Tracking PM2.5 and O3 Pollution and the Related Health Burden in China 2013-2020.

Based on the exposure data sets from the Tracking Air Pollution in China (TAP, http://tapdata.org.cn/), we characterized the spatiotemporal variations in PM2.5 and O3 exposures and quantified the long- and short-term exposure related premature deaths during 2013-2020 with respect to the two-stage clean air actions (2013-2017 and 2018-2020). We find a 48% decrease in national PM2.5 exposure during 2013-2020, although the decrease rate has slowed after 2017. At the same time, O3 pollution worsened, with the average April-September O3 exposure increased by 17%. The improved air quality led to 308 thousand and 16 thousand avoided long- and short-term exposure related deaths, respectively, in 2020 compared to the 2013 level, which was majorly attributed to the reduction in ambient PM2.5 concentration. It is also noticed that with smaller PM2.5 reduction, the avoided long-term exposure associated deaths in 2017-2020 (13%) was greater than that in 2013-2017 (9%), because the exposure-response curve is nonlinear. As a result of the efforts in reducing PM2.5-polluted days with the daily average PM2.5 higher than 75 μg/m3 and the considerable increase in O3-polluted days with the daily maximum 8 h average O3 higher than 160 μg/m3, deaths attributable to the short-term O3 exposure were greater than those due to PM2.5 exposure since 2018. Future air quality improvement strategies for the coordinated control of PM2.5 and O3 are urgently needed.