Spatiotemporal patterns of particulate matter (PM) and associations between PM and mortality in Shenzhen, China

Adverse short-term effects of ozone on cardiovascular mortalities modified by season and temperature: a time-series study

Introduction

Ambient ozone pollution becomes critical in China. Conclusions on the short-term effects of ozone on cardiovascular mortality have been controversial and limited on cause-specific cardiovascular mortalities and their interactions with season and temperature. This research aimed to investigate the short-term effects of ozone and the modifications of season and temperature on cardiovascular mortality.

Methods

Cardiovascular death records, air pollutants, and meteorological factors in Shenzhen from 2013 to 2019 were analyzed. Daily 1-h maximum of ozone and daily maximum 8-h moving average of ozone were studied. Generalized additive models (GAMs) were applied to evaluate their associations with cardiovascular mortalities in sex and age groups. Effect modifications were assessed by stratifying season and temperature.

Results

Distributed lag impacts of ozone on total cardiovascular deaths and cumulative effects on mortality due to ischemic heart disease (IHD) were most significant. Population under 65 years old was most susceptible. Majority of significant effects were found in warm season, at high temperature, and at extreme heat. Ozone-associated risks in total deaths caused by hypertensive diseases reduced in warm season, while risks in IHD in males increased at high temperature. Extreme heat enhanced ozone effects on deaths caused by CVDs and IHD in the population under 65 years old.

Discussion

The revealed cardiovascular impacts of ozone below current national standard of air quality suggested improved standards and interventions in China. Higher temperature, particularly extreme heat, rather than warm season, could significantly enhance the adverse effects of ozone on cardiovascular mortality in population under 65 years old.

Health Impact Assessment of Short-Term Exposure to Particulate Matter (PM10) in Northern Thailand

In northern Thailand, in recent decades, particulate pollution from the burning of biomass has become a serious issue with toxicological implications for human health, especially during the winter months of January to April. The purpose of this study was to explore short-term exposure to particulate matter (PM₁₀) in northern Thailand. The high PM₁₀ concentration in 2012 was used as a case study. We used the EPA's Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) for the health impact assessment, along with ground-based measurement data. The annual average observed PM₁₀ concentration was in the range of 43-61 μg/m³, with a maximum observed PM₁₀ concentration of 300 μg/m³ in March. We then assessed the impacts of PM₁₀ exposure in northern Thailand. When the PM₁₀ concentration was reduced to 120 μg/m³, the undesirable effects on respiratory mortality decreased by 5%-11%. When the concentration of PM₁₀ was reduced to 45 μg/m³, the deleterious effects on respiratory mortality decreased by 11-30%. In conclusion, adherence to the WHO-AQG, particularly for PM₁₀ (45 μg/m³), tends to result in considerable reductions in respiratory disease mortality in northern Thailand.

Short-term exposure to ambient particulate matter and mortality among HIV/AIDS patients: Case-crossover evidence from all counties of Hubei province, China

BACKGROUND

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been a worrisome public health problem in the world. However, evidence for associations between short-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients is scarce.

METHODS

We collected daily death records in people with HIV/AIDS from all counties (N = 103) of Hubei province, China from 2018 to 2019. The county-level daily concentrations of PM₁, PM_2.5 and PM₁₀ in the same period were extracted from ChinaHighAirPollutants dataset. A time-stratified case-crossover design with conditional logistic regression analysis was performed to assess the associations between PM and mortality.

RESULTS

Each 1 μg/m³ increased in PM₁ corresponded with 0.89 % elevated in all-cause deaths (ACD) at lag 0-4 days. The largest effects of PM₁, PM_2.5 and PM₁₀ on AIDS-related deaths (ARD) were detected at lag 0-4 days, and PM₁ [percent changes in odds ratio: 2.51 % (95 % CIs: 0.82, 4.22)] appeared greater health hazards than PM_2.5 [1.24 % (95 % CIs: 0.33, 2.15)] as well as PM₁₀ [0.65 % (95 % CIs: 0.01, 1.30)]. In subgroup analyses, the significant associations of PM₁/PM_2.5 and ACD were only found in male and the cold season. We also observed the effects of PM₁ and PM₁₀ on ARD were significantly stronger (P for interaction <0.05) in males than females. In addition, we caught sight of HIV/AIDS patients aged over 60 years old were more susceptible to ARD caused by PM than younger population.

