-Jul;174(6):845-50; discussion 850-1. PMID: 2271989 French. |
| Glycosphingolipids covalently linked to agarose gel or glass beads. Use of the compounds for purification of antibodies directed against globoside and hematoside. Laine RA, Yoggeswaran G, Hakorori S. J Biol Chem. 1974 Jul 25;249(14):4460-6. PMID: 4210505 No abstract available. |
| Gas-liquid chromatography of oligosaccharides released from red cell glycosphingolipids by ozonolysis. Oashi M, Yamakawa T. J Lipid Res. 1973 Nov;14(6):698-700. PMID: 4742565 |
