Temporal trend of cause-specific mortality burden attributable to ambient PM_2.5 from different sectors and fuel types...

To estimate the disease-specific mortality burden attributable to fine particulate matter (PM_2.5) pollution in China across multiple sectors and fuel types during 2015-2022.

The Greenhouse Gas-Air Pollution Interactions and Synergies (GAINS) model was used to estimate PM_2.5 concentrations in Chinese provinces from seven sectors and five fuel types. The relative risks (RR) of seven diseases were assessed using the Integrated Exposure-Response (IER) model. The number of deaths attributable to PM_2.5 pollution (DAPP) and the attributable fraction (AF), representing the proportion of total deaths caused by PM_2.5 exposure, were estimated by province, sector, and fuel type, then compared across the years 2015, 2019, 2021, and 2022.

Ambient PM_2.5 concentrations in China exhibited a gradual decline, the most substantial reductions were observed in household, industry, and agriculture. There were 1,440,000 PM_2.5-related deaths and 13.8 % AF for China in 2022, with a reduction of 290,000 compared with 2015. The largest reductions among 31 provinces were observed in Henan, followed by Hebei and Shandong, with 27,000, 26,000, and 25,000 decreases, respectively. Additionally, DAPP decreased most in stroke and ischemic heart disease (IHD). For different sectors, agriculture, household and industry sectors demonstrated the greatest reductions in DAPP from 2015 to 2022, accounting for 131,000, 130,000, and 72,000, respectively. In 2022, DAPP attributable to coal combustion decreased by 190,000, with the most substantial reduction observed in the household sector. However, DAPP increased by 23,000 in 2022 compared to 2021, despite a continued decline in AF.

The findings highlight the substantial public health benefits of emission control measures implemented across multiple sectors in China, including industry, agriculture, and transport. To alleviate the health burden of an aging population, it is necessary and feasible to implement further PM_2.5 control efforts and develop targeted policies for different regions, diseases, and industries in China.