J Hazard Mater. 2026 Jul 29;515:143101. doi: 10.1016/j.jhazmat.2026.143101. Online ahead of print.
ABSTRACT
Ambient fine particulate matter (PM) remains a leading contributor to the global disease burden. China's Clean Air Actions (CAAs) implemented from 2013 to 2020 achieved substantial progress in PM mitigation. However, since the third-phase CAA was launched in 2023, nationwide evidence has remained limited on whether further PM improvements and related health benefits can be sustained amid population aging. We generated a daily 1 km PM dataset for Chinese Mainland for 2015-2024 to evaluate changes in PM pollution, exceedances of the WHO Air Quality Guidelines (AQGs), and population-weighted exposure. Health benefits were assessed by estimating PM-attributable cardiovascular disease (CVD) mortality, while decomposition analysis quantified the offsetting effect of population aging. National PM concentration declined from 35.57 in 2015 to 20.62 μg/m3 in 2024, with a rebound occurring in 2023. Population-weighted PM decreased by 37.35%. The proportion of the area exceeding the WHO first interim target (35 μg/m3) declined from 51.07% to 1.49%. More than 99% of the population still lived in areas exceeding the WHO AQG level (5 μg/m3). PM-attributable CVD deaths declined from 2.16 (1.64-2.58) million in 2015 to 1.55 (1.14-1.91) million in 2022, before rebounding to 1.76 (1.30-2.15) million in 2024. The share of health benefits offset by population aging rose from around 40% before 2020 to 56.54% in 2024, exceeding 70% in some subregions. Although the third-phase CAA curbed the rebound in 2023, sustained efforts are still required to further reduce PM. Rapid population aging highlights the need for future policies to shift from a concentration-oriented framework toward a health-oriented framework to ensure sustained health benefits.
PMID:42537299 | DOI:10.1016/j.jhazmat.2026.143101