CONCLUSIONS

Our study suggested PM₁ was positively linked with the risk of ACD and ARD. Male patients with HIV/AIDS were more significantly susceptible to PM₁, PM_2.5 and PM₁₀. PM₁/PM_2.5 appeared stronger associations with ARD in HIV/AIDS patients aged over 60 years old and in the cold season.

Impact of Heavy PM2.5 Pollution Events on Mortality in 250 Chinese Counties

We explored the impact of heavy PM_2.5 pollution events on the health of residents in 250 counties in China. A time-series approach involving a two-stage analysis was applied to estimate the association between heavy PM_2.5 pollution events and mortality from 2013 to 2018. The associations between heavy (PM_2.5 ≥75 μg/m³ and <150 μg/m³) and extremely heavy (PM_2.5 ≥150 μg/m³) PM_2.5 pollution days with mortality were explored. The added effects of the heavy PM_2.5 pollution events were evaluated by controlling PM_2.5 concentration in the model. From 2013 to 2018, there were 57,279 county days of heavy PM_2.5 pollution and 21,248 county days of extremely heavy PM_2.5 pollution. The risks of mortality during this period of heavy PM_2.5 pollution events increased by 1.22% (95% CI: 0.82-1.63%), 1.14% (95% CI: 0.74-1.53%), 1.09% (95% CI: 0.58-1.60%), and 1.30% (95% CI: 0.40-2.20%), for all-cause, nonaccidental, circulatory, and respiratory mortality, respectively. We also observed that heavy PM_2.5 pollution events had an added effect on mortality risk associated with all-cause, nonaccidental, circulatory, and respiratory mortality, evident from an observed increase by 0.77% (95% CI: 0.29-1.24%), 0.73% (95% CI: 0.27-1.19%), 0.96% (95% CI: 0.37-1.55%), and 0.55% (95% CI: -0.52-1.63%), respectively. Heavy PM_2.5 pollution events increased mortality risks and caused an independent added effect. The findings serve as a foundation for policymakers in developing early warning systems and policy interventions.

Three exposure metrics of size-specific particulate matter associated with acute lower respiratory infection hospitalization in children: A multi-city time-series analysis in China

BACKGROUND

The global burden of acute lower respiratory infection (ALRI) attributable to air pollution has increased in recent years, but the association between ALRI and exposure to size-specific particulate matter has not been investigated using different exposure metrics.

METHODS

We obtained ALRI admission from seven cities from 2014 to 2016 in China. Different sized particles were measured using three metrics (a) daily mean, (b) hourly peak, and (c) daily excessive concentration hours (DECH). Generalized additive models were fitted for each of the seven cities, and the city-specific estimates were then pooled using random-effects meta-analysis models. Stratified analyses were conducted to examine the effect modifications of gender, age, and season. We also estimated the disease burden due to particulate matter exposures.

RESULTS

There were 111,426 ALRI (79,803 pneumonia and 31,622 bronchiolitis) hospital admissions under the age of 15 between 2014 and 2016 in our study. Daily means were associated with the largest ALRI estimates (95% confidence interval [CI]): 2.43% (0.79%, 4.11%) for PM_2.5, 2.25% (0.11%, 4.44%) for PM_c, and 2.64% (0.73%, 4.58%) for PM₁₀. The magnitude of effect sizes were followed by DECH: 1.94% (0.51%, 3.39%) for PM_2.5, 0.88% (-0.14%, 1.92%) for PM_c, 1.86% (0.50%, 2.01%) for PM₁₀; and hourly peak: 0.70% (-0.60%, 2.01%) for PM_2.5, 1.05% (-0.13%, 2.66%) for PM_c, and 1.20% (-0.20%, 2.62%) for PM₁₀ at lag03. We found significantly higher effects in cold seasons than that in warm seasons, while we did not find a significant different between gender and age groups.

