To evaluate the health benefits brought about by air environmental treatment and determine the main drivers of health risk, we calculated the health and economic benefits attributed to PM2.5 control in Eastern and Central China from 2013 to 2017 by combining PM2.5 concentrations with a human activity enhanced exposure-response model. The relative contributions of changes in four factors related to the PM2.5 health burden were also quantified, namely total population, population aging, baseline mortality rates, and ambient exposure. The results show that the population weighted PM2.5 concentration decreased by 28.73% and the proportion of the population exposed to annual PM2.5 concentrations lower than or equal to 35 μg·m-3 increased from 11.23% to 27.91% across the study area during this period. Avoided deaths were decreased to 14.43%, which equates to avoided economic losses of approximately 559 billion RMB. If PM2.5 concentration meets the Chinese Ambient Air Quality Standard Grade Ⅱ (35 μg·m-3) or Grade Ⅰ (15 μg·m-3), or the World Health Organization Air Quality Guidelines (AQG) standards (10 μg·m-3), a 8.22%, 55.05%, and 79.36% reduction in the total deaths could be achieved in the base year (2017) with equivalent total economic benefits of approximately 319, 2137, and 3081 billion RMB, respectively. Total population, population aging, baseline mortality rates, and PM2.5 concentrations contributed -2.69%, -12.38%, 1.66%, and 14.57% to PM2.5-related deaths. Overall, during the study period, the reduction in PM2.5 concentrations has been the main factor contributing to the reduction in the public health burden. China has implemented significant air pollution control measures; however, the health burden associated with high PM2.5 concentrations in densely populated areas is still extremely high, requiring an aggressive air pollution control strategy.
Keywords: PM2.5; air pollution prevention and control action plan; driving factor; exposure factor; health risk assessment.