Synergistic Health Benefits of Household Stove Upgrading and Energy Switching in Rural China

Fractions of smoke leakage into indoor space from residential solid fuel combustion in chimney stoves

Severe indoor air pollution from solid-fuel combustion is a global health concern. Although stove chimneys can expel most of the smoke to outside, unignorable amounts can remain indoors, known as indoor fugitive emissions. Quantitative analyses of indoor emission rates (IER) and indoor fugitive fractions (IFF) are limited, particularly in field settings. This study quantified the IERs and IFFs of particulate matters (PMs) from residential solid fuel combustion, covering different fuel-stove combinations in rural China. The study showed that both IERs and IFFs were not normally distributed. The median IER for PM2.5, which peaked at 860 mg/min, was 32 mg/min. IERs very significantly among different fuel and stove types, with biomass pellets and improved stoves demonstrating lower IERs than traditional biomass and coal. Approximately 27% of PM2.5 was leaked into indoor air, but this fraction ranged largely from a low percentage to 80%. Higher IFFs were observed for coals burned in traditional stoves. The median IFFs of organic carbon and elemental carbon were 26% (12%-43% as the interquartile range) and 19% (9%-40%), respectively. The chimney lifting effect significantly affected the degree of indoor leakage, with relatively low IFFs under high gas velocity conditions. Chimney exhaust and fugitive smoke had distinct size distributions, and small particles exhibited fewer leakages than coarse particles. The study provides valuable datasets for quantifying internal combustion impacts on indoor air quality and consequently human health.

Assessing the spatiotemporal evolution and socioeconomic determinants of PM2.5-related premature deaths in China from 2000 to 2021

China's swift socioeconomic development has led to extremely severe ambient PM2.5 levels, the associated negative health outcomes of which include premature death. However, a comprehensive explanation of the socioeconomic mechanism contributing to PM2.5-related premature deaths has not yet to be fully elucidated through long-term spatial panel data. Here, we employed a global exposure mortality model (GEMM) and the system generalized method of moments (Sys-GMM) to examine the primary determinants contributing to premature deaths in Chinese provinces from 2000 to 2021. We found that in the research period, premature deaths in China increased by 46 %, reaching 1.87 million, a figure that decreased somewhat after the COVID-19 outbreak. 62 thousand premature deaths were avoided in 2020 and 2021 compared to 2019, primarily due to the decline in PM2.5 concentrations. Premature deaths have increased across all provinces, particularly in North China, and a discernible spatial agglomeration effect was observed, highlighting effects on nearby provinces. The findings also underscored the significance of determinants such as urbanization, import and export trade, and energy consumption in exacerbating premature deaths, while energy intensity exerted a mitigating influence. Importantly, a U-shaped relationship between premature deaths and economic development was unveiled for the first time, implying the need for vigilance regarding potential health impact deterioration and the implementation of countermeasures as the per capita GDP increases in China. Our findings deserve attention from policymakers as they shed fresh insights into atmospheric control and Health China action.

Mitigating black carbon emissions: key drivers in residential usage and coke/brick production

Black carbon (BC) is a crucial air pollutant that contributes to short-lived climate forcing and adverse health impacts. BC emissions have rapidly declined over the past three decades and it is important to uncover the major factors behind this decline. Herein, the temporal trends in BC emissions were compiled from 146 detailed sources from 1960 to 2019. Results revealed that the major emission sources were residential solid fuel usage, coke production and brick production. Furthermore, 96.9% of the emission reduction from 3.03 Tg in 1995 to 1.02 Tg in 2019 was attributed to these three sources. It was determined that the transition in residential energy/stove usage, phasing-out of beehive coke ovens and brick kiln upgrading were the most important drivers leading to this reduction and will continue to play a key role in future emission mitigation. In addition, this study identified the need to address emissions from coal used in vegetable greenhouses and the commercial sector, and diesel consumption in on/off-road vehicles.

