Accountability analysis of health benefits related to National Action Plan on Air Pollution Prevention and Control in China

Tiantian Li; Chen Chen; Mengxue Zhang; Liang Zhao; Yuanyuan Liu; Yafei Guo; Qing Wang; Hang Du; Qingyang Xiao; Yang Liu; Mike Z He; Patrick L Kinney; Aaron J Cohen; Shilu Tong; Xiaoming Shi

doi:10.1093/pnasnexus/pgae142

Accountability analysis of health benefits related to National Action Plan on Air Pollution Prevention and Control in China

PNAS Nexus. 2024 Apr 30;3(4):pgae142. doi: 10.1093/pnasnexus/pgae142. eCollection 2024 Apr.

Authors

Tiantian Li^{1

2

3}, Chen Chen^{1

2}, Mengxue Zhang^{1

2

3}, Liang Zhao¹, Yuanyuan Liu^{1

2}, Yafei Guo^{1

2}, Qing Wang^{1

2}, Hang Du^{1

2}, Qingyang Xiao⁴, Yang Liu⁵, Mike Z He⁶, Patrick L Kinney⁷, Aaron J Cohen⁸, Shilu Tong^{1

9}, Xiaoming Shi^{1

2

3}

Affiliations

¹ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan South, Chaoyang District, Beijing 100021, China.
² National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan South, Chaoyang District, Beijing 100021, China.
³ School of Public Health, Nanjing Medical University, No.101 Longmian Avenue, Jiangning District, Nanjing 211166, China.
⁴ State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Haidian District, Tsinghua University, Beijing 100084, China.
⁵ Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
⁶ Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA.
⁷ Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA.
⁸ Health Effects Institute, 75 Federal Street, Boston, MA 02110, USA.
⁹ School of Public Health and Social Work, Queensland University of Technology, 2 George Street, Brisbane, QLD 4001, Australia.

Abstract

China is one of the largest producers and consumers of coal in the world. The National Action Plan on Air Pollution Prevention and Control in China (2013-2017) particularly aimed to reduce emissions from coal combustion. Here, we show whether the acute health effects of PM_2.5 changed from 2013 to 2018 and factors that might account for any observed changes in the Beijing-Tianjin-Hebei (BTH) and the surrounding areas where there were major reductions in PM_2.5 concentrations. We used a two-stage analysis strategy, with a quasi-Poisson regression model and a random effects meta-analysis, to assess the effects of PM_2.5 on mortality in the 47 counties of BTH. We found that the mean daily PM_2.5 levels and the SO₄^2- component ratio dramatically decreased in the study period, which was likely related to the control of coal emissions. Subsequently, the acute effects of PM_2.5 were significantly decreased for total and circulatory mortality. A 10 μg/m³ increase in PM_2.5 concentrations was associated with a 0.16% (95% CI: 0.08, 0.24%) and 0.02% (95% CI: -0.09, 0.13%) increase in mortality from 2013 to 2015 and from 2016 to 2018, respectively. The changes in air pollution sources or PM_2.5 components appeared to have played a core role in reducing the health effects. The air pollution control measures implemented recently targeting coal emissions taken in China may have resulted in significant health benefits.

Keywords: PM2.5 and components; acute effect; clean air actions; mortality; temporal variation.