The air quality and health impacts of domestic trans-boundary pollution in various regions of China

- Concentration-response functions are established for Chinese health assessments.
- TBI, on average, accounts for 27% of the total PM2.5 in China.
- TBI accounts for 18% of premature mortalities (160,000) due to air pollution in China.
- 22% of Taiwan premature mortalities due to air pollution are caused by TBI from China.

Air pollution is one of the most pressing environmental problems in China. Literature has reported that outdoor air pollution leads to adverse health problems every year in China. Recent measurement studies found the important regional nature of particulates in China. Trans-boundary air pollution within China has yet to be fully understood. This study aimed to comprehensively understand the processes of domestic trans-boundary air pollution in China and to apportion the impacts of emissions in different regions on air quality and public health. We applied a state-of-the-art air quality model to simulate air quality in China and then adapted a form of integrated concentration-response function for China to estimate the resultant amount of premature mortality due to exposures to PM2.5. Our findings show that domestic trans-boundary impacts (TBI), on average, account for 27% of the total PM2.5 in China. We estimated that outdoor air pollution caused ~ 870,000 (95% CI: 130,000-1500,000) premature mortalities in China in 2010, of which on average 18% are attributed to TBI. Among all the regions, North China is the largest contributor to TBI due to 41% of the health impacts of its emissions occurring in other regions. Taiwan (TW) is the smallest contributor to TBI occurring in China, contributing 2% of the national TBI, while TBI causes 22% of the premature mortalities due to outdoor air pollution in TW. Our findings pinpoint the significant impacts of TBI on public health in China, indicating the need for cross-region cooperation to mitigate the air quality impacts and the nation's resultant health problems.