Mortality effects assessment of ambient PM2.5 pollution in the 74 leading cities of China

Background: Ambient fine particulate matter (PM2.5) pollution is currently a most severe and worrisome environmental problem in China. However, current knowledge of the health effects of this pollution is insufficient. Objectives: This study aims to provide an overall understanding regarding the long-term mortality effects of current PM2.5 pollution in China and the potential health benefits of realizing the goals stipulated in the ongoing action plan of Air Pollution Prevention and Control (APPC) and the targets suggested by the WHO. Methods: Three typical causes and all-cause of PM2.5-related mortality were considered. The log-linear exposure-response function was adopted, and a meta-analysis was used to determine the exposure-response coefficients, based on newly available data in China and abroad. Results: In the 74 leading cities of China, approximately 32% of the reported deaths, with a mortality rate of 1.9%, were associated with PM2.5 in 2013, in which deaths from cardiovascular, respiratory and lung-cancer causes accounted for 20% of the reported deaths, with a mortality rate of 1.2%. The regional difference is remarkable for the mortalities and proportions of the different causes. If the PM2.5 concentration goals of the APPC plan, the first interim and the guideline targets of the WHO could be achieved, the PM2.5-related all-cause mortality would be reduced by 25%, 64% and 95%, respectively, compared with that of 2013. Conclusions: PM2.5 pollution in China has incurred great health risks that are even worse than those of tobacco smoking. The health benefits of the APPC plan could be outstanding, although there is still great potential to improve future air quality. (C) 2016 Elsevier B.V. All rights reserved.