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      Impacts of climate change on future air quality and human health in China

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          Significance

          More intense extreme events are projected under future climate change. However, the impacts of climate extremes on future air quality and associated health implications are not well recognized and are rarely quantified in China, with an enormous health burden from air pollution. Here, we estimate the climate-driven air pollution mortality in China and find that future climate change is likely to exacerbate air pollution mortality, largely influenced by the more intense extreme events such as stagnation events and heat waves. Our analysis provides quantitative assessments and insights regarding the links between climate extremes, future air quality, and public health, suggesting that extreme weather events may be an important mechanism by which climate change will affect air quality, and especially fine particulate matter.

          Abstract

          In recent years, air pollution has caused more than 1 million deaths per year in China, making it a major focus of public health efforts. However, future climate change may exacerbate such human health impacts by increasing the frequency and duration of weather conditions that enhance air pollution exposure. Here, we use a combination of climate, air quality, and epidemiological models to assess future air pollution deaths in a changing climate under Representative Concentration Pathway 4.5 (RCP4.5). We find that, assuming pollution emissions and population are held constant at current levels, climate change would adversely affect future air quality for >85% of China’s population (∼55% of land area) by the middle of the century, and would increase by 3% and 4% the population-weighted average concentrations of fine particulate matter (PM 2.5) and ozone, respectively. As a result, we estimate an additional 12,100 and 8,900 Chinese (95% confidence interval: 10,300 to 13,800 and 2,300 to 14,700, respectively) will die per year from PM 2.5 and ozone exposure, respectively. The important underlying climate mechanisms are changes in extreme conditions such as atmospheric stagnation and heat waves (contributing 39% and 6%, respectively, to the increase in mortality). Additionally, greater vulnerability of China’s aging population will further increase the estimated deaths from PM 2.5 and ozone in 2050 by factors of 1 and 3, respectively. Our results indicate that climate change and more intense extremes are likely to increase the risk of severe pollution events in China. Managing air quality in China in a changing climate will thus become more challenging.

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          Most cited references42

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          An Overview of CMIP5 and the Experiment Design

          The fifth phase of the Coupled Model Intercomparison Project (CMIP5) will produce a state-of-the- art multimodel dataset designed to advance our knowledge of climate variability and climate change. Researchers worldwide are analyzing the model output and will produce results likely to underlie the forthcoming Fifth Assessment Report by the Intergovernmental Panel on Climate Change. Unprecedented in scale and attracting interest from all major climate modeling groups, CMIP5 includes “long term” simulations of twentieth-century climate and projections for the twenty-first century and beyond. Conventional atmosphere–ocean global climate models and Earth system models of intermediate complexity are for the first time being joined by more recently developed Earth system models under an experiment design that allows both types of models to be compared to observations on an equal footing. Besides the longterm experiments, CMIP5 calls for an entirely new suite of “near term” simulations focusing on recent decades and the future to year 2035. These “decadal predictions” are initialized based on observations and will be used to explore the predictability of climate and to assess the forecast system's predictive skill. The CMIP5 experiment design also allows for participation of stand-alone atmospheric models and includes a variety of idealized experiments that will improve understanding of the range of model responses found in the more complex and realistic simulations. An exceptionally comprehensive set of model output is being collected and made freely available to researchers through an integrated but distributed data archive. For researchers unfamiliar with climate models, the limitations of the models and experiment design are described.
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            Long-term ozone exposure and mortality.

            Although many studies have linked elevations in tropospheric ozone to adverse health outcomes, the effect of long-term exposure to ozone on air pollution-related mortality remains uncertain. We examined the potential contribution of exposure to ozone to the risk of death from cardiopulmonary causes and specifically to death from respiratory causes. Data from the study cohort of the American Cancer Society Cancer Prevention Study II were correlated with air-pollution data from 96 metropolitan statistical areas in the United States. Data were analyzed from 448,850 subjects, with 118,777 deaths in an 18-year follow-up period. Data on daily maximum ozone concentrations were obtained from April 1 to September 30 for the years 1977 through 2000. Data on concentrations of fine particulate matter (particles that are < or = 2.5 microm in aerodynamic diameter [PM(2.5)]) were obtained for the years 1999 and 2000. Associations between ozone concentrations and the risk of death were evaluated with the use of standard and multilevel Cox regression models. In single-pollutant models, increased concentrations of either PM(2.5) or ozone were significantly associated with an increased risk of death from cardiopulmonary causes. In two-pollutant models, PM(2.5) was associated with the risk of death from cardiovascular causes, whereas ozone was associated with the risk of death from respiratory causes. The estimated relative risk of death from respiratory causes that was associated with an increment in ozone concentration of 10 ppb was 1.040 (95% confidence interval, 1.010 to 1.067). The association of ozone with the risk of death from respiratory causes was insensitive to adjustment for confounders and to the type of statistical model used. In this large study, we were not able to detect an effect of ozone on the risk of death from cardiovascular causes when the concentration of PM(2.5) was taken into account. We did, however, demonstrate a significant increase in the risk of death from respiratory causes in association with an increase in ozone concentration. 2009 Massachusetts Medical Society
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              Addressing Global Mortality from Ambient PM2.5.

              Ambient fine particulate matter (PM2.5) has a large and well-documented global burden of disease. Our analysis uses high-resolution (10 km, global-coverage) concentration data and cause-specific integrated exposure-response (IER) functions developed for the Global Burden of Disease 2010 to assess how regional and global improvements in ambient air quality could reduce attributable mortality from PM2.5. Overall, an aggressive global program of PM2.5 mitigation in line with WHO interim guidelines could avoid 750 000 (23%) of the 3.2 million deaths per year currently (ca. 2010) attributable to ambient PM2.5. Modest improvements in PM2.5 in relatively clean regions (North America, Europe) would result in surprisingly large avoided mortality, owing to demographic factors and the nonlinear concentration-response relationship that describes the risk of particulate matter in relation to several important causes of death. In contrast, major improvements in air quality would be required to substantially reduce mortality from PM2.5 in more polluted regions, such as China and India. Moreover, forecasted demographic and epidemiological transitions in India and China imply that to keep PM2.5-attributable mortality rates (deaths per 100 000 people per year) constant, average PM2.5 levels would need to decline by ∼20-30% over the next 15 years merely to offset increases in PM2.5-attributable mortality from aging populations. An effective program to deliver clean air to the world's most polluted regions could avoid several hundred thousand premature deaths each year.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc. Natl. Acad. Sci. U.S.A
                pnas
                pnas
                PNAS
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                27 August 2019
                12 August 2019
                12 August 2019
                : 116
                : 35
                : 17193-17200
                Affiliations
                [1] aMinistry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University , 100084 Beijing, China;
                [2] bDepartment of Marine, Earth, and Atmospheric Sciences, North Carolina State University , Raleigh, NC 27695;
                [3] cDepartment of Earth System Science, University of California, Irvine , CA 92697;
                [4] dDepartment of Civil and Environmental Engineering, University of California, Irvine , CA 92697;
                [5] eState Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University , 100084 Beijing, China;
                [6] fPotsdam Institute for Climate Impact Research , 14412 Potsdam, Germany
                Author notes
                1To whom correspondence may be addressed. Email: qiangzhang@ 123456tsinghua.edu.cn or john@ 123456pik-potsdam.de .

                Contributed by Hans Joachim Schellnhuber, July 4, 2019 (sent for review August 6, 2018; reviewed by Yi Ming and Geeta G. Persad)

                Author contributions: Q.Z., Y. Zhang, K.H., and H.J.S. designed research; C.H., Q.Z., and Y. Zhang performed research; D.T., Y. Zheng, and D.G. contributed new reagents/analytic tools; and C.H., Q.Z., Y. Zhang, S.J.D., Z.L., and H.J.S. wrote the paper.

                Reviewers: Y.M., National Oceanic and Atmospheric Administration; and G.G.P., Carnegie Institution for Science.

                Author information
                http://orcid.org/0000-0002-9338-0844
                Article
                201812881
                10.1073/pnas.1812881116
                6717307
                31405979
                b0d61ab5-7522-4f25-84f5-47f1ee837761
                Copyright © 2019 the Author(s). Published by PNAS.

                This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).

                History
                Page count
                Pages: 8
                Funding
                Funded by: Ministry of Science and Technology of the People's Republic of China (MOST) 501100002855
                Award ID: 2016YFC0208801
                Award Recipient : Qiang Zhang
                Funded by: National Natural Science Foundation of China (NSFC) 501100001809
                Award ID: 41625020
                Award Recipient : Qiang Zhang
                Funded by: National Science Foundation (NSF) 100000001
                Award ID: AGS-1049200
                Award Recipient : Yang Zhang
                Funded by: Tsinghua University (THU) 501100004147
                Award ID: 2014203
                Award Recipient : Chaopeng Hong
                Categories
                9
                Physical Sciences
                Earth, Atmospheric, and Planetary Sciences
                Social Sciences
                Sustainability Science

                climate change,air quality,health,extreme event,china
                climate change, air quality, health, extreme event, china

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