Health Impacts of Long-Term NO2 Exposure and Inequalities among the Chinese Population from 2013 to 2020,Environmental Science & Technology

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Health Impacts of Long-Term NO2 Exposure and Inequalities among the Chinese Population from 2013 to 2020
Environmental Science & Technology ( IF 11.4 ) Pub Date : 2023-03-23 , DOI: 10.1021/acs.est.2c08022
Tao Xue _{1,

2} , Mingkun Tong ₁ , Meng Wang _{3,

4,

5} , Xinyue Yang ₆ , Yanying Wang ₆ , Huan Lin ₆ , Hengyi Liu ₁ , Jiajianghui Li ₁ , Conghong Huang _{7,

8} , Xia Meng ₉ , Yixuan Zheng ₁₀ , Dan Tong ₁₁ , Jicheng Gong ₁₂ , Shiqiu Zhang ₆ , Tong Zhu ₁₂

Affiliation

Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China.
Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York 14214, United States.
Research and Education in Energy, Environment and Water Institute, University at Buffalo, Buffalo, New York 14214, United States.
Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98115, United States.
College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
College of Land Management, Nanjing Agricultural University, Nanjing 210095, China.
National & Local Joint Engineering, Research Center for Rural Land Resources Use and Consolidation, Nanjing 210095, China.
School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education, and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China.
Center of Air Quality Simulation and System Analysis, Chinese Academy of Environmental Planning, Beijing 100012, China.
Department of Earth System Science, Tsinghua University, Beijing 100084, China.
SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing 100871, China.

Nitrogen dioxide (NO₂) is associated with mortality and many other adverse health outcomes. In 2021, the World Health Organization established a new NO₂ air quality guideline (AQG) (annual average <10 μg/m³). However, the burden of diseases attributable to long-term NO₂ exposure above the AQG is unknown in China. Nitrogen oxide is a major air pollutant in populous cities, which are disproportionately impacted by NO₂; this represents a form of environmental inequality. We conducted a nationwide risk assessment of premature deaths attributable to long-term NO₂ exposure from 2013 to 2020 based on the exposure-response relationship, high-resolution annual NO₂ concentrations, and gridded population data (considering sex, age, and residence [urban vs rural]). We calculated health metrics including attributable deaths, years of life lost (YLL), and loss of life expectancy (LLE). Inequality in the distribution of attributable deaths and YLLs was evaluated by the Lorenz curve and Gini index. According to the health impact assessments, in 2013, long-term NO₂ exposure contributed to 315,847 (95% confidence interval [CI]: 306,709–319,269) premature deaths, 7.90 (7.68–7.99) million YLLs, and an LLE of 0.51 (0.50–0.52) years. The high-risk subgroup (top 20%) accounted for 85.7% of all NO₂-related deaths and 85.2% of YLLs, resulting in Gini index values of 0.81 and 0.67, respectively. From 2013 to 2020, the estimated health impact from NO₂ exposure was significantly reduced, but inequality displayed a slightly increasing trend. Our study revealed a considerable burden of NO₂-related deaths in China, which were disproportionally frequent in a small high-risk subgroup. Future clean air initiatives should focus not only on reducing the average level of NO₂ exposure but also minimizing inequality.

更新日期：2023-03-23

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