Tracking PM_2.5 and O₃ Pollution and the Related Health Burden in China 2013-2020

Based on the exposure data sets from the Tracking Air Pollution in China (TAP, http://tapdata.org.cn/), we characterized the spatiotemporal variations in PM_2.5 and O₃ exposures and quantified the long- and short-term exposure related premature deaths during 2013-2020 with respect to the two-stage clean air actions (2013-2017 and 2018-2020). We find a 48% decrease in national PM_2.5 exposure during 2013-2020, although the decrease rate has slowed after 2017. At the same time, O₃ pollution worsened, with the average April-September O₃ exposure increased by 17%. The improved air quality led to 308 thousand and 16 thousand avoided long- and short-term exposure related deaths, respectively, in 2020 compared to the 2013 level, which was majorly attributed to the reduction in ambient PM_2.5 concentration. It is also noticed that with smaller PM_2.5 reduction, the avoided long-term exposure associated deaths in 2017-2020 (13%) was greater than that in 2013-2017 (9%), because the exposure-response curve is nonlinear. As a result of the efforts in reducing PM_2.5-polluted days with the daily average PM_2.5 higher than 75 μg/m³ and the considerable increase in O₃-polluted days with the daily maximum 8 h average O₃ higher than 160 μg/m³, deaths attributable to the short-term O₃ exposure were greater than those due to PM_2.5 exposure since 2018. Future air quality improvement strategies for the coordinated control of PM_2.5 and O₃ are urgently needed.