CONCLUSIONS

The adverse effects of exposure to particulate matter on ALRI hospitalizations are reconfirmed. DECH was a possible alternative exposure indicator for PM_2.5 assessment, which may affect air quality standards in the future.

Acute effects of ambient nitrogen oxides and interactions with temperature on cardiovascular mortality in Shenzhen, China

BACKGROUND

Though inconsistent, acute effects of ambient nitrogen oxides on cardiovascular mortality have been reported. Whereas, interactive roles of temperature on their relationships and joint effects of different indicators of nitrogen oxides were less studied. This study aimed to extrapolate the independent roles of ambient nitrogen oxides and temperature interactions on cardiovascular mortality.

METHODS

Data on mortality, air pollutants, and meteorological factors in Shenzhen from 2013 to 2019 were collected. Three indicators including nitric oxide (NO), nitrogen dioxide (NO₂), and nitrogen oxides (NO_X) were studied. Adjusted generalized additive models (GAMs) were applied to analyse their associations with cardiovascular mortality in different groups.

RESULTS

The average daily concentrations of NO, NO₂, and NO_X were 11.7 μg/m³, 30.7 μg/m³, and 53.2 μg/m³, respectively. Significant associations were shown with each indicator. Cumulative effects of nitrogen oxides were more obvious than distributed lag effects. Males, population under 65 years old, and population with stroke-related condition were more susceptible to nitrogen oxides. Adverse effects of nitrogen oxides were more significant at low temperature. Impacts of NO₂ on cardiovascular mortality, and NO on stroke mortality were the most robust in the multi-pollutant models, whereas variations were shown in the other relationships.

CONCLUSIONS

Low levels of nitrogen oxides showed acute and adverse impacts and the interactive roles of temperature on cardiovascular mortality. Cumulative effects were most significant and joint effects of nitrogen oxides required more attention. Population under 65 years old and population with stroke-related health condition were susceptible, especially days at lower temperature.

An Integration Method for Regional PM2.5 Pollution Control Optimization Based on Meta-Analysis and Systematic Review

PM_2.5 pollution in China is becoming increasingly severe, threatening public health. The major goal of this study is to evaluate the mortality rate attributed to PM_2.5 pollution and design pollution mitigation schemes in a southern district of China through a two-objective optimization model. The mortality rate is estimated by health effect evaluation model. Subjected to limited data information, it is assumed that the meta-analysis method, through summarizing and combining the research results on the same subject, was suitable to estimate the percentage of deaths caused by PM_2.5 pollution. The critical parameters, such as the total number of deaths and the background concentration of PM_2.5, were obtained through on-site survey, data collection, literature search, policy analysis, and expert consultation. The equations for estimating the number of deaths caused by PM_2.5 pollution were established by incorporating the relationship coefficient of exposure to reaction, calculated residual PM_2.5 concentration of affected region, and statistical total base number of deaths into a general framework. To balance the cost from air quality improvement and human health risks, a two-objective optimization model was developed. The first objective is to minimize the mortality rate attributable to PM_2.5 pollution, and the second objective is to minimize the total system cost over three periods. The optimization results demonstrated that the combination of weights assigned to the two objectives significantly influenced the model output. For example, a high weight value assigned to minimizing the number of deaths results in the increased use of treatment techniques with higher efficiencies and a dramatic decrease in pollutant concentrations. In contrast, a model weighted more toward minimizing economic loss may lead to an increase in the death toll due to exposure to higher air pollution levels. The effective application of this model in the Nanshan District of Shenzhen City, China, is expected to serve as a basis for similar work in other parts of the world in the future.

Short-term effect of fine particulate matter and ozone on non-accidental mortality and respiratory mortality in Lishui district, China

Background

In recent years, air pollution has become an imminent problem in China. Few studies have investigated the impact of air pollution on the mortality of the middle-aged and elderly people. Therefore, this study aims to evaluate the impact of PM_2.5 (fine particulate matter) and O₃ (ozone) on non-accidental mortality and respiratory mortality of the middle-aged and elderly people in Lishui District of Nanjing and provide the evidence for potential prevention and control measures of air pollution.