Status and frontier analysis of indoor PM2.5-related health effects: a bibliometric analysis

Epidemiological data indicate atmospheric particulate matter, especially fine particulate matter (PM2.5), has many negative effects on human health. Of note, people spend about 90% of their time indoors. More importantly, according to the World Health Organization (WHO) statistics, indoor air pollution causes nearly 1.6 million deaths each year, and it is considered as one of the major health risk factors. In order to obtain a deeper understanding of the harmful effects of indoor PM2.5 on human health, we used bibliometric software to summarize articles in this field. In conclusion, since 2000, the annual publication volume has increased year by year. America topped the list for the number of articles, and Professor Petros Koutrakis and Harvard University were the author and institution with the most published in this research area, respectively. Over the past decade, scholars gradually paid attention to molecular mechanisms, therefore, the toxicity can be better explored. Particularly, apart from timely intervention and treatment for adverse consequences, it is necessary to effectively reduce indoor PM2.5 through technologies. In addition, the trend and keywords analysis are favorable ways to find out future research hotspots. Hopefully, various countries and regions strengthen academic cooperation and integration of multi-disciplinary.

A review of the pollution signatures of polycyclic aromatic hydrocarbons in the sediments of the East China Sea

Marine sediments serve as crucial reservoirs for polycyclic aromatic hydrocarbons (PAHs), and their PAH signatures offer valuable historical pollution records. This article provides a comprehensive review of the pollution status of 16 priority PAHs in more than 1000 sediments from the East China Sea (ECS). It focuses on the PAH sources, spatiotemporal distributions, driving factors, and ecological risks, with information derived from peer-reviewed papers published between 2003 and 2023. The results revealed that vehicular emissions, mixed combustion sources of coal, biomass, and coke, as well as petrogenic sources, were the primary contributors to PAH pollution in the ECS sediments, accounting for 50%, 34%, and 16%, respectively. Human activities, hydrodynamic mechanisms, and environmental variables such as particle size and organic matter, collectively influenced the distribution of PAHs. Additionally, the population size and economic development played a key role in the temporal distribution of PAHs in the ECS sediments. The ecotoxicity assessment of PAHs in sediments indicated a low risk level. These outcomes are expected to provide environmentalists with detailed and up-to-date insights into sedimentary PAHs in the ECS, helping to develop suitable monitoring plans and strategies for promoting better management of ECS environment.

Identifying Key Sources for Air Pollution and CO2 Emission Co-control in China

China is confronting the dual challenges of air pollution and climate change, mandating the co-control of air pollutants and CO2 emissions from their shared sources. Here we identify key sources for co-control that prioritize the mitigation of PM2.5-related health burdens, given the homogeneous impacts of CO2 emissions from various sources. By applying an integrated analysis framework that consists of a detailed emission inventory, a chemical transport model, a multisource fused dataset, and epidemiological concentration-response functions, we systematically evaluate the contribution of emissions from 390 sources (30 provinces and 13 socioeconomic sectors) to PM2.5-related health impacts and CO2 emissions, as well as the marginal health benefits of CO2 abatement across China. The estimated source-specific contributions exhibit substantial disparities, with the marginal benefits varying by 3 orders of magnitude. The rural residential, transportation, metal, and power and heating sectors emerge as pivotal sources for co-control, with regard to their relatively large marginal benefits or the sectoral total benefits. In addition, populous and heavily industrialized provinces such as Shandong and Henan are identified as the key regions for co-control. Our study highlights the significance of incorporating health benefits into formulating air pollution and carbon co-control strategies for improving the overall social welfare.

The Long Hazy Tail: Analysis of the Impacts and Trends of Severe Outdoor and Indoor Air Pollution in North China

China, especially the densely populated North China region, experienced severe haze events in the past decade that concerned the public. Although the most extreme cases have been largely eliminated through recent mitigation measures, severe outdoor air pollution persists and its environmental impact needs to be understood. Severe indoor pollution draws less public attention due to the short visible distance indoors, but its public health impacts cannot be ignored. Herein, we assess the trends and impacts of severe outdoor and indoor air pollution in North China from 2014 to 2021. Our results demonstrate the uneven contribution of severe hazy days to ambient and exposure concentrations of particulate matter with an aerodynamic diameter <2.5 (PM2.5). Although severe indoor pollution contributes to indoor PM2.5 concentrations (23%) to a similar extent as severe haze contributes to ambient PM2.5 concentrations (21%), the former's contribution to premature deaths was significantly higher. Furthermore, residential emissions contributed more in the higher PM2.5 concentration range both indoors and outdoors. Notably, severe haze had greater health impacts on urban residents, while severe indoor pollution was more impactful in rural areas. Our findings suggest that, besides reducing severe haze, mitigating severe indoor pollution is an important aspect of combating air pollution, especially toward improving public health.

