The spatio-temporal trends of the PM2.5-related premature death across China: a county level modeling study

Abstract:

Ambient fine particulate matter (PM2.5) is a global concern and China’s PM2.5 pollution has attracted global attention. Many studies estimated the premature death related to PM2.5 in China but few focus on the long-term historic PM2.5-related disease burden, mainly due to the lack of PM2.5 exposure data. This study aims to estimate the PM2.5-related premature deaths from 2005 to 2017 across China and determine its spatial disparities and change trends.

On the basis of PM2.5 concentration from our spatial modeling integrated with multi-source data, and the Global Exposure Mortality Model (GEMM) to estimate the relative risk, we calculated the number of PM2.5-related premature death from ischemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD), lung cancer, lower respiratory infections (LRIs), and non-communicable diseases and LRIs (NCD+LRI) of each county in China from 2005 to 2017 and draw maps to find the spatial disparities of PM2.5-related premature death across China.

There is a general declining trend of PM2.5-related premature deaths from NCD+LRI in China, especially after the year of 2013, mainly due to the improvement of air quality. The annual numbers of PM2.5-related premature deaths from NCD+LRI were around 1.6 million, which is higher than the Global Burden of Disease Study 2017 (GBD 2017) and our previous estimates from IER model.

The spatial patterns of PM2.5-related premature deaths did not change much from 2005 to 2017. Regions with dense population and higher PM2.5 concentration, such as the Huai River Basin and Sichuan Province, have high level of PM2.5-related death. The Northwestern China have lower burden from PM2.5-related death. The vast majority of the counties show a significant reduction of PM2.5 concentration and related death. There is a more obvious reduction of PM2.5-related death in the south part of China, and the Northeastern. There are obvious variations of the spatial patterns of PM2.5 related death among the five endpoints.

China still has a high level of mortality burden from PM2.5, although in recent years both the PM2.5 concentration and the related disease burden are declining. There are great spatial disparities on the mortality burden from PM2.5, indicating the need of efficient spatial planning on economic development and air pollution control.