The burden of disease attributable to indoor air pollutants in China from 2000 to 2017
Summary: Background: High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for Ch...
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Format: | Article |
Language: | English |
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Elsevier
2023-11-01
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Series: | The Lancet Planetary Health |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2542519623002152 |
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author | Ningrui Liu, PhD Wei Liu, PhD Furong Deng, ProfMD Yumeng Liu, PhD Xuehuan Gao, MM Lin Fang, PhD Zhuoru Chen, MPH Hao Tang, MPH Shijie Hong, MSc Minyi Pan, MSc Wei Liu, MSc Xinyue Huo, PhD Kangqi Guo, MSc Fangfang Ruan, PhD Wenlou Zhang, MSc Bin Zhao, ProfPhD Jinhan Mo, ProfPhD Chen Huang, ProfPhD Chunxiao Su, PhD Chanjuan Sun, PhD Zhijun Zou, MSc Hao Li, MSc Yuexia Sun, PhD Hua Qian, ProfPhD Xiaohong Zheng, PhD Xiangang Zeng, ProfPhD Jianguo Guo, PhD Zhongming Bu, PhD Corinne Mandin, PhD Otto Hänninen, PhD John S Ji, ScD Louise B Weschler, MAT Haidong Kan, ProfMD Zhuohui Zhao, ProfPhD Yinping Zhang, ProfPhD |
author_facet | Ningrui Liu, PhD Wei Liu, PhD Furong Deng, ProfMD Yumeng Liu, PhD Xuehuan Gao, MM Lin Fang, PhD Zhuoru Chen, MPH Hao Tang, MPH Shijie Hong, MSc Minyi Pan, MSc Wei Liu, MSc Xinyue Huo, PhD Kangqi Guo, MSc Fangfang Ruan, PhD Wenlou Zhang, MSc Bin Zhao, ProfPhD Jinhan Mo, ProfPhD Chen Huang, ProfPhD Chunxiao Su, PhD Chanjuan Sun, PhD Zhijun Zou, MSc Hao Li, MSc Yuexia Sun, PhD Hua Qian, ProfPhD Xiaohong Zheng, PhD Xiangang Zeng, ProfPhD Jianguo Guo, PhD Zhongming Bu, PhD Corinne Mandin, PhD Otto Hänninen, PhD John S Ji, ScD Louise B Weschler, MAT Haidong Kan, ProfMD Zhuohui Zhao, ProfPhD Yinping Zhang, ProfPhD |
author_sort | Ningrui Liu, PhD |
collection | DOAJ |
description | Summary: Background: High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017. Methods: We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure–response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure–response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach. Findings: From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070–5040) to 3700 (3210–4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3–15·6) of total DALYs and 3·45% (3·01–3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins. Interpretation: DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China. Funding: The National Key Research and Development Program of China and the National Natural Science Foundation of China. |
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format | Article |
id | doaj.art-7148ebc50a6a4f5097d6d3704e722029 |
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issn | 2542-5196 |
language | English |
last_indexed | 2024-03-11T12:01:43Z |
publishDate | 2023-11-01 |
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series | The Lancet Planetary Health |
spelling | doaj.art-7148ebc50a6a4f5097d6d3704e7220292023-11-08T04:08:54ZengElsevierThe Lancet Planetary Health2542-51962023-11-01711e900e911The burden of disease attributable to indoor air pollutants in China from 2000 to 2017Ningrui Liu, PhD0Wei Liu, PhD1Furong Deng, ProfMD2Yumeng Liu, PhD3Xuehuan Gao, MM4Lin Fang, PhD5Zhuoru Chen, MPH6Hao Tang, MPH7Shijie Hong, MSc8Minyi Pan, MSc9Wei Liu, MSc10Xinyue Huo, PhD11Kangqi Guo, MSc12Fangfang Ruan, PhD13Wenlou Zhang, MSc14Bin Zhao, ProfPhD15Jinhan Mo, ProfPhD16Chen Huang, ProfPhD17Chunxiao Su, PhD18Chanjuan Sun, PhD19Zhijun Zou, MSc20Hao Li, MSc21Yuexia Sun, PhD22Hua Qian, ProfPhD23Xiaohong Zheng, PhD24Xiangang Zeng, ProfPhD25Jianguo Guo, PhD26Zhongming Bu, PhD27Corinne Mandin, PhD28Otto Hänninen, PhD29John S Ji, ScD30Louise B Weschler, MAT31Haidong Kan, ProfMD32Zhuohui Zhao, ProfPhD33Yinping Zhang, ProfPhD34Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, ChinaInstitute for Health and Environment, Chongqing University of Science and Technology, Chongqing, ChinaSchool of Public Health, Peking University, Beijing, ChinaDepartment of Building Science, Tsinghua University, Beijing, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, ChinaDepartment of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environmental Science and Engineering, Tianjin University, Tianjin, ChinaSchool of Environmental Science and Engineering, Tianjin University, Tianjin, ChinaSchool of Energy and Environment, Southeast University, Nanjing, ChinaSchool of Environment and Natural Resources, Renmin University of China, Beijing, ChinaSchool of Public Health, Peking University, Beijing, ChinaDepartment of Building Science, Tsinghua University, Beijing, ChinaDepartment of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, ChinaSchool of Environmental Science and Engineering, Tianjin University, Tianjin, ChinaSchool of Energy and Environment, Southeast University, Nanjing, ChinaSchool of Energy and Environment, Southeast University, Nanjing, ChinaSchool of Environment and Natural Resources, Renmin University of China, Beijing, ChinaInstitute of Laboratory Animal Science, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaDepartment of Energy and Environmental System Engineering, Zhejiang University of Science and Technology, Hangzhou, ChinaInstitute for Radiation Protection and Nuclear Safety, Fontenay-aux-Roses Cedex, Marne-la-Vallée, FranceFinnish Institute for Health and Welfare, Department of Health Security, Kuopio, FinlandVanke School of Public Health, Tsinghua University, Beijing, ChinaColts Neck, NJ, USASchool of Public Health, Fudan University, Shanghai, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai, China; Correspondence to: Prof Haidong Kan, School of Public Health, Fudan University, Shanghai 200032, ChinaSchool of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai, China; Correspondence to: Prof Zhuohui Zhao, School of Public Health, Fudan University, Shanghai 200032, ChinaDepartment of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China; Correspondence to: Prof Yinping Zhang, Department of Building Science, Tsinghua University, Beijing 100084, ChinaSummary: Background: High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017. Methods: We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure–response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure–response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach. Findings: From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070–5040) to 3700 (3210–4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3–15·6) of total DALYs and 3·45% (3·01–3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins. Interpretation: DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China. Funding: The National Key Research and Development Program of China and the National Natural Science Foundation of China.http://www.sciencedirect.com/science/article/pii/S2542519623002152 |
spellingShingle | Ningrui Liu, PhD Wei Liu, PhD Furong Deng, ProfMD Yumeng Liu, PhD Xuehuan Gao, MM Lin Fang, PhD Zhuoru Chen, MPH Hao Tang, MPH Shijie Hong, MSc Minyi Pan, MSc Wei Liu, MSc Xinyue Huo, PhD Kangqi Guo, MSc Fangfang Ruan, PhD Wenlou Zhang, MSc Bin Zhao, ProfPhD Jinhan Mo, ProfPhD Chen Huang, ProfPhD Chunxiao Su, PhD Chanjuan Sun, PhD Zhijun Zou, MSc Hao Li, MSc Yuexia Sun, PhD Hua Qian, ProfPhD Xiaohong Zheng, PhD Xiangang Zeng, ProfPhD Jianguo Guo, PhD Zhongming Bu, PhD Corinne Mandin, PhD Otto Hänninen, PhD John S Ji, ScD Louise B Weschler, MAT Haidong Kan, ProfMD Zhuohui Zhao, ProfPhD Yinping Zhang, ProfPhD The burden of disease attributable to indoor air pollutants in China from 2000 to 2017 The Lancet Planetary Health |
title | The burden of disease attributable to indoor air pollutants in China from 2000 to 2017 |
title_full | The burden of disease attributable to indoor air pollutants in China from 2000 to 2017 |
title_fullStr | The burden of disease attributable to indoor air pollutants in China from 2000 to 2017 |
title_full_unstemmed | The burden of disease attributable to indoor air pollutants in China from 2000 to 2017 |
title_short | The burden of disease attributable to indoor air pollutants in China from 2000 to 2017 |
title_sort | burden of disease attributable to indoor air pollutants in china from 2000 to 2017 |
url | http://www.sciencedirect.com/science/article/pii/S2542519623002152 |
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