Method

Using daily mortality and atmospheric monitoring data from 2015 to 2019, we applied a generalized additive model with time-series analysis to evaluate the association of PM_2.5 and O₃ exposure with daily non-accidental mortality and respiratory mortality in Lishui District. Using the population attributable fractions to estimate the death burden caused by short-term exposure to O₃ and PM_2.5。.

Result

For every 10 μg/m³ increase in PM_2.5, non-accidental mortality increased 0.94% with 95% confidence interval (CI) between 0.05 and 1.83%, and PM_2.5 had a more profound impact on females than males. For every 10 μg/m³ increase in O₃, respiratory mortality increased 1.35% (95% CI: 0.05, 2.66%) and O₃ had a more profound impact on males than females. Compared with the single pollutant model, impact of the two-pollutant model on non-accidental mortality and respiratory mortality slightly decreased. In summer and winter as opposed to the other seasons, O₃ had a more obvious impact on non-accidental mortality. The population attributable fractions of non-accidental mortality were 0.84% (95% CI:0.00, 1.63%) for PM_2.5 and respiratory mortality were 0.14% (95% CI:0.01, 0.26%) for O₃. For every 10 μg/m³ decrease in PM_2.5, 122 (95% CI: 6, 237) non-accidental deaths could be avoided. For every 10 μg/m³ decrease in O₃, 10 (95% CI: 1, 38) respiratory deaths could be avoided.

Conclusion

PM_2.5 and O₃ could significantly increase the risk of non-accidental and respiratory mortality in the middle-aged and elderly people in Lishui District of Nanjing. Exposed to air pollutants, men were more susceptible to O₃ damage, and women were more susceptible to PM_2.5 damage. Reduction of PM_2.5 and O₃ concentration in the air may have the potential to avoid considerable loss of lives.

Assessing PM2.5-associated risk of hospitalization for COPD: an application of daily excessive concentration hours

Existing PM2.5-morbidity studies using daily mean concentration as exposure metric may fail to capture intra-day variations of PM2.5 concentrations, resulting in underestimated health impacts to some extent. This study introduced a novel indicator, daily excessive concentration hours (DECH), defined as sums of per-hourly excessive concentrations of PM2.5 against a specific threshold within a day. PM2.5 DECHs were separately calculated as daily concentration-hours >8, 10, 15, 20, and 25 μg/m3 (abbreviations: DECH-8, DECH-10, DECH-15, DECH-20, and DECH-25). We adopted a time-stratified case-crossover design with conditional logistic regression models to compare risks of hospitalizations for chronic obstructive pulmonary disease (COPD) associated with PM2.5 mean and DECHs in Shenzhen, China. We observed highly comparable PM2.5-COPD associations using exposure metrics of daily mean and DECHs with above-defined thresholds. For instance, PM2.5 mean and DECHs showed similar increases in risks of COPD hospitalization for an interquartile range rise in exposure, with odds ratio estimates of 1.26 (95% confidence interval: 1.06-1.50) for PM2.5 mean, 1.24 (1.05-1.46) for DECH-10 and 1.21 (1.06-1.39) for DECH-25, respectively. Findings remained robust after further adjusting for gaseous pollutants (e.g., SO2, NO2, CO, and O3) and meteorologic factors (e.g., wind speed and air pressure). Our study strengthened the evidence that DECHs could come be as a novel exposure metric in health risk assessments associated with short-term exposure to ambient PM2.5.

