These findings provide a scientific basis for targeted O3 mitigation policies in China and offer a "Chinese solution" for developing nations around the world to seek a balance between air quality management and economic development.
Abstract
Ground-level ozone (O3) pollution is a pressing global environmental health threat. In 2021, the World Health Organization (WHO) introduced stringent O3 control strategies. However, their uniform application across regions with various economic conditions has raised concerns about equity and feasibility, particularly in low- and middle-income areas. To develop region-specific O3 control strategies, we adopted a log-linear concentration-response (C-R) model to quantify O3-attributable Chronic Obstructive Pulmonary Disease (COPD) mortality burden and further applied a cost-benefit model to assess the economic costs and health benefits of O3 reduction across different regions in China. Results showed that in 2021, O3 concentrations in all Chinese cities exceeded WHO Air Quality Guidelines (AQG), with 54.78% surpassing the Interim target 1 (IT-1). The health burden of O3-attributable COPD remained severe, with the worst in Eastern China. Based on the cost-benefit model, the O3 control strategies for Eastern, Central, and Western China were determined as 116 μg/m3, 111 μg/m3, and 100 μg/m3, respectively. This regionalized strategy could reduce COPD deaths by 5.44% while lowering emission reduction costs. Our findings provide a scientific basis for targeted O3 mitigation policies in China and offer a "Chinese solution" for developing nations around the world to seek a balance between air quality management and economic development.
This study quantifies the annual health and economic burden caused by exposure to local emissions of fine particulate matter (PM2.5), ozone, nitrogen dioxide (NO2) and benzene in the Haifa Bay Area, Israel.
A spatial health impact assessment was conducted using high-resolution pollution modeling and fine-scale population data. National disease rates and local concentrations were combined to estimate mortality and morbidity across statistical areas. Economic costs were evaluated using cost-of-illness and Value of a Statistical Life (VSL) and the Value of a Life Year (VOLY).
Significant spatial differences were found in both exposure levels and attributable health outcomes, with specific neighborhoods facing higher risks of mortality and chronic diseases, including cardiovascular disease, cancer, Diabetes, asthma and low birthweight. The total annual economic burden was estimated at 0.56–1.36 billion ILS (approximately 150–366 million USD).
Results provide essential data for local policymakers to target high-risk areas and inform cost-effective pollution-reduction strategies in complex urban zones.
This research offers a novel, spatially resolved quantification of the health and economic burden of local air pollution in Israel, combining advanced epidemiological methods and economic analysis to support integrated environmental management.
Asael Greenfeld, Yossi Erel, Gad Schaffer et al.· Management of environmental...· 0 citations
China has invested heavily in air pollution control in recent years, yet comprehensive assessments of the associated health economic benefits remain limited. Prior research on the health economic benefits of air pollution control has mainly focused on mortality outcomes and PM2.5, which may substantially underestimates the true benefits of clean air policies. This study aims to evaluate the health economic benefits and losses associated with air pollution control by incorporating multiple health outcomes, population groups and air pollutants. We integrate daily mortality, hospital admission and outpatient visits and air pollutant (nitrogen dioxide, ozone [O3] and fine particulate matter) data from 18 cities from 2015 to 2022 to assess the health economic benefits. A generalized additive model was used to estimate concentration-response relationships. Health economic benefits were calculated based on the value of statistical life (VSL) and direct medical costs. Between 2015 and 2022, controlling PM2.5 and NO2 yielded significant health economic benefits across all health outcomes. Air pollution control generated significant health economic benefits across multiple outcomes in Guangdong Province. The total health economic benefits associated with PM2.5 and NO2 were 10,305.35 and 1017.00 million CNY, respectively. In contrast, O3 control yielded negative net benefits across all outcomes. Between 2015 and 2022, the multi-outcome health benefits of controlling PM2.5 exceeded mortality-only estimates by 31.79%, respectively For PM2.5 control, the elderly accounted for over 85% of the mortality-related benefits. These findings highlight the need for coordinated PM2.5-O3 control, the integration of multi-outcome evaluations into policy design, and targeted protection for vulnerable populations particularly the elderly.
Summary Chronic obstructive pulmonary disease (COPD) remains a major contributor to morbidity and mortality, making comparative evidence on long-term burden and risk factors important for prevention. Using the Global Burden of Disease (GBD) 2023 data, we assessed COPD prevalence, incidence, deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), and age-standardized rates (ASRs) in China and the Group of Twenty (G20) countries from 1990–2023. Joinpoint regression characterized temporal changes, autoregressive integrated moving average (ARIMA) models projected burden to 2028, and two-sample Mendelian randomization evaluated genetically proxied risk factors in human populations. In 2023, China had substantial COPD burden, with 52.5 million prevalent cases and nearly 1.0 million deaths. Absolute burden increased since 1990, whereas ASRs generally declined across China and G20 countries. Fifteen exposures showed Bonferroni-corrected associations with COPD risk. These findings highlight persistent disparities in COPD burden and support targeted prevention while recognizing that genetic evidence requires further validation.
