Premature mortality attributable to PM_2.5 pollution in China during 2008-2016: Underlying causes and responses to...

Long-term exposure to fine particulate matter (PM_2.5) poses a great threat to public health in China. To this end, the Chinese government promulgated the Air Pollution Prevention and Control Action Plan (the Action Plan) in 2013. However, the health benefits of the Action Plan have not been well explained. In this paper, the underlying causes of changes in premature mortality attributable to PM_2.5 pollution and the response of this mitigation policy in China were explored using sensitivity analysis. The simulated annual average PM_2.5 concentration reduced by 24.9% over mainland China from 2008 to 2016. Subsequently, national premature mortality would decrease by 14.4% from 1.14 million (95% CI: 0.54, 1.55) in 2008 to 0.98 million (95% CI: 0.44, 1.38) in 2016. Specifically, premature mortality reduced by 209,600 cases (-18.3%) owing to PM_2.5 reduction during 2008-2016, of which 188,500 cases were from 2014 to 2016 due to the Action Plan in 2013. Note that the health benefits were limited when compared with air quality improvements, mainly due to that the IER functions have a stable curve at higher concentration intervals. Meanwhile, premature mortality would have increased by 14.2% from 2008 to 2016 owing to demographic changes, substantially weakening the impact of the decrease in PM_2.5 and baseline mortality. The effectiveness of China's new air pollution mitigation policy was proved through the research. However, considering the non-linear response of mortality to PM_2.5 changes and the aggravation of demography trends, stronger emission control steps should be further taken to protect public health in China.