Tracking long-term population exposure risks to PM2.5 and ozone in urban agglomerations of China 2015–2021

China has experienced severe air pollution in the past decade, especially PM2.5 and emerging ozone pollution recently. In this study, we comprehensively analyzed long-term population exposure risks to PM2.5 and ozone in urban agglomerations of China during 2015-2021 regarding two-stage clean-air actions based on the Ministry of Ecology and the Environment (MEE) air monitoring network. Overall, the ratio of the population living in the regions exceeding the Chinese National Ambient Air Quality Standard (35 μg/m3) decreases by 29.9 % for PM2.5 from 2015 to 2021, driven by high proportions in the Middle Plain (MP, 42.3 %) and Lan-Xi (35.0 %) regions. However, this ratio almost remains unchanged for ozone and even increases by 1.5 % in the MP region. As expected, the improved air quality leads to 234.7 × 103 avoided premature mortality (ΔMort), mainly ascribed to the reduction in PM2.5 concentration. COVID-19 pandemic may influence the annual variation of PM2.5-related ΔMort as it affects the shape of the population exposure curve to become much steeper. Although all eleven urban agglomerations share stroke (43.6 %) and ischaemic heart disease (IHD, 30.1 %) as the two largest contributors to total ΔMort, cause-specific ΔMort is highly regional heterogeneous, in which ozone-related ΔMort is significantly higher (21 %) in the Tibet region than other urban agglomeration. Despite ozone-related ΔMort being one order of magnitude lower than PM2.5-related ΔMort from 2015 to 2021, ozone-related ΔMort is predicted to increase in major urban agglomerations initially along with a continuous decline for PM2.5-related ΔMort from 2020 to 2060, highlighting the importance of ozone control. Coordinated controls of PM2.5 and O3 are warranted for reducing health burdens in China during achieving carbon neutrality.