Population aging might mask the health benefit from China&amp;#8217;s 2013 Clean Air Action

Yifan Liu,Clive Sabel,Ziheng Jiao,Ge Zhu,Haikun Wang,Xiaojing He,Zixiao Zhao,Zongwei Ma,Jing Zhao

doi:10.5194/egusphere-egu2020-12322

Abstract

&lt;p&gt;Ambient PM&lt;sub&gt;2.5&lt;/sub&gt; (fine particulate matter) pollution in China has been greatly reduced in recent years, especially since the implementation of Clean Air Action in 2013. Analysis of variations in the pollution related health burden and the driving factors has important implications for the policymakers to further improve the health benefit of air pollution controls. Here we adopted an annual population distribution estimate, disaggregated by age structure, together with PM&lt;sub&gt;2.5&lt;/sub&gt; concentration and incidence data, to better estimate total PM&lt;sub&gt;2.5&lt;/sub&gt; attributable mortality considering the effect of changing population size and age structure. We then quantified the contribution of each factor to the total variation of PM&lt;sub&gt;2.5&lt;/sub&gt; attributable mortality both nationally and regionally. Our analysis showed that national PM&lt;sub&gt;2.5&lt;/sub&gt; attributable mortality generally increased from 861,140 (95% confidence interval: 525,860~1,161,550) in 2004 to 932,500 (546,590~1,300,160) in 2017. In most 2&lt;sup&gt;nd&lt;/sup&gt;- and higher-tier cities in China, which stand for highly developed cities like Beijing, Shanghai, Guangzhou, etc., the PM&lt;sub&gt;2.5&lt;/sub&gt; health burden increased. Meanwhile, the decrease in city-level PM&lt;sub&gt;2.5&lt;/sub&gt; health burden mainly happened in 3&lt;sup&gt;rd&lt;/sup&gt;- and lower-tier cities, where local developments were relatively smaller. The effect of exposure to PM&lt;sub&gt;2.5&lt;/sub&gt; on air pollution-related mortality has altered from aggravating to mitigating since 2012, and the abated PM&lt;sub&gt;2.5&lt;/sub&gt; exposure resulted in a reduction of 19.7% of PM&lt;sub&gt;2.5&lt;/sub&gt; attributable mortality between 2012 and 2017. However, such benefit was almost masked by the effect of the population aging, which brought an increase of 18.4% to the health burden. Our results implied that the increasing trend in China&amp;#8217;s PM&lt;sub&gt;2.5&lt;/sub&gt; health burden since 2006 was halted after 2012 due to the pollution control policies, and population aging impeded it from declining further. For future air pollution control and public health affairs, growing cities in China should focus attention on old-age care, where the growth of attributable mortality might occur.&lt;/p&gt;

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