Air Pollution's Deadly Grip On China's Cities

Air pollution in China is a pressing issue that has serious social, economic, and political implications. It is a major public health challenge, causing millions of premature deaths annually and contributing to diseases such as cancer, stroke, heart disease, and respiratory infections. The economic costs are also significant, with air pollution resulting in losses of up to 6.6% of China's GDP, or $38 billion, each year. With China's rapid industrialization and immense population growth, addressing air pollution and its deadly consequences is a critical priority for the country.

Economic costs of air pollution

Air pollution has had a significant impact on China's economy, with a total annual cost estimated at $900 billion. In 2018, this figure was equivalent to 6.6% of China's GDP, and it is estimated that the country loses $38 billion in revenue each year due to early deaths and reduced food production as a result of air pollution.

The economic costs of air pollution in China are not limited to direct financial losses but also include the impact on public health and environmental degradation. The country's rapid economic growth has been accompanied by increased energy consumption and environmental pollution, particularly in the form of atmospheric pollution. This has resulted in a significant drop in air quality, which has, in turn, adversely affected the health of residents. For example, the high levels of SO2, CO2, and nitrogen oxide in the atmosphere are believed to have contributed to respiratory and cardiovascular diseases, especially in children. The health impact of air pollution has led to increased healthcare costs, reduced labour force participation, and lost productivity due to sick days and preterm births.

The impact of air pollution on China's economy is also felt through the loss of productivity and efficiency. As air pollution is often a result of industrial output and urbanisation, the trade-off between economic growth and environmental protection presents a challenge for the country. Improving air quality and reducing pollution can lead to increased GDP growth rates and long-term welfare gains. However, implementing measures to reduce pollution can be costly for industries and may hinder economic recovery.

Furthermore, air pollution has also impacted China's social development. The country's vast territory means that there are significant differences in economic and social development between regions. While eastern cities like Beijing, Shanghai, and Guangzhou have better economic and environmental efficiencies, other regions, particularly in the central and western parts of the country, are still struggling to balance economic growth with environmental protection.

Overall, the economic costs of air pollution in China are far-reaching and impact not only the country's financial well-being but also the health, social development, and environmental sustainability of its citizens. Addressing air pollution and improving air quality are crucial not just for the country's economy but also for the well-being of its people.

Cancer as the leading cause of death

Air pollution in China has become a serious social, economic, and political problem. It is responsible for about 2 million deaths in China annually, with ambient air pollution causing more than 1 million deaths, and household air pollution causing another million. The high levels of air pollution are due to industrialization, transportation, coal power plants, and household solid fuel usage. As a result, China has become the world's largest energy consumer, and the rapid economic development has introduced a health threat in the form of air pollution.

Cancer is now the leading cause of death in China, with lung cancer being the most common cancer. The incidence of lung cancer is higher in urban areas, particularly among males in lower economic or lower education counties. The relationship between PM2.5 and lung cancer incidence is stronger in these urban areas, with a 3.97% shift in the incidence rate for every 10 μg/m3 change in PM2.5. The high levels of air pollution in China's rapidly growing cities, such as Shanghai and Beijing, contribute to the high number of cancer deaths, with nearly 30% of cancer deaths being from lung cancer.

The aging population, high smoking rates among males, limited physical activity, changing diets, and increasing obesity are also contributing factors to the high cancer mortality rates in China. The cancer epidemic is particularly evident in the so-called "cancer villages" and "cancer belt," where residents are struck by unusually high rates of cancer due to proximity to polluted waterways or industrial parks. Liver and stomach cancers are also prevalent in rural areas, with liver cancer being three times more likely to kill a Chinese farmer than the average global citizen.

The magnitude of China's cancer epidemic may be far greater than imagined due to the lag time before diagnosis or death and the lack of healthcare in many of the poorest, most polluted areas. The economic costs of air pollution in China are significant, with an estimated RMB 267 billion ($38 billion) in revenue lost annually due to early deaths and lost food production.

Impact on life expectancy

Air pollution in China leads to exposure to fine particles that penetrate the lungs and cardiovascular system, causing diseases such as stroke, heart disease, lung cancer, chronic obstructive pulmonary diseases, and respiratory infections. Industry, transportation, coal power plants, and household solid fuel usage are major contributors to air pollution.

Air pollution is responsible for about 2 million deaths in China annually. Of these deaths, ambient air pollution alone causes more than 1 million deaths, while household air pollution from cooking with polluting fuels and technologies causes another million deaths. In 2017, an estimated 1.24 million deaths in China were attributable to air pollution, including 851,660 from ambient PM2.5 pollution, 271,089 from household air pollution, and 178,187 from ambient ozone pollution. The age-standardized death rate attributable to air pollution in China decreased by 60.6% between 1990 and 2017, driven by a 85.4% decline in household air pollution and a 12.0% decline in ambient PM2.5 pollution.

The impact of air pollution on life expectancy in China is significant. It is estimated that the average life expectancy in China would have been 1.25 years higher if pollution levels had been lower than the minimum levels associated with health loss in 2017. This includes a potential gain of 0.84 years for ambient PM2.5 reduction and 0.26 years for household air pollution reduction. The effect of PM2.5 on life expectancy varies across China's provinces, with the western provinces showing considerably larger potential benefits from household air pollution reduction.

Several studies have investigated the relationship between PM2.5 air pollution and China's older adult population, analyzing the impact of air pollution on respiratory and heart diseases in this age group. For example, a study by Liu et al. estimated that population aging caused an additional 950,000 deaths from 2004 to 2017, delaying the reduction of the health burden of PM2.5 air pollution. It is expected that population aging will be the leading contributor to increased deaths attributable to PM2.5 in China by 2035, surpassing the positive gains from improvements in air quality and healthcare.

Overall, the impact of air pollution on life expectancy in China is complex and influenced by various factors such as age distribution, baseline rates of disease, and exposure levels. Places with higher air pollution exposures generally experience larger impacts on life expectancy. China's aging population and high levels of air pollution contribute to a significant health burden, making it crucial to prioritize actions to address both ambient and household air pollution.

Indoor air pollution

The Chinese government has primarily focused on improving outdoor air quality in key cities, leaving the resolution of indoor air pollution to consumers and the market. However, there has been increasing awareness and action to address indoor air pollution. For instance, companies in big cities are constructing offices with high-quality air filtration systems, and hotels are advertising the air quality of their guest rooms. Wealthier urban consumers are also driving demand for healthier indoor environments, with real estate prices in Beijing found to be lower in polluted neighbourhoods.

To address indoor air pollution, various interventions have been introduced, including technological solutions such as improved stoves and air purifiers. The establishment of IAQ-related regulations and standards, research on indoor air pollution control, and the development of indoor environmental monitoring and cleaning industries have also played a role in prevention and control. However, challenges remain, including the lack of mandatory standards for IAQ, inadequate regulation of pollutant emissions from indoor decorating materials, and the need for an effective performance evaluation system for air cleaning products.

Overall, indoor air pollution in China has significant health, social, and economic impacts, and addressing it requires a combination of government initiatives, consumer awareness, and technological solutions.

Governmental clean air policies

Air pollution is responsible for about 2 million deaths in China each year. The Chinese government has implemented various policies and initiatives to tackle this issue and improve air quality.

In 2014, the Chinese government demonstrated its commitment to addressing pollution, stating in a work report that it would "strengthen the prevention and control of pollution" and "declare war against pollution." This was followed by the China National Action Plan on Air Pollution Prevention and Control (2013-2017), which set clear goals and timelines for improving air quality in key regions and outlined ten key actions for comprehensive air quality management.

Beijing, known for its poor air quality, has been a priority for the government. As early as 1998, the central leadership made air pollution control in Beijing a top environmental priority. Measures implemented in the city included substituting coal with clean fuels in certain zones, applying desulfurization and dust control techniques in power plants, increasing green spaces, and implementing vehicle emission standards.

The Law on Air Pollution Prevention and Control is China's overarching framework for addressing air pollution. It aims to protect and improve the environment, prevent and control air pollution, safeguard public health, and promote ecological infrastructure development. This law directs relevant ministries and local governments to formulate air quality and emission standards.

The National Health Commission has also recognised the importance of environmental pollution control in reducing health hazards, integrating health policies with pollution reduction initiatives. "Health China 2030," released in 2016, emphasises managing health risks caused by pollution and improving air quality. The initiative sets targets for increasing residents' environmental and health literacy levels by 2022 and 2030.

Additionally, China has acknowledged the social, economic, and political challenges posed by air pollution, with citizens expressing their concerns through protests and documentaries. The government continues to face the challenge of balancing economic growth with environmental and social welfare.

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