印度主要空气污染源造成的疾病负担Burden of Disease Attributable to Major Air Pollution Sources in India in 2018

本研究补充了什么？本报告首次全面评估了印度主要空气污染源造成的当前和预测疾病负担。在2015，来自几个主要来源的颗粒物（PM）空气污染造成约110万人死亡，占印度死亡总数的10.6%。燃烧源是主要贡献者之一：在印度，住宅生物质燃烧是造成疾病负担的最大个人贡献者。住宅生物质燃烧造成267700人死亡，占PM2.5死亡人数的近25%，是2015年与死亡率相关的最重要的单一人为来源。这些负荷估计数不包括因室内暴露于生物质燃烧而产生的相当大的额外负荷。煤炭燃烧和露天燃烧也大大增加了疾病负担。在2015年，煤炭燃烧造成169300人死亡（15.5%）。农业废弃物的露天焚烧造成了66200人（6.1%）的PM2.5死亡。运输、分布式柴油和砖块生产也是造成PM2.5所致疾病负担的重要因素。2015年，交通运输造成23100人死亡，分布式柴油造成20400人死亡，砖块生产造成24100人死亡。•如果不采取行动，到2050年，人口对PM2.5的接触可能增加40%以上。评估了三种不同的能源效率和空气污染控制途径（情景）。在很少采取额外行动的参考情景（REF）中，暴露量从2015年的74 g/m3增加到2050年的106 g/m3。在雄心勃勃的S2情景下，风险敞口水平保持在接近2015年的水平。只有在雄心勃勃的S3情景中设想的最积极的减少情况下，预计暴露量才会以主要方式减少——从2015年到2050年减少近35%，达到约48 g/m3。•如果不采取行动，到2050年，来自所有来源的疾病的未来负担将大幅度增加。随着人口的老龄化和增长，使更多的人容易受到空气污染的影响，尽管预计在S2和S3情景中暴露量会减少，但疾病负担预计在未来会增加。与2015年近110万人死亡相比，环境PM2.5造成的死亡预计将上升至360万人，无需采取行动。•积极行动可避免近120万人死亡；所有主要部门都需要减少空气污染，以减轻疾病负担。印度政府已经开始采取行动改善空气质量。该分析表明，与REF情景相比，S3情景下的积极行动在2050年可以避免近120万人死亡。这对于减少住宅生物质燃烧、燃煤和粉尘暴露的措施尤其适用

What This Study Adds • This report provides the first comprehensive assessment of the current and predicted burdens of disease attributable to major sources of air pollution in India. • In 2015, particulate matter (PM) air pollution from several major sources was responsible for approximately 1.1 million deaths, or 10.6% of the total number of deaths in India. Combustion sources are among the leading contributors: Residential biomass burning is the largest individual contributor to the burden of disease in India. Residential biomass burning was responsible for 267,700 deaths, or nearly 25% of the deaths attributable to PM2.5, making it the most important single anthropogenic source related to mortality in 2015. These burden estimates do not include the considerable additional burden from indoor exposure to biomass burning. Coal combustion and open burning also contribute substantially to disease burden. Coal combustion, roughly evenly split between industrial sources and thermal power plants, was responsible for 169,300 deaths (15.5%) in 2015. The open burning of agricultural residue was responsible for 66,200 (6.1%) PM2.5-attributable deaths. Transport, distributed diesel, and brick production are also important contributors to PM2.5-attributable disease burden. In 2015, transportation contributed 23,100 deaths, distributed diesel contributed 20,400 deaths, and brick production contributed 24,100 deaths. • If no action is taken, population exposures to PM2.5 are likely to increase by more than 40% by 2050. Three different energy efficiency and air pollution control pathways (scenarios) were evaluated. In the reference scenario (REF), in which little additional action is taken, exposures increase from 74 g/m3 in 2015 to 106 g/m3 in 2050. Exposure levels are kept close to 2015 levels under an ambitious S2 scenario. Only under the most active reductions envisioned in the aspirational S3 scenario are exposures projected to be reduced in a major way — by nearly 35% from 2015 to 2050, reaching about 48 g/m3. • If no action is taken, the future burden of disease from all sources will grow substantially by 2050. The burden of disease is expected to grow in the future, as the population ages and grows and leaves more people susceptible to air pollution, despite the projected exposure decreases in the S2 and S3 scenarios. Compared with nearly 1.1 million deaths in 2015, deaths attributable to ambient PM2.5 are projected to rise to 3.6 million with no action. • Aggressive action could avoid nearly 1.2 million deaths; all major sectors will need to achieve reductions in air pollution to reduce disease burden. The Indian government has begun taking actions to improve air quality. This analysis demonstrates that aggressive actions under the S3 scenario could avoid nearly 1.2 million deaths in 2050 compared with the REF scenario. That will be especially true for actions to reduce exposure from residential biomass combustion, coal burning, and dusts