The contribution of emission sources to the future air pollution disease burden in China

Air pollution exposure is a leading public health problem in China. Despite recent air quality improvements, fine particulate matter (PM2.5) exposure remains large, the associated disease burden is substantial, and population ageing is projected to increase the susceptibility to disease. Here, we used emulators of a regional chemical transport model to quantify the impacts of future emission scenarios on air pollution exposure in China. We estimated how key emission sectors contribute to these future health impacts from air pollution exposure. We found that PM2.5 exposure declines in all scenarios across China over 2020–2050, with reductions of 15% under current air quality legislation, 36% when exploiting the full potential of air pollutant emission reduction technologies, and 39% when that technical mitigation potential is combined with emission controls for climate mitigation. However, population ageing means that the PM2.5 disease burden under current legislation (CLE) increases by 17% in 2050 relative to 2020. In comparison to CLE in 2050, the application of the best air pollution technologies provides substantial health benefits, reducing the PM2.5 disease burden by 16%, avoiding 536 600 (95% uncertainty interval, 95UI: 497 800–573 300) premature deaths per year. These public health benefits are mainly due to reductions in industrial (43%) and residential (30%) emissions. Climate mitigation efforts combined with the best air pollution technologies leads to an additional 2% reduction in the PM2.5 disease burden, avoiding 57 000 (95UI: 52 800–61 100) premature deaths per year. Up to 90% of the 2020–2050 reductions in PM2.5 exposure are already achieved by 2030, assuming efficient implementation and enforcement of currently committed air quality policies in key sectors. Achieving reductions in PM2.5 exposure and the associated disease burden after 2030 will require further tightening of emission limits for regulated sectors, addressing other sources including agriculture and waste management, and international coordinated action to mitigate air pollution across Asia.