Policy-Driven Changes In The Health Risk Of Pm2.5 And O-3 Exposure In China During 2013-2018

China issued a series of control measures to mitigate PM2.5 pollution, including long-term (i.e., Air Pollution Prevention and Control Action Plan, APPCAP) and short-term (emergency measures in autumn and winter) acts. However, the O-3 concentration increased significantly as PM2.5 levels sharply decreased when these measures were implemented. Therefore, the policy-driven positive/negative health effects of PM2.5/O-3 need to be comprehensively estimated. The health impact function (HIF) is applied to evaluate the health burden attributable to long- and short-term PM2.5 and O-3 exposure. The results show that the PM2.5 concentration decreased by 42.95% in 74 cities, whereas O-3 pollution is increased by 1756% from 2013 to 2018. Compared with 2013, the number of premature deaths attributable to long- and short-term PM2.5 exposure decreased by almost 5.31 x 10(4) (95% confidence interval [CI]: 2.87 x 10(4)-4.71 x 10(4)) (10.13%) and 3.00 x 10(4) (95% CI: 1.66 x 10(4)-4.39 x 10(4)) (72.49%), respectively, in 2018. In contrast, O-3-attributable deaths, increased by 1.98 x 10(4) (95% CI: 0.31 x 10(4)-3.59 x 10(4)) (130.57%) and 0.91 x 10(4) (95% CI: 0.50 x 10(4)-1.33 x 10(4)) (76.16%) for long-and short-term exposure, respectively. The number of avoidable deaths attributed to PM2.5 reduction is larger than the level of premature deaths related to increasing O-3. Although annual mean PM2.5 concentrations have fallen rapidly, the benefits of reducing long-term exposure are limited, whereas the deaths associated with acute exposure decrease more significantly due to the reduction of heavy-pollution days by implementing emergency measures. The results show appreciable effectiveness in protecting human health and illustrate that synchronous control of PM2.5 and O-3 pollution should be emphasized. (C) 2020 Elsevier B.V. All rights reserved.