Air Quality and Key Variables in High-Density Housing

The high-rise and high-density housing development in nearby industry relocations is a general urban sprawl phenomenon in fast-growing cities in Southern China. Aside from the low price, the improved air quality in the suburban area is always a reason for home buyers, but the consistent monitoring of air quality and knowledge about how to plan housing estates are lacking. This paper investigates the relationship between the housing morphology and the air quality in three housing estates in Shenzhen. This research utilizes on-site monitoring equipment to examine negative air ions (NAIs) and fine particulate matter (PM2.5) and the Computational Fluid Dynamics (CFD) simulation to examine the air flow. This study reveals the effect of the urban form on the concentration of NAIs and PM2.5 in spatial variation. A correlation study between the configuration variables of the urban form and the CFD air flow pattern helps to identify the key variables influencing the air quality. This study concludes that in housing estates with good air quality of surroundings, the building density has no remarkable effect. However, the footprint of buildings, the layout of podiums, the roughness length of the building, the distance between buildings, the open space aspect ratio and the mean building height may have a remarkable impact on the air flow and quality. These findings may encourage high-density housing development and provide planning guidance for the configuration of housing forms in Southern China and subtropical climate regions around the world.

The short-term harvesting effects of ambient particulate matter on mortality in Taiyuan elderly residents: A time-series analysis with a generalized additive distributed lag model

The evaluation on mortality displacement and distributed lag effects of airborne particulate matter (PM) on death risks is important to understand the positive association of short-term pollution from both ambient PM₁₀ and PM_2.5 with daily mortality. Herein, short-term influences of urban PM₁₀ and PM_2.5 exposure on the mortality of respiratory diseases (RD) and cardiovascular diseases (CVD) were studied at Taiyuan, China, a typical inland city suffering from heavy ambient PM loading and having high morbidity of RD and CVD. Using a time-series analysis with generalized additive distributed lag model (DLM), the potential mortality displacement was determined and the single-day and cumulative lag-day effects of PM on mortality were estimated after the daily mass concentrations of urban PM_2.5 and PM₁₀ from January 2013 to October 2015 and the daily number of non-accidental death (NAD) and cause-specific mortality in the residents aged more than 65 years old were obtained. Results showed there were significant associations of PM_2.5 and PM₁₀ with daily mortality on the current day and within one week. And a statistically significant increase (P < 0.05) in the cumulative effect estimates of PM_2.5 and PM₁₀ on CVD, ischemic heart disease (IHD), and myocardial infarction (MI) mortality (as well as PM_2.5 on NAD) was observed, while the associations of PM_2.5 with RD and pneumonia mortality, PM₁₀ with NAD and RD mortality were not statistically significant, when the exposure window was extended to lag 0-30 days. It was concluded that there were harvesting effects and cumulative effects of ambient PM_2.5 and PM₁₀ on the elderly residents' mortality due to RD and CVD at Taiyuan and they could be estimated quantitatively when the broader time window was used, suggesting that the underestimation on the association of ambient PM with non-accidental death can be avoided using the present method in our study.

Monitoring history and change trends of ambient air quality in China during the past four decades

This study summarized the history of ambient air quality monitoring and air pollution prevention and control, and it analyzed the spatiotemporal patterns of ambient air pollutants during 1981-2017 in China. The results showed that monitoring of ambient air quality has changed dramatically in terms of determinants, sampling methods, monitoring extent, and evaluation basis during the previous four decades. Annual average concentrations of total suspended particulates, PM₁₀ and SO₂ have shown obvious decreasing trends during the studied period. These improvements have been closely related to the considerable efforts and various approaches undertaken to prevent and control air pollution. However, although policy implementation has been decisive and, at least in part, it has been enforced effectively, significant challenges remain. Air pollution control cannot be accomplished without a long-term strategy designed to achieve clean air in all parts of China.

The economic benefits of fulfilling the World Health Organization's limits for particulates: A case study in Algeciras Bay (Spain)

Algeciras Bay is an important industrial and port zone in the south of Spain whose pollution by particulate matter surpasses the threshold levels recommended by the World Health Organization (WHO) in its 2005 Guide on Air Quality. This study analyses the mortality avoided and the economic benefit which would be derived from a reduction of the pollution of PM2.5 and PM10 to the levels recommended by the WHO in Algeciras Bay in the period 2005-2015. The analysis carried out shows that the industrial zones, such as Los Barrios and San Roque, are those which have greater levels of pollution and in which the relative risk is greater. The calculations for Algeciras Bay between 2000 and 2015 show 182 deaths which would be avoided if the particulate matter pollution were reduced to the levels recommended by the WHO. Likewise, the economic valuation which this impact has on health is carried out through two concepts: the cost of illness and the Value of Statistical Life (VSL). The result shows that the economic benefit that would come out with the cost of illness valuation is 5,329,110€ and from the VSL is 414,787,113€. Implications: PM_2.5 has a greater concentration in industrial localities and is linked to the industrial activity. When the particulate matter pollution is reduced to the levels recommended by the WHO in an industrialised area such as Algeciras (Spain), 182 deaths which would be avoided. The result shows that the economic benefit that would come out with the cost of illness valuation is 5,329,110€ and from the value of statistical life is 414,787,113€.