Costs and health benefits of the rural energy transition to carbon neutrality in China

The rural energy transition is critical in China's efforts to achieve carbon neutrality and improve air quality. However, the costs and health benefits associated with the transition to carbon neutrality remain unclear. Here we explore the cost-effective transition pathways and air quality-related health impacts using an integrated energy-air quality-health modeling framework. We find that decarbonizing rural cooking and heating would triple contemporary energy consumption from 2014 to 2060, considerably reducing energy poverty nationwide. By 2060, electric cooking ranges and air-to-air heat pumps should be widely integrated, costing an additional 13 billion USD nationally in transformation costs, with ~40% concentrated in Shandong, Heilongjiang, Shanxi and Hebei provinces. Rural residential decarbonization would remarkably improve air quality in northern China, yielding substantial health co-benefits. Notably, monetized health benefits in most provinces are projected to offset transformation costs, except for certain relatively lower-development southwestern provinces, implying more financial support for rural residents in these areas will be needed.

Economic Growth Facilitates Household Fuel Use Transition to Reduce PM2.5-Related Deaths in China

Exposure to ambient and indoor particle matter (PM2.5) leads to millions of premature deaths in China. In recent years, indoor air pollution and premature deaths associated with polluting fuel cooking demonstrate an abrupt decline. However, the driving forces behind the mortality change are still unclear due to the uncertainty in household fuel use prediction. Here, we propose an integrated approach to estimate the fuel use fractions and PM2.5-related deaths from outdoor and indoor sources during 2000-2020 across China. Our model estimated 1.67 and 1.21 million premature deaths attributable to PM2.5 exposure in 2000 and 2020, respectively. We find that the residential energy transition is associated with a substantial reduction in premature deaths from indoor sources, with 100,000 (95% CI: 76,000-122,000) for urban and 265,000 (228,000-300,000) for rural populations during 2000-2020. Economic growth is the dominant driver of fuel use transition and avoids 21% related deaths (357,000, 315,000-402,000) from polluting fuel cooking since 2000, which offsets the adverse impact of ambient emissions contributed by economic growth. Our findings give an insight into the coupled impact of socioeconomic factors in reshaping health burden in exposure pathways.

Impact of Stove Renovation on PM2.5 Exposure, Risk Perception, Self-Protective Willingness of Rural Residents

To improve household air quality, the Chinese government has launched a number of pilot stove renovation projects, but few studies have explored the impact of the project on people's perception of and willingness to participate in these renovations; moreover, factors affecting willingness to pay for the project in rural China are not yet clear. We conducted a field measurement and a corresponding door-to-door questionnaire survey using the renovated group and the unrenovated group. The results showed that (1) the stove renovation project could not only reduce PM_2.5 exposure and the excess mortality risk of rural residents, but also (2) improve residents' risk perception and self-protective willingness. (3) Specifically, the project had a deeper impact on female and low-income residents. (4) Meanwhile, the higher the income and the larger family size, the higher the risk perception and self-protective willingness. (5) Furthermore, willingness to pay for the project was related with residents' support for the project, benefit from renovation, income, and family size. Our results recommended that stove renovation policies should pay more attention to families with lower income and smaller size.

