中国燃煤和其他主要大气污染源造成的疾病负担Burden of Disease Attributable to Coal-Burning and Other Major Sources of Air P

本研究补充了什么？本报告首次全面评估了中国国家和省级燃煤和其他主要空气污染源造成的疾病负担和预测负担。•燃煤是造成环境PM2.5的最重要因素，占中国人口加权PM2.5的40%。鉴于煤炭燃烧对周围PM2.5浓度的巨大影响，煤炭燃烧是中国疾病负担的重要因素，2013年估计造成36.6万人死亡。•煤炭（155000人死亡）和非煤（95000人死亡）排放的工业来源是造成中国疾病负担的最大部门因素，占2013年环境PM2.5死亡率的27%。•燃煤和生物质家庭固体燃料燃烧也是中国疾病负担的一个重要来源。2013年，国内生物量和煤炭燃烧是造成环境PM2.5可归因死亡率的第二大因素，其综合影响（177000人死亡；2013年环境PM2.5可归因死亡率的19%）大于工业煤（155000人死亡）、交通运输（137000人死亡），或者在发电厂燃烧煤炭（86500人死亡）。•在四种不同的能源效率和空气污染控制方案下，人口加权平均PM2.5暴露量预计将显著减少（BAU1、BAU2、PC1和PC2分别从2013年的54 g/m3降至2030年的50 g/m3、38 g/m3、38 g/m3和27 g/m3）。•尽管减少了这些空气污染，但随着人口老龄化，更容易感染与空气污染最密切相关的疾病，预计到2030年，总体健康负担将增加。•即使在最严格的能源使用和污染控制的未来情景下，到2030年，煤炭仍将是造成环境PM2.5和健康负担的最大单一来源。这一发现突出表明，迫切需要采取更加积极的战略，减少燃煤排放，同时减少其他部门的排放，这些战略已开始纳入“十三五”规划。•GBD地图估计表明，工业和家庭部门的减排应优先考虑未来的能源和空气质量管理战略。由于家庭燃烧也会因暴露于空气污染而导致巨大的疾病负担，因此减少家庭生物量和煤炭排放将特别有利于公众健康。

WHAT THIS STUDY ADDS • This report provides the first comprehensive assessment of the current and predicted burdens of disease attributable to coal-burning and other major sources of air pollution in China at the national and provincial levels. • Coal-burning was the most important contributor to ambient PM2.5, responsible for 40% of population-weighted PM2.5 in China. Given the large impact of coal combustion on ambient PM2.5 concentrations, coal combustion was an important contributor to disease burden in China, causing an estimated 366,000 deaths in 2013. • Industrial sources, from both coal (155,000 deaths) and noncoal (95,000 deaths) emissions, were the largest sectoral contributor to disease burden in China, responsible for 27% of the mortality attributable to ambient PM2.5 in 2013. • Household solid fuel combustion, of both coal and biomass, is also an important source of disease burden in China. Domestic biomass and coal combustion were together the next greatest contributor to ambient PM2.5-attributable mortality in 2013 — with a combined impact (177,000 deaths; 19% of the mortality attributable to ambient PM2.5 in 2013) larger than that of industrial coal (155,000 deaths), transportation (137,000 deaths), or coal combustion in power plants (86,500 deaths). • Under four different energy efficiency and air pollution control scenarios, population-weighted mean exposure to PM2.5 is projected to decrease significantly (from 54 g/m3 in 2013 to 50, 38, 38, and 27 g/m3 in 2030 for BAU1, BAU2, PC1, and PC2, respectively). • Despite these air pollution reductions, the overall health burden is expected to increase by 2030 as the population ages and becomes more susceptible to diseases most closely linked to air pollution. • Even under the most stringent energy use and pollution control future scenario, coal will remain the single largest source contributor to ambient PM2.5 and health burden in 2030. This finding highlights the urgent need for even more aggressive strategies to reduce emissions from coal combustion along with reductions in emissions from other sectors, strategies that are beginning to be incorporated in the Thirteenth Five-Year Plan. • The GBD MAPS estimates suggest that emissions reductions in the industrial and domestic sectors should be prioritized for future energy and air quality management strategies. Because domestic combustion also leads to a large disease burden due to household air pollution exposure, reductions in domestic biomass and coal emissions would be particularly beneficial to public health.