Estimating short-term mortality and economic benefit attributable to PM10 exposure in China based on BenMAP

With the rapidly booming economy, China has been suffering from serious particulate matter (PM) pollution in recent years. In order to improve the air quality, Chinese government issued a new China National Ambient Air Quality Standard (No. GB3095-2012) in 2012. In this study, PM₁₀ exposure level was simulated based on the data of 912 newly constructed monitoring sites and Voronoi Neighborhood Averaging (VNA) interpolation method. It is widely accepted that PM₁₀ can cause short-term health effects. We calculated the short-term health benefit due to decreasing PM₁₀ concentration to the levels of China National Ambient Air Quality Standard based on Environmental Benefits Mapping and Analysis Program (BenMAP). Our results indicated that if the daily average concentration of PM₁₀ reduced to the daily Grade II standard (150 μg/m³), the avoided deaths for all cause, cardiovascular disease, and respiratory disease would be 82,000 (95%CI: 49,000-120,000), 56,000 (95%CI: 34,000-78,000), and 16,000 (95%CI: 10,000-22,000) in 2014, respectively. The economic benefits of avoiding deaths due to all cause for rolling back the concentration of PM₁₀ to the level of 50 μg/m³ were estimated to be 240 billion CNY and 16 billion CNY using willingness to pay (WTP) and human capital (HC) methods, respectively, which accounted for 0.38% (95%CI: 0.11-0.64%) and 0.03% (95%CI: 0.02-0.03%) of the total annual gross domestic product (GDP) of China in 2014.

Fine particulate matter (PM2.5): The culprit for chronic lung diseases in China

Air pollution is a world public health problem. Particulate matter (PM), a mix of solid and liquid particles in the air, becomes an increasing concern in the social and economic development of China. For decades, epidemiological studies have confirmed the association between fine particle pollutants and respiratory diseases. It has been reported in different populations that increased Fine particulate matter (PM_2.5) concentrations cause elevated susceptibility to respiratory diseases, including acute respiratory distress, asthma, chronic obstructive pulmonary disease, and lung cancer. This review will discuss the pathophysiology of PM_2.5 in respiratory diseases, which are helpful for the prevention of air pollution and treatment of respiratory tract inflammatory diseases.

Neglected environmental health impacts of China's supply-side structural reform

"Supply-side structural reform" (SSSR) has been the most important ongoing economic reform in China since 2015, but its important environmental health effects have not been properly assessed. The present study addresses that gap by focusing on reduction of overcapacity in the coal, steel, and iron sectors, combined with reduction of emissions of sulfur dioxide (SO₂), nitrogen oxide (NO_x), and fine particulate matter (PM_2.5), and projecting resultant effects on air quality and public health across cities and regions in China. Modeling results indicate that effects on air quality and public health are visible and distributed unevenly across the country. This assessment provides quantitative evidence supporting projections of the transregional distribution of such effects. Such uneven transregional distribution complicates management of air quality and health risks in China. The results challenge approaches that rely solely on cities to improve air quality. The article concludes with suggestions on how to integrate SSSR measures with cities' air quality improvement attainment planning and management performance evaluation.

