| Ambient air pollution is a major environmental health problem in China. Coal combustion type air pollution is the major type of air pollution. However, in some large cities of China, air pollution has gradually changed from the conventional coal combustion type to the mixed coal combustion/motor vehicle emission type. Unoptimized energy structure and energy waste are among the major causes of severe air pollution. Epidemiologic studies have confirmed the association between ambient air pollution and increased mortality and morbidity both in China and worldwide. Under such circumstance, a comprehensive assessment of energy policies, ambient air pollution and its health impact is of great significance to the future development of China's cities. Using the health-based risk assessment and health economics approach, this project aimed for an estimation of health impact due to air pollution currently and in the future under various energy scenarios in Shanghai. The results could be applied to priority setting in energy and environmental policies, air pollution intervention and improvement measures, and health-based cost-benefit analysis. Health-based risk assessment framework, including hazard identification, exposure assessment, dose-response assessment and risk characterization, combined with the unit increase in mortality or morbidity per unit increase of air pollutants level, was introduced into the estimation of health impact due to ambient air pollution. The recommended approach could be applied to the health impact estimation of ambient air pollution in other cities in China. The MARKAL (MARKet ALlocation) optimisation model was employed for estimation of pollutant emissions under various energy scenarios in Shanghai. One type of quick air quality model - the transfer-matrix was developed to link emission scenarios of MARKAL model and air pollutant concentrations. Population exposure level to ambient PM10 currently and in the future was presented in the Shanghai Geographical Information System (GIS). It was found that population-weighted PM10 level in 2000 was 100.9μg/m3 for Shanghai residents, and the implementation of various energy policies could significantly ameliorate the population exposure level to PM10 in Shanghai. The dose-response assessment included a time-series study of air pollution and daily mortality in Shanghai, and a meta analysis ofexposure-response functions of air particulate matter and adverse health outcomes. In the time-series study, semi-parametric generalized additive model (GAM) was used to allow for the highly flexible long-term and seasonal trends, as well as nonlinear weather variables. In the single-pollutant models, it was found that an increase of 10μg/m3 of PM10, SO2 and NO2 corresponded to 1.003 (95%CI 1.001-1.005), 1.014 (95%CI 1.008-1.020), and 1.015 (95%CI 1.008-1.022) relative risk of all-causes mortality, respectively. In the multi-pollutants models, the association between SO2 and daily mortality was not affected by the inclusion of other pollutants. However, for PM10 and NO2, the inclusion of other pollutants may weaken their effects on mortality.In the meta analysis, electronic searches for relevant literatures were conducted to determine the exposure-response (E-R) functions for each health outcome associated with exposure to air particulate matter, and the "meta analysis" approach was used to combine the E-R functions when there were several studies describing the same health endpoint. As a result, for each health outcome from morbidity to mortality changes, the relative risks (mean and 95% CI) were estimated when the concentration of air particulate matter increased certain amount of units, which can then be applied to health risk assessment of air particulate matter in other cities in China. Based on the data mentioned above, the health impact of ambient air pollution in Shanghai was estimated quantitatively. It was estimated that PM10 level was associated with 8,220 excess deaths in Shanghai in 2000, and it accounted for 16,870 new cases o...
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