Improving Building Envelope Efficiency Lowers Costs and Emissions from Rural Residential Heating in China

In 2017, the Chinese government launched a clean heating campaign that replaced millions of rural coal stoves with various clean heaters. The clean heating program contributed to remarkable improvements in air quality. However, the benefits of reducing heating demand by improving building envelope efficiency were not sufficiently considered. This study provides a needed quantitative assessment of potential energy-savings, costs, greenhouse gas emission reductions, and adoption strategies for improving building envelope efficiency in Chinese rural residential buildings. We find that different strategies must be employed in existing and new buildings to achieve desired outcomes. For existing buildings, to encourage easy and beneficial building retrofits (e.g., air sealing, efficient windows), current fuel subsidies should be replaced with retrofit subsidies. Building retrofits can reduce the size and hence capital costs of new clean heaters. They can also reduce operating costs, hence reducing the likelihood of backsliding to coal. For new construction, whole-home insulation and heat pumps would best avoid carbon lock-in. These efficient technologies have high upfront costs but decrease heating costs and significantly reduce carbon emissions relative to current policies. Hence, subsidies and policies that encourage improvements in building envelopes as well as the uptake of clean and efficient heaters are critical.

Prevalence and risk factors of chronic rhinosinusitis among Chinese: A systematic review and meta-analysis

Background

Chronic rhinosinusitis (CRS) can be seen in people of all ages. CRS heavily affects the quality of a patient's daily life and also causes tremendous economic burdens on patients' families and society. The prevalence of CRS in different countries varies and no systematic review of the prevalence of CRS among Chinese has been published previously. The objective of this systematic review and meta-analysis is to determine the prevalence of CRS among Chinese and to explore the main risk factors of CRS among Chinese.

Methods

Using relevant keywords, data resources including PubMed, Scopus, Web of Science, Google Scholar, Embase, Cochrane Library, Chinese National Knowledge of Infrastructure (CNKI), WANGFANG, VIP, and China Biomedical Literature database (CMB) were searched to obtain literature reporting the prevalence of and risk factors of CRS among Chinese which were clearly diagnosed with CRS from inception to 30 June 2022. The random/fixed effect model was used for meta-analysis, and the I² index was employed to assess heterogeneity among studies. All analyses were performed by using the STATA version 16.0 software. The study was registered with PROSPERO, register number. CRD42022341877.

Result

A total of 12 relevant kinds of literature were qualified for the present systematic review, including 4,033 patients. The results showed that the overall prevalence of CRS among Chinese was 10% (95%CI: 0.06-0.13, I² = 99.6%, P < 0.001). The prevalence of CRS among Chinese who lived in urban cities was 18% (95%CI: -0.07 to 0.43, I² = 99.9%, P < 0.001), which was obviously lower than the prevalence of CRS among Chinese who lived in rural areas (27%, 95%CI: -0.14 to 0.68, I² = 99.8%, P < 0.001). The prevalence of CRS among Chinese before 2010 was 23% (95%CI: -0.05 to 0.50, I² = 99.8%, P < 0.001), which was remarkably higher than the prevalence of CRS among Chinese after 2010 (7%, 95%CI: 0.05-0.09, I² = 99.0%, P < 0.001). The prevalence of CRS among Chinese who were divorced was 17% (95%CI: 0.12-0.22, I² = 0.0%, P = 0.436), while the prevalence of CRS among Chinese who were married, widowed, and unmarried was 9% (95%CI: 0.06-0.11, I² = 88.1%, P = 0.004), 9% (95%CI: 0.06-0.11, I² = 0.0%, P = 0.863), and 9% (95%CI: 0.08-0.10, I² = 0.0%, P = 0.658), respectively. The prevalence of CRS among Han and minority Chinese was 8% (95%CI: 0.07-0.10, I² = 69.6%, P = 0.070) and 12% (95%CI: 0.10-0.15, I² = 38.6%, P = 0.202), respectively. The prevalence of CRS among Chinese who was never exposed to moldy or damp environments was 8% (95%CI: 0.08-0.09, I² = 0.0%, P = 0.351), the prevalence of CRS among Chinese who was occasionally exposed to moldy or damp environments was 16% (95%CI: 0.10-0.22, I² = 78.9%, P = 0.030), and the prevalence of CRS among Chinese who was frequently or every day exposed to moldy or damp environments was up to 20% (95%CI: 0.15-0.24, I² = 0.0%, P = 0.558).

Conclusion

This meta-analysis shows that the prevalence of CRS among Chinese is at a high level. People who have some risk factors, such as occasional or frequent or everyday exposure to moldy or damp environments, have a higher prevalence of CRS. We should attach more importance to the risk factors of CRS in clinical practice and disseminate scientific information and carry out education to lower the prevalence of CRS in China.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341877, identifier: CRD42022341877.

A review of indoor Gaseous organic compounds and human chemical Exposure: Insights from Real-time measurements

Gaseous organic compounds, mainly volatile organic compounds (VOCs), have become a wide concern in various indoor environments where we spend the majority of our daily time. The sources, compositions, variations, and sinks of indoor VOCs are extremely complex, and their potential impacts on human health are less understood. Owing to the deployment of the state-of-the-art real-time mass spectrometry during the last two decades, our understanding of the sources, dynamic changes and chemical transformations of VOCs indoors has been significantly improved. This review aims to summarize the key findings from mass spectrometry measurements in recent indoor studies including residence, classroom, office, sports center, etc. The sources and sinks, compositions and distributions of indoor VOCs, and the factors (e.g., human activities, air exchange rate, temperature and humidity) driving the changes in indoor VOCs are discussed. The physical and chemical processes of gas-particle partitioning and secondary oxidation processes of VOCs, and their impacts on human health are summarized. Finally, the recommendations for future research directions on indoor VOCs measurements and indoor chemistry are proposed.

Reduced inequality in ambient and household PM2.5 exposure in China

The society has high concerns on the inequality that people are disproportionately exposed to ambient air pollution, but with more time spent indoors, the disparity in the total exposure considering both indoor and outdoor exposure has not been explored; and with the socioeconomical development and efforts in fighting against air pollution, it is unknown how the exposure inequality changed over time. Based on the city-level panel data, this study revealed the Concentration Index (C) in ambient PM_2.5 exposure inequality was positive, indicating the low-income group exposed to lower ambient PM_2.5; however, the total PM_2.5 exposure was negatively correlated with the income, showing a negative C value. The low-income population exposed to high PM_2.5 associated with larger contributions of indoor exposure from the residential emissions. The total PM_2.5 exposure caused 1.13 (0.63-1.73) million premature deaths in 2019, with only 14 % were high-income population. The toughest-ever air pollution countermeasures have reduced ambient PM_2.5 exposures effectively that, however, benefited the rich population more than the others. The transition to clean household energy sources significantly affected on indoor air quality improvements, as well as alleviation of ambient air pollution, resulting in notable reductions of the total PM_2.5 exposure and especially benefiting the low-income groups. The negative C values decreased from 2000 to 2019, indicating a significantly reducing trend in the total PM_2.5 exposure inequality over time.

Dwindling aromatic compounds in fine aerosols from chunk coal to honeycomb briquette combustion

With the implementation of clean coal policy in China, the chunk coal has been gradually replaced by honeycomb briquette in domestic energies. In this study, the molecular composition of fine particles (PM_2.5) from chunk coal and honeycomb briquette combustion is characterized using the Fourier transform-ion cyclotron resonance mass spectrometry (FT-ICR MS). More than 6000 molecular formulae were detected in each PM_2.5 sample. A remarkable decrease in unsaturation and aromatic compounds was found from chunk coal to honeycomb briquette derived aerosols. Around 73.6% of the unique CHON compounds in chunk coal are considered to have aromatic structures, while it decreased to 7.3% in honeycomb briquette. Most of these nitroaromatics detected only in chunk coal are highly carcinogenic and mutagenic with 4-6 rings. Moreover, the aromatic compounds in sulfur-containing compounds also showed a significant decrease. Meanwhile, because of the perforated shape and the additives added during the production of honeycomb briquettes, there are more heteroatoms-containing molecules released from honeycomb briquette combustion, which are highly functional compounds with high molecular weight, high degree of oxidation, and low volatility. Our results provide molecular level evidence that the transformation from chunk coal to honeycomb briquette can effectively reduce the emission of aromatic compounds, which is beneficial to assessing and reducing the impacts to climate change as well as human health.

Dynamic Evolution and Covariant Response Mechanism of Volatile Organic Compounds and Residual Functional Groups during the Online Pyrolysis of Coal and Biomass Fuels

Volatile organic compound (VOC) emissions from pyrolysis of widely used biomass are expected to increase significantly under the carbon neutrality target. However, the dynamic emissions and evolution mechanism of biomass-VOCs remain unclear, hindered by complex reactions and offline measurements. Here, we propose a novel covariant evolution mechanism to interpret the emission heterogeneities, sequential temperature responses, and evolved correlations of both VOCs and residual functional groups (RFGs) during corn straw (CS), wood pellet (WP), and semibituminous coal (SBC) pyrolysis. An innovative combination of online thermogravimetric-Fourier transform infrared-gas chromatography/mass spectrometry and two dimensional-correlation spectroscopy was applied. The relative percentages of CS/WP-VOCs were higher than those of SBC-VOCs, and most VOCs tended to have relatively small carbon skeletons as the average carbon oxidation state increased. With the temperature increased from low to high during CS/WP pyrolysis, the primary sequential response of VOCs (acids → phenols/esters → alcohols/ethers/aldehydes/ketones → hydrocarbons/aromatics) corresponded to the RFG response (hydroxyl groups → -CH₃/-CH₂-/-CH groups → aliphatic ethers and conjugated ketones). Compared with the relative regularity for CS/WP responses, the gas-solid products from SBC pyrolysis exhibited complex temperature-dependent responses and high oxidation-induced variability. These insights provide favorable strategies for the online monitoring system to facilitate priority removal of coal and biomass fuels-VOCs.

Improving Combustion Technology for Cooking Activities for Pollutant Emission Reduction and Carbon Neutrality

Inefficient residential solid fuel combustion contributes significantly to ambient and indoor air pollutants. It consumes large quantities of fuel and produces harmful effects on health. Improvements in residential biomass cooking stoves have great potential for energy savings and emission reduction. This study presents an advanced biomass gasifier cooking stove to overcome the disadvantages of high-pollutant emissions from widely used stoves in China. The most innovative features of the stove are (1) negative pressure produced by a jet fan located at the junction of the chimney, and (2) combustion and carbonization processes taking place in the same chamber. Compared with a traditional chimney stove, the advanced biomass gasifier cooking stove presented higher TE (thermal efficiency) and comprehensively lower pollutant emissions when raw crop straws, crop straw briquettes, and pellets were burned in it. Approximately 40% CO2 and 90% of PM2.5 (the aerodynamic diameter was less than or equal to 2.5 μm) EFs (emission factors) were eliminated, and TE drastically tripled. Furthermore, biomass briquette/pellet was identified as more suitable than raw biomass as a fuel to be burned in the new stove, especially because the raw biomass displayed an increase in the EFs of As, Se, and Pb when burned in the new stove. The advancement in biomass cooking stove technology is a practical approach to reducing the emissions of CO2, PM2.5, and other hazardous pollutants.

Burden of lung cancer attributable to household air pollution in the Chinese female population: trend analysis from 1990 to 2019 and future predictions

This study analyzes the long-term trend of the burden of lung cancer attributable to household air pollution in the Chinese female population, from 1990 to 2019, and make predictions for the next decade. Based the data from the 2019 Global Burden of Diseases (GBD 2019), the joinpoint regression model was used to reflect the temporal trend of the burden of lung cancer attributable to household air pollution, and an autoregressive integrated moving average (ARIMA) model was used to predict the burden of disease over the next decade. From 1990 to 2019, the age-standardized mortality and disability-adjusted life years (DALYs) rates of the Chinese female population were higher than the global rates, and the gap due to residential radon increased over time. The burden of lung cancer attributable to solid fuels has shown a significant downward trend while that due to residential radon has increased slightly overall, but remains lower than the former. The burden of lung cancer increased with age, and the peak age of DALYs rates changed from 70 < 75 years in 1990 to 75 < 80 years in 2019. The model predicted that the burden of lung cancer attributable to solid fuels will gradually decrease over the next decade, whereas the burden of lung cancer due to residential radon will gradually increase and surpass the burden due to solid fuels in 2023. Residential radon will become a more important factor of household air pollution than solid fuels in the next decade for the Chinese female population. Future interventions targeted at household air pollution are needed to reduce the burden of lung cancer.