Spatiotemporal characteristics of PM2.5 and PM10 at urban and corresponding background sites in 23 cities in China

Air pollution episodes in China are frequent and a more comprehensive understanding of pollution sources and impacts is needed to design appropriate strategies and set emission reduction targets. This study analyzes PM2.5 and PM10 concentrations measured in 23 cities at 178 urban sites and at 23 corresponding "urban contrast" sites in China with the goals of understanding spatial and temporal trends and quantifying the regional component of PM pollution. The contrast sites, located an average of 29km from cities in the upwind direction, are intended to represent "background" levels. Using daily measurements from April 2013 to March 2014, we assess compliance with air quality standards, PM2.5/PM10 ratios and urban "increments," defined as the increase in PM levels in the city compared to the contrast site. Spatial and temporal patterns at daily, monthly and annual levels are shown using distributions, correlations, spatial autocorrelation, and factor analyses. At the contrast sites, PM2.5 and PM10 concentrations averaged 56±26 and 91±44μgm-3, respectively, and China's daily and annual average air quality standards were frequently exceeded. PM2.5 and PM10 concentrations in most cities exceeded levels at the corresponding contrast sites, but by an average of only 14±14 and 26±27μgm-3, respectively. Seasonal changes in PM2.5 and PM10 concentrations and urban increments were striking, e.g., levels increased 2 to 3-fold in winter at several sites. The significance of exurban and regional sources of PM2.5 is demonstrated by the small urban increments, the strong correlations across broad regions, and the correlation between daily levels at city and contrast sites. These sources will require control to achieve air quality goals, in particular, the PM10 and PM2.5 targets announced by the Chinese government in 2013.

The Association between Air Pollution and Population Health Risk for Respiratory Infection: A Case Study of Shenzhen, China

Nowadays, most of the research on air pollution and its adverse effects on public health in China has focused on megacities and heavily-polluted regions. Fewer studies have focused on cities that are slightly polluted. Shenzhen used to have a favorable air environment, but its air quality has deteriorated gradually as a result of development in recent years. So far, no systematic investigations have been conducted on the adverse effects of air pollution on public health in Shenzhen. This research has applied a time series analysis model to study the possible association between different types of air pollution and respiratory hospital admission in Shenzhen in 2013. Respiratory hospital admission was divided into two categories for comparison analysis among various population groups: acute upper respiratory infection and acute lower respiratory infection. The results showed that short-term exposure to ambient air pollution was significantly associated with acute respiratory infection hospital admission in Shenzhen in 2013. Children under 14 years old were the main susceptible population of acute respiratory infection due to air pollution. PM₁₀, PM_2.5 and NO₂ were the primary air pollutants threatening respiratory health in Shenzhen. Though air pollution level is generally relatively low in Shenzhen, it will benefit public health to control the pollution of particulate matter as well as other gaseous pollutants.

External costs of PM2.5 pollution in Beijing, China: Uncertainty analysis of multiple health impacts and costs

Some cities in China are facing serious air pollution problems including high concentrations of particles, SO₂ and NO_x. Exposure to PM2.5, one of the primary air pollutants in many cities in China, is highly correlated with various adverse health impacts and ultimately represents a cost for society. The aim of this study is to assess health impacts and external costs related to PM2.5 pollution in Beijing, China with different baseline concentrations and valuation methods. The idea is to provide a reasonable estimate of the total health impacts and external cost due to PM2.5 pollution, as well as a quantification of the relevant uncertainty. PM2.5 concentrations were retrieved for the entire 2012 period in 16 districts of Beijing. The various PM2.5 related health impacts were identified and classified to avoid double counting. Exposure-response coefficients were then obtained from literature. Both the value of statistical life (VSL) and the amended human capital (AHC) approach were applied for external costs estimation, which could provide the upper and lower bound of the external costs due to PM2.5. To fully understand the uncertainty levels, the external cost distribution was determined via Monte Carlo simulation based on the uncertainty of the parameters such as PM2.5 concentration, exposure-response coefficients, and economic cost per case. The results showed that the external costs were equivalent to around 0.3% (AHC, China's guideline: C₀ = 35 μg/m³) to 0.9% (VSL, WHO guideline: C₀ = 10 μg/m³) of regional GDP depending on the valuation method and on the assumed baseline PM2.5 concentration (C₀). Among all the health impacts, the economic loss due to premature deaths accounted for more than 80% of the overall external costs. The results of this study could help policymakers prioritizing the PM2.5 pollution control interventions and internalize the external costs through the application of economic policy instruments.

Health risk assessment of China's main air pollutants

Background

With the rapid development of China’s economy, air pollution has attracted public concern because of its harmful effects on health.

Methods

The source apportioning of air pollution, the spatial distribution characteristics, and the relationship between atmospheric contamination, and the risk of exposure were explored. The in situ daily concentrations of the principal air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO and O₃) were obtained from 188 main cities with many continuous air-monitoring stations across China (2014 and 2015).

Results

The results indicate positive correlations between PM_2.5 and SO₂ (R² = 0.395/0.404, P < 0.0001), CO (R² = 0.187/0.365, P < 0.0001), and NO₂ (R² = 0.447/0.533, P < 0.0001), but weak correlations with O₃ (P > 0.05) for both 2014 and 2015. Additionally, a significant relationship between SO₂, NO_2, and CO was discovered using regression analysis (P < 0.0001), indicating that the origin of air pollutants is likely to be vehicle exhaust, coal consumption, and biomass open-burning. For the spatial pattern of air pollutants, we found that the highest concentration of SO₂, NO_2, and CO were mainly distributed in north China (Beijing-Tianjin-Hebei regions), Shandong, Shanxi and Henan provinces, part of Xinjiang and central Inner Mongolia (2014 and 2015).

Conclusions

The highest concentration and risk of PM_2.5 was observed in the Beijing–Tianjin–Hebei economic belts, and Shandong, Henan, Shanxi, Hubei and Anhui provinces. Nevertheless, the highest concentration of O₃ was irregularly distributed in most areas of China. A high-risk distribution of PM₁₀, SO₂ and NO₂ was also observed in these regions, with the high risk of PM₁₀ and NO₂ observed in the Hebei and Shandong province, and high-risk of PM₁₀ in Urumchi. The high-risk of NO₂ distributed in Beijing-Yangtze River Delta region-Pearl River Delta region-central. Although atmospheric contamination slightly improved in 2015 compared to 2014, humanity faces the challenge of reducing the environmental and public health effects of air pollution by altering the present mode of growth to achieve sustainable social and economic development.

Tackling air pollution and extreme climate changes in China: Implementing the Paris climate change agreement

China still depends on coal for more than 60% of its power despite big investments in the process of shifting to nuclear, solar and wind power renewable energy resources alignment with Paris climate change agreement (Paris CCA). Chinese government through the Communist Party Central Committee (CPCC) ascribes great importance and commitment to Paris CCA legacy and history landmark implementation at all levels. As the world's biggest carbon dioxide emitter, China has embarked on "SMART" pollution and climate changes programs and measures to reduce coal-fired power plants to less than 50% in the next five years include: new China model of energy policies commitment on CO2 and greenhouse gas emissions reductions to less than 20% non-fossil energy use by 2030 without undermining their economic growth, newly introduced electric vehicles transportation benefits, interactive and sustained air quality index (AQI) monitoring systems, decreasing reliance on fossil fuel economic activities, revision of energy price reforms and renewable energy to less energy efficient technologies development. Furthermore, ongoing CPCC improved environmental initiatives, implemented strict regulations and penalties on local companies and firms' pollution production management, massive infrastructures such as highways to reduce CO2 expansion of seven regional emissions trading markets and programs for CO2 emissions and other pollutants are being documented. Maximizing on the centralized nature of the China's government, implemented Chinese pollution, climate changes mitigation and adaptation initiatives, "SMART" strategies and credible measures are promising. A good and practical example is the interactive and dynamic website and database covering 367 Chinese cities and providing real time information on environmental and pollution emissions AQI. Also, water quality index (WQI), radiation and nuclear safety monitoring and management systems over time and space. These are ongoing Chinese valuable and exemplary leadership in Paris CCA implementation to the global community. Especially to pragmatic and responsible efforts to support pollution and climate changes capacity development, technology transfer and empowerment in emissions surveillance and monitoring systems and "SMART" integrated climate changes mitigation packages in global Sustainable Development Goals (SDGs) context, citizenry health and wellbeing.