Health Economic Loss Assessment Of Exposure To Air Pollutants In The Key Composite Pollution Areas Of South And North China

Objectives With the rapid development of social economy,atmosphere pollution has become a hot issue in China,and people’s burden caused by atmosphere pollution becomes more and more serious.With the increase of motor vehicles and the development of industry,China’s atmosphere is no longer a traditional soot type,but a composite type,which can not be ignored for the health damage and health economic loss.In order to evaluate the damage caused by pollution and the formulation of environmental policies.The purpose of this study is to quantitatively evaluate the health effects and health economic losses of air pollutants on people in key complex pollution areas in South China,and to provide basis for the formulation of environmental related strategies in China.Methods The literature between five atmosphere pollutants(including PM_2.5,PM₁₀,SO₂,NO₂and O₃)and six health endpoints（including non-accidental death,respiratory diseases death,cardiovascular diseases death,respiratory diseases hospital admission,cardiovascular diseases hospital admission,and incidence of diabetes）published before December 31,2020 were selected and screened according to inclusion and exclusion criteria.Meta-analysis was performed by using Stata 16.0 software.The association of pollutants with the study endpoints was reported in meta-analysis by random-effects models and sensitivity analyses was performed.The population data,baseline health data,economic data and pollutant concentration data of 34 cities in key complex pollution areas such as Beijing-Tianjin-Hebei region,Yangtze River Delta,Pearl River Delta and Shandong urban agglomeration were collected.Meanwhile,the poisson regression model,revised human capital and cost of illness method were used to calculate the number of people with health effects and the related health economic losses caused by PM_2.5,PM₁₀and O₃respectively.Results 1 A total of 105 literatures were included in this study,and the results of meta-analysis showed that every 10μg/m³increase in PM_2.5,the risk of non-accidental mortality,respiratory disease mortality,cardiovascular disease mortality,respiratory diseases hospital admission rate,cardiovascular diseases hospital admission rate and incidence of diabetes increased by 1.0054（95%CI:1.0041～1.0067）,1.0062（95%CI:1.0045～1.0078）,1.0050（95%CI:1.0039～1.0061）,1.0109（95%CI:1.0069～1.0069）,1.0109（95%CI:1.0069～1.0148）,and 1.1475（95%CI:1.1097～1.1865）,respectively.The risk of non-accidental mortality,respiratory diseases mortality,cardiovascular diseases mortality,respiratory diseases admission rate and cardiovascular diseases admission rate increased by 1.0045（95%CI:1.0033～1.0056）,1.0059（95%CI:1.0042～1.0077）,1.0039（95%CI:1.0031～1.0047）,1.0046（95%CI:1.0021～1.0071）and1.0017（95%CI:1.0008～1.0026）,respectively,per 10μg/m³increase in PM₁₀.The risk of mortality for non-accidental,respiratory and cardiovascular diseases attributable to O₃was 1.0043（95%CI:1.0033～1.0054）,1.0074（95%CI:1.0058～1.0091）and 1.0069（95%CI:1.0058～1.0080）,respectively,per 10μg/m³increase in O₃.The risk of mortality for non-accidental,respiratory and cardiovascular diseases attributable to NO₂was 1.0130（95%CI:1.0107～1.0152）,1.0176（95%CI:1.0131～1.0222）and 1.0130（95%CI:1.0100～1.0160）,respectively,per 10μg/m³increase in NO₂.The risk of mortality for non-accidental,respiratory and cardiovascular diseases attributable to SO₂was 1.0098（95%CI:1.0075～1.0122）,1.0153（95%CI:1.0106～1.0199）and 1.0104（95%CI:1.0067～1.0140）,respectively,per 10μg/m³increase in SO₂.2 The results of health effect research showed that PM_2.5would cause 181000 non-accidental deaths in 34cities,and the deaths from cardiovascular diseases and respiratory diseases account for23.2%of the non-accidental deaths in 2020;PM₁₀would cause 134000 non-accidental deaths in 2020;O₃would cause 10000 non-accidental deaths,including 59000 deaths from cardiovascular diseases and 64000 deaths from respiratory diseases in 2020.The mortality caused by PM_2.5and PM₁₀has decreased in both the north and the south from2013 to 2020,and the mortality in the south were lower than that in the north.The mortality of O₃to the population was increasing in key complex pollution areas in South and north China.The relationship between PM_2.5and the incidence rate of diabetes showed that the incidence of the disease dropped from 7.51 million in 2013 to 6.45million in 2020.The results of the study on the impact of atmosphere pollutants on hospitalization showed that the number of inpatients with respiratory diseases and cardiovascular diseases caused by PM_2.5,PM₁₀and O₃decreased from 2013 to 2020.3 In2020,the health economic losses caused by PM_2.5and PM₁₀in 34 cities were 360.60billion RMB and 224.24 billion RMB respectively,and down 61.6%and 73.9%respectively compared with 2013.The health economic losses caused by O₃was 722.20billion RMB,an increase of 12.4%compared with 2013,of which the loss in 2018 was the highest,1243.05 billion RMB.The per capita economic losses caused by PM_2.5and PM₁₀in the key complex pollution areas in north China were more than in the South.From 2013 to 2015,the per capita health economic losses caused by O₃in the key complex pollution areas in south China was lower than that in the north,while after 2015,the per capita health economic loss caused by O₃in the South was higher than that in the north.In 2020,the percentages of total health economic losses caused by pollutants in the study areas such as Beijing-Tianjin-Hebei region,Shandong urban agglomeration,Yangtze River Delta and Pearl River Delta in the GDP of that year were as follows:PM_2.5:1.80%,1.93%,0.91%,0.36%;PM₁₀:1.32%,1.89%,0.39%,0.06%;O₃:3.46%,1.76%,2.07%,1.59%.Conclusions 1 PM_2.5,PM₁₀,SO₂,NO₂and O₃pollutants would increase the risk of non-accidental death,respiratory diseases death,cardiovascular diseases death,respiratory diseases hospital admission,cardiovascular diseases hospital admission and incidence of diabetes.2 The risk of health endpoint in key complex pollution areas in south China caused by PM₁₀and PM_2.5were higher than in north China.3 From 2013 to2020,the health economic losses caused by PM_2.5and PM₁₀decreased significantly,while the O₃concentration led to an overall increase in the number of people with health effects and health economic losses.Figure 56;Table 23;Reference 203...