Unequal Health Risks and Attributable Mortality Burden of Source-Specific PM2.5 in China

Anthropogenic emissions, originating from human activities, stand as the primary contributors to PM 2.5, which is recognized as a global health threat. The disease burden associated with PM 2.5 has been extensively documented. However, the prevailing estimations have predominantly relied on PM 2.5 exposure-response functions, neglecting the distinct risks posed by PM 2.5 from various sources. China has experienced a significant reduction in the PM 2.5 concentration due to stringent emission controls. With diverse sources and abundant mortality data, this situation provides a unique opportunity to estimate short-term source-specific attributable mortality. Our approach involves an integrated unequal health risk-oriented modeling in China, incorporating a source-oriented Community Multiscale Air Quality model, an adjustment and downscaling method for exposure measurement, a generalized linear model with random-effects meta-analysis, and premature mortality estimation. Adhering to the unequal health risk concept, we calculated the attributable mortality of multiple PM 2.5 sources by determining the source risk-adjusted factor. In this study, we observed varying excess risks associated with multiple PM 2.5 sources, with transportation-related PM 2.5 exhibiting the most substantial association. An interquartile range increase (7.65 μg/m 3 ) was linked to a 1.98% higher daily nonaccidental mortality. Residential use- and transportation-related PM 2.5 emerged as the two principal sources of premature mortality. In 2018, a remarkable 53,381 avoiding deaths were estimated compared to 2013, and over 67% of these were attributed to reductions in coal-dependent sources. Notably, transportation-related PM 2.5 emerged as the largest contributor to premature mortality in 2018. This study underscores the significance of a new source-oriented health risk assessment to support actions aimed at reducing air pollution. It strongly advocates for heightened attention to PM 2.5 reductions in the transportation sector in China.