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Xue T, Wang R, Wang M, Wang Y, Tong D, Meng X, Huang C, Ai S, Li F, Cao J, Tong M, Ni X, Liu H, Deng J, Lu H, Wan W, Gong J, Zhang S, Zhu T. Health benefits from the rapid reduction in ambient exposure to air pollutants after China's clean air actions: progress in efficacy and geographic equality. Natl Sci Rev 2024; 11:nwad263. [PMID: 38213522 PMCID: PMC10776362 DOI: 10.1093/nsr/nwad263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/13/2023] [Accepted: 10/08/2023] [Indexed: 01/13/2024] Open
Abstract
Clean air actions (CAAs) in China have been linked to considerable benefits in public health. However, whether the beneficial effects of CAAs are equally distributed geographically is unknown. Using high-resolution maps of the distributions of major air pollutants (fine particulate matter [PM2.5] and ozone [O3]) and population, we aimed to track spatiotemporal changes in health impacts from, and geographic inequality embedded in, the reduced exposures to PM2.5 and O3 from 2013 to 2020. We used a method established by the Global Burden of Diseases Study. By analyzing the changes in loss of life expectancy (LLE) attributable to PM2.5 and O3, we calculated the gain of life expectancy (GLE) to quantify the health benefits of the air-quality improvement. Finally, we assessed the geographic inequality embedded in the GLE using the Gini index (GI). Based on risk assessments of PM2.5 and O3, during the first stage of CAAs (2013 to 2017), the mean GLE was 1.87 months. Half of the sum of the GLE was disproportionally distributed in about one quarter of the population exposed (GI 0.44). During the second stage of CAAs (2017 to 2020), the mean GLE increased to 3.94 months and geographic inequality decreased (GI 0.18). According to our assessments, CAAs were enhanced, from the first to second stages, in terms of not only preventing premature mortality but also ameliorating health inequalities. The enhancements were related to increased sensitivity to the health effects of air pollution and synergic control of PM2.5 and O3 levels. Our findings will contribute to optimizing future CAAs.
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Affiliation(s)
- Tao Xue
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
- Advanced Institute of Information Technology, Peking University, Hangzhou311215, China
| | - Ruohan Wang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY14214, USA
| | - Yanying Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
| | - Dan Tong
- Department of Earth System Science, Tsinghua University, Beijing100084, China
| | - Xia Meng
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education, and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai200433, China
| | - Conghong Huang
- College of Land Management, Nanjing Agricultural University, Nanjing 210095, China
- National & Local Joint Engineering, Research Center for Rural Land Resources Use and Consolidation, Nanjing 210095, China
| | - Siqi Ai
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
| | - Fangzhou Li
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
| | - Jingyuan Cao
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
| | - Mingkun Tong
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
| | - Xueqiu Ni
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
| | - Hengyi Liu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
| | - Jianyu Deng
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
| | - Hong Lu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing100191, China
| | - Wei Wan
- Clean Air Asia, Beijing100600, China
| | - Jicheng Gong
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
| | - Shiqiu Zhang
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
| | - Tong Zhu
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing100871, China
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing100871, China
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