Hu Shiyu, Xiaoli Tan, Miaomiao Zhao et al.· iScience· 0 citations
The implementation of the Air Quality Health Index (AQHI) is a regional climate action intended to protect population health, but its empirical linkage to the sustainability goal of good health and well-being remains untested. Using mortality data from Hong Kong (2013–2022), we employed a two-month-lag fixed-effects model to estimate the change in years of life lost (YLL) associated with monthly AQHI warning frequency. We further assessed heterogeneity across demographic and geographic subgroups, and explored the underlying mechanisms. The findings show that monthly AQHI warning frequency is negatively associated with YLL two months later. Each additional warning per month is associated with a reduction of 0.0032 units (SE = 0.0011) in per capita YLL across districts in Hong Kong. The baseline result was further supported by extended survival analyses. Heterogeneity analyses showed that each additional AQHI warning was associated with a significant reduction in YLL among males (coef. = −0.0066, SE = 0.0001) and those with spouses (coef. = −0.0065, SE = 0.0083), but not among females or those without spouses. Mechanism analyses suggested that the effect of AQHI warning frequency on YLL reduction was significantly moderated by individual behavioral responses, including increased face mask usage (int. coef. = −0.0047, SE = 0.0016) and reduced short-term travel (int. coef.= −0.0069, SE = 0.0004), and through socio-environmental pathways such as reduced traffic accidents (int. coef. = −0.0134, SE = 0.0034) and lower carbon emissions (int. coef. = −0.0367, SE = 0.0112). Hong Kong’s AQHI forecasting experience demonstrates the viability of health risk warnings as a climate adaptation strategy in sustainable urban governance, while its observed equity gaps offer critical lessons for refining inclusive environmental health policies.
The deterioration of ambient air quality worldwide has intensified the need to examine the environmental factors associated with the growing burden of respiratory disease. This study aimed to identify broad patterns in the adverse effects of environmental exposures on the respiratory system, while accounting for regional variation and population-specific vulnerability. A systematic literature review was conducted between April and December 2024 using four international databases: PubMed, Web of Science, Scopus, and Google Scholar. Seventy-one relevant publications were included in the final analysis. The findings indicate that, in India, concentrations of particulate matter with aerodynamic diameters of up to 10 μm (PM₁₀) and 2.5 μm (PM₂.₅) exceed recommended limits by a factor of 2.56. In Northern Thailand, reductions of 5.3%–34.3% in particulate matter concentrations were associated with significant declines in hospitalization rates. In China and South Africa, pollutant levels substantially exceed the World Health Organization guideline of 5 μg/m³, while national standards in some settings permit concentrations of up to 40 μg/m³, thereby increasing the risk of chronic inflammatory respiratory conditions. In Bogotá, Colombia, heavy traffic contributes to increased morbidity and mortality from respiratory complications. In Kyrgyzstan, seasonal variation and changes in vegetation patterns have been linked to a rise in allergic reactions, whereas in Slovakia, prolonged pollen seasons are associated with a higher prevalence of bronchial asthma. Children, particularly those under 5 years of age, older adults, and industrial workers were identified as the most vulnerable groups. Climate change further aggravates these risks by intensifying exposure to fine particulate matter and gaseous pollutants. The findings underscore the need for integrated policies focused on emission reduction, environmental monitoring, public awareness, and the harmonization of air-quality standards. The study provides evidence that may support cross-sectoral planning and the development of preventive strategies aimed at reducing the burden of acute and chronic respiratory disease.
Zhanibek Muratov, Aida Zotaj, A. Kalandarova et al.· Luna Azul· 0 citations
Air pollution has become a major global challenge, imposing substantial health and economic burdens while threatening progress toward the Sustainable Development Goals (SDGs). This study investigates the impact of air pollution on healthcare expenditure using panel data from 95 countries over the period 2010-2020. Two complementary indicators of air pollution, emissions per unit area (EMS) and ambient PM2.5 concentration, are employed to distinguish pollution intensity from population exposure. Pooled Ordinary Least Squares (OLS) models with robust standard errors are estimated to examine the direct effects of air pollution, while interaction models are used to assess the moderating roles of urbanization, industrialization, and national income levels. The results indicate that EMS significantly increases healthcare expenditure, whereas PM2.5 exhibits a counterintuitive negative association, suggesting that institutional capacity, preventive healthcare, and policy responses may influence the pollution-healthcare expenditure relationship. Urbanization mitigates the adverse effect of PM2.5, and heterogeneous impacts are observed across income groups. The findings contribute to the literature by integrating dual pollution indicators and crosscountry heterogeneity, providing evidence to support policies aimed at strengthening environmental governance, improving preventive healthcare systems, and advancing sustainable development.
Loan Thị Vũ, Trang Dinh, Thao Phuong Hoang et al.· VNU University of Economics...· 0 citations