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...

Full description

Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2023-11-01
Series:The Lancet Planetary Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2542519623002152
_version_ 1797634003986022400
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.
first_indexed 2024-03-11T12:01:43Z
format Article
id doaj.art-7148ebc50a6a4f5097d6d3704e722029
institution Directory Open Access Journal
issn 2542-5196
language English
last_indexed 2024-03-11T12:01:43Z
publishDate 2023-11-01
publisher Elsevier
record_format Article
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
work_keys_str_mv AT ningruiliuphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT weiliuphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT furongdengprofmd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT yumengliuphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xuehuangaomm theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT linfangphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhuoruchenmph theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT haotangmph theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT shijiehongmsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT minyipanmsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT weiliumsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xinyuehuophd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT kangqiguomsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT fangfangruanphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT wenlouzhangmsