The Lancet Planetary Health, March 2025

National and provincial burden of disease attributable to fine particulate matter air pollution in China, 1990–2021: an analysis of data from the Global Burden of Disease Study 2021

Fine particulate matter (PM2·5) air pollution was identified as the leading contributor to disability-adjusted life-years (DALYs) and the second primary risk factor for deaths worldwide in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. It was estimated that 7·8 million deaths were attributable to PM2·5 pollution globally, of which more than 2·2 million were reported in China alone.

As the world’s largest middle-income country, China faces the dual challenge of ambient PM2·5 pollution and household PM2·5 pollution from solid fuels, both of which contribute substantially to PM2·5-related health effects. Since 2013, the Chinese Government has issued a series of air pollution control policies. Most actions target ambient PM2·5 pollution, such as controlling industrial emissions, promoting electric vehicles, and reducing reliance on coal. Some measures, such as the switch of residential energy from coal to natural gas or electricity, have contributed to reducing household air pollution from solid fuels. Despite a notable decline in PM2·5 concentrations over the past decade, the absolute levels of PM2·5 frequently exceeded recommended guidelines in certain regions, thereby posing adverse effects on public health.