Report Briefing
Dangerous Breathing 2：A study on the health effects of atmospheric PM2.5 in urban China At 2013 atmospheric PM2.5 concentration levels, the PM2.5 pollution‐related premature death rate in the 31 provincial capitals and province‐level cities came close to 0.1%. The PM2.5 pollution‐related premature death rate of 12 of these 31 cities was higher than 0.1%. These 12 cities were Shijiazhuang, Jinan, Changsha, Chengdu, Nanjing, Wuhan, Nanchang, Hefei, Tianjin, Harbin, Chongqing and Shenyang. One: Background China's rapid economic development, the acceleration of urbanization, and the continual growth in energy consumption and air pollution emissions have posed a severe challenge to the country’s air quality, particularly from fine particulate air pollution (PM2.5). Since 2011, the public’s top environmental concern has been the frequent smog smothering Beijing, Tianjin, Hebei and the Yangtze River Delta. The 2013 Report on the State of the Environment in China reported that in the first batch of 74 cities that implemented Ambient Air Quality Standards (GB3095‐2012), 96% were not able to meet the national annual average PM2.5 standard (35 μg/m3) level two. The PM2.5 situation in Beijing, Tianjin and Hebei was the most serious. The State Council released its Action Plan on Prevention and Control of Air
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Pollution in September 2013, in which it proposed that by 2017 the concentrations of PM2.5 should be reduced by around 25% in Beijing, Tianjin and Hebei; 20% in the Yangtze River Delta; and 15% in the Pearl River Delta. Beijing's annual average PM2.5 concentrations should also be kept to around 60 μg/m3. As of the end of October 2014, of the 31 provincial capitals and province‐level cities, 21 had announced their own specific PM2.5 reduction targets for 2017. The relationship between the characteristics of China’s PM2.5 pollution and the impact on public health has received widespread attention from the public, the government and academia. Regardless of whether we are talking about current levels of atmospheric PM2.5 pollution or the 2017 PM2.5 reduction targets of China's key environmental protection cities, there is disagreement over whether they are already or will continue to adversely affect public health. There is a lack of research using actual PM2.5 monitoring data. That is why Greenpeace is collaborating again with the School of Public Health of Peking University, and using an extensive set of objective data and conducting painstaking research, we are jointly releasing this latest report: Dangerous Breathing 2：A study on the health effects of atmospheric PM2.5 in urban China. Two: Methodology This report is the first domestic study of the health effects of long‐term exposure to PM2.5 based on actual PM2.5 monitoring data and focused on the 31 provincial capitals and province‐level cities in China. This study took each city's 2013 annual average PM2.5 concentrations
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, and used the Integrated
Exposure-Response (IER) model developed by the Global Burden of Diseases to estimate the burden of diseases (ischemic heart disease, stroke, lung cancer and chronic obstructive pulmonary disease) attributable to long‐term exposure to 1 All the data used in this report on urban 2013 PM2.5 annual average concentrations comes from the China Air Quality Index by Fresh‐Ideas Studio, website: http://air.fresh-ideas.cc。 2
fine particulate matter (PM2.5) in each city. Integrated Exposure‐Response (IER) is one of the internationally‐recognized ways to estimate the long‐term health impacts of ambient PM2.5.. Our study assumed that there was no significant harm to health when annual average ambient PM2.5 concentrations are kept at or below 10 μg/m3, which is also the WHO air quality guideline. We calculated the number of PM2.5 –related premature deaths from the four diseases listed above from long‐term exposure at 2013 actual annual average PM2.5 concentrations. Then we used the 2013 resident population for each city to estimate the number of premature deaths per 100,000 people. Three: Results 1. At 2013 PM2.5 pollution levels, PM2.5 pollution‐related premature deaths in the 31 provincial capitals and province‐level cities came to 257,000, that is for every 100,000 people, there were around 90 premature deaths from PM2.5 pollution. 2. At 2013 PM2.5 pollution levels, PM2.5 pollution‐related deaths reached or exceeded 100 deaths per 100,000 people (0.1%) in 12 of the 31 provincial capitals and province‐level cities. These were Shijiazhuang, Jinan, Changsha, Chengdu, Nanjing, Wuhan, Nanchang, Hefei, Tianjin, Harbin, Chongqing and Shenyang. Shijiazhuang had the most PM2.5 pollution‐related deaths in 2013, with 134 deaths per 100,000 people (0.134%.). 3. Lhasa, Haikou and Fuzhou met the national annual average PM2.5 standard (35 μg/m3) level two in 2013. If the remaining 28 cities were also able to meet
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this standard then, the total number of PM2.5 pollution‐related premature deaths could have been reduced by 41 deaths per 100,000 (0.041%) compared with 2013. 4. If those 21 cities across China that have set clear 2017 PM2.5 reduction targets were to meet these targets then compared with 2013, PM2.5 pollution‐related deaths would fall by 11 premature deaths per 100,000 people (0.011%). 5. Worth noting is that even though Lhasa, Haikou and Fuzhou’s 2013 PM2.5 annual average concentrations met the national annual average PM2.5 standard (35 μg/m3) in 2013, their PM2.5 pollution still led to an average 50 premature deaths per 100,000 people (0.05%). Lhasa had the lowest rate of 39 premature deaths per 100,000 people (0.039%). In summary, there is a major adverse impact on the long‐term health of the public from PM2.5 pollution in China's 31 provincial capitals and province‐level cities. It is not just the cities in the economically‐developed east of the country where the serious health impacts are being felt, cities in the central and western regions are facing a similar serious threat to public health from atmospheric PM2.5 pollution. The results of this study also showed that according to the Air Pollution Action Plan ending in 2017, of those 21 cities that have set clear targets for PM2.5 reduction targets, the people living in Beijing, Tianjin, Hebei, the Yangtze River Delta and the Pearl River Delta will benefit from more aggressive pollution reduction targets, and their health benefits will be the most obvious. If each city is able to quickly reach the national annual average PM2.5 standard (35 μg/m3) level two there will be a much greater improvement to public health. Four: Policy Recommendations
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1: Air pollution is one of China’s most serious environmental problems today. The situation has become so grave that it is threatening the health of people across the country. Although a series of air pollution policies have been released over the past two years, there is still a huge disparity between efforts to control smog and the public demand. There is an urgent need to strengthen measures in all aspects, particularly the provinces in the central and western regions of the country need to follow the examples of Beijing, Tianjin, Hebei and Shandong in how to tackle their smog problem – by using a reduction in coal consumption, and adjusting the energy mix to bring smog more quickly under control. 2: If those cities that have set 2017 PM2.5 reduction targets met those targets then they would reduce PM2.5 –related deaths by 11 premature deaths per 100,000 people, which falls short of significantly reducing the harm to public health from PM2.5 pollution. We recommend that in the mid‐term evaluation of the Action Plan on Prevention and Control of Air Pollution in 2015, cities across the country should urgently set more aggressive reduction targets so as to reach national annual average PM2.5 standard (35 μg/m3) level two standards sooner. Only then can we significantly remove the adverse health effects of atmospheric PM2.5 pollution. It would allow the Chinese public to see that the government is taking radical action and has a practical plan and the determination to tackle smog, allowing the public to reap the real benefits of better health and a longer life. Those cities that met national air quality standards in 2013 should draw up air quality action plans to reach the WHO air quality standard (annual average of 10μg/m3 or below), which will create real benefits and mean that their residents can enjoy the same blue skies and access to a healthy environment as those cities in the developed world in Europe and America. 3: The Beijing‐Tianjin‐Hebei region, the Yangtze River Delta and the Pearl River Delta have placed the most emphasis so far on controlling PM2.5; the Action Plan
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on Prevention and Control of Air Pollution mentions that all these regions’ PM2.5 ‐reduction targets will be reviewed. However, PM2.5 pollution is also threatening people’s health in other cities, such as Chengdu, Wuhan, Taiyuan and Xian. Therefore, we recommend that after the mid‐term evaluation of the Action Plan on Prevention and Control of Air Pollution in 2015, reviews should be carried out on all cities' PM2.5 reduction targets, this will speed up progress nationwide on tackling PM2.5 pollution. 4. When governments draw up air pollution control measures, they generally tend to overlook the issue of public health. We recommend that policymakers across the country make protecting public health a key consideration in the future. All major cities should urgently evaluate how air pollution is affecting the health of their city's residents, especially the long‐term health effects, and use this to come up with an effective reduction target and further improve government policy on controlling smog. Table： City
Shijiazh
2013
PM2.5 ‐related
2017 PM2.5
The decrease in the
The decrease in the
annual
premature
reduction
number of
number of
average
deaths per
targets
premature deaths
premature deaths
PM2.5
100,000
（g/m3）
per 100,000 people
per 100,000 people
concentrati
people at 2013
under 2017 PM2.5
under national
ons2
PM2.5
reduction targets
standard 35g/m3*
（g/m3）
concentrations
compared with 2013
compared with
levels
2013 levels
137.02
134
91.8
21
77
2 The annual average concentrations came from daily and hourly publicly‐released PM2.5 air quality monitoring data by the Ministry of Environmental Protection and local environmental bureaus; we used the arithmetic mean to calculate each city's PM2.5 annual average concentrations. 6
uang 116.42
128
93.1
12
108.25
83
92.0
6
Xian
106.99
95
96.3
4
51
Tianjin
94.46
106
70.8
14
53
Urumqi
93.56
46
No target
——
23
Beijing
92.91
79
60.0
17
40
Wuhan
92.88
114
75.0
11
56
89.85
116
71.9
13
87.04
110
69.6
12
82.13
124
71.0
9
Harbin
79.26
101
72.9
4
46
Taiyuan
77.52
97
62.0
11
44
Nanjing
77.33
116
61.9
14
52
75.56
100
No target
——
Jinan Zhengzh ou
Chengd u Hefei Changsh a
Shenyan g
Gradual
70 44
58
53 58
45
34
reduction Changch un
70.58
80
of annual
——
average concentra tions
Nancha
47
68.90
111
50.0
21
Lanzhou
68.68
92
65.2
3
39
Hangzh
67.96
78
50.3
14
32
ng
7
ou 67.43
68
No target
——
64.89
100
54.5
11
64.70
81
51.8
11
Hohhot
64.48
83
58.0
5
33
Nanning
55.12
87
No target
——
29
Guiyang
50.94
94
47.4
5
28
48.43
63
38.7
11
Xining Chongqi ng Shangha i
Guangz hou
Gradual
28 41
32
17
14
reduction Yinchua n
46.60
56
of annual
——
average concentra tions
Kunmin g Fuzhou
7
38.40
71
No target
——
34.57
64
No target
——
Target met
——
Target met
——
Target met
Maintain Haikou
27.05
49
2013 levels Do not
Lhasa
25.22
39
exceed 2013 levels
* China Ambient Air Quality Standard (GB3095‐2012) grade two standard for annual average concentrations of PM2.5 pollution.
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