Transition in air pollution, disease burden and health cost in China: A comparative study of long-term and short-term exposure

Ambient air pollution is one of the leading environmental risk factors to human health, largely offsetting economic growth. This study evaluated health burden and cost associated with the short-term and long-term exposure of major air pollutants (fine particulate matter [PM2.5] and ozone [O3]) during 2013–2018. We developed a database of gridded daily and annual PM2.5 and O3 exposure in China at 15 km × 15 km resolution. Then, we estimated the age- and cause-specific premature deaths and quantified related health damage with an age-adjusted value of statistical life (VSL) measure. The health cost estimated in this study captured direct cost, indirect cost and intangible cost of the premature death attributable to ambient PM2.5 and O3. We found that the national premature deaths attributable to long-term and short-term exposure to PM2.5 decreased by 15% and 59%, whereas the national premature deaths attributable to long-term and short-term exposure to O3 increased by 36% and 94%. Despite a 15% reduction of attributable deaths, the health cost attributable to long-term exposure to PM2.5 did not change significantly as a result of GDP growth and population aging. On the other hand, the long-term O3 related health cost in 2018 doubled that in 2013. Our study suggests that while premature deaths fell as a result of China’s clean air actions, the health costs of air pollution remained high. The growing trends of O3 highlighted the needs for strategies to reduce both PM2.5 and O3 emissions, for the sake of public health and social well-being in China.