Mortality burden attributable to long-term exposure to ambient PM2.5: a systematic subnational analysis in 296 Chinese cities

Abstract

BACKGROUND AND AIM: BACKGROUND: Quantifying the spatial and socioeconomic variation of mortality burden attributable to particulate matters with aerodynamic diameter ≤ 2.5 µm (PM2.5) has important implications for pollution control policy. This study aims to examine the regional and socioeconomic disparities in the mortality burden attributable to long-term exposure to ambient PM2.5 in China. METHODS: METHODS: Using data of 296 cities across China from 2015 to 2019, we estimated all-cause mortality (people aged ≥30 years) attributable to the long-term exposure to ambient PM2.5 above the WHO air quality guideline (10 µg/m3) with the AirQ+ software. Attributed fraction (AF), attributed deaths (AD), attributed mortality rate (AMR) and total value of statistical life lost (VSL) by regional and socioeconomic levels were reported. RESULTS:RESULTS: Over the period of 2015-2019, 18.1% [95% confidence interval (CI): 12.3-23.1] of all-cause mortality for adults ≥30 years were attributable to long-term exposure to ambient PM2.5, corresponding to 1540.8 thousand deaths (95% CI: 1050.1-1961.5), 180.5/105 (95% CI: 122.7-230.4) AMR, and 20.0 billion USD (95% CI: 15.8-24.3) total VSL per year. The highest mortality burden was observed in the central region (annual average AF = 24.5%, 95% CI: 16.8-30.9; annual average AMR = 236.1/105, 95% CI: 161.9-298.8). The highest AD and economic loss were observed in the east region (annual average AD = 416.0 thousand persons, 95% CI: 282.6-531.1; annual total VSL = 27.4 billion USD, 95% CI: 21.6-33.2). Highest AMR was in the cities with middle level of GDP per capita (PGDP)/urbanization. The majority of the top ten cities of AF and AMR were in low and middle PGDP/urbanization regions while top ten VSL in high PGDP/urbanization regions. CONCLUSIONS:CONCLUSION: There were significant regional and socioeconomic disparities in PM2.5 attributed mortality burden among Chinese cities, suggesting differential mitigation policies should be needed for different regions in China. KEYWORDS: mortality burden, ambient PM2.5, socioeconomic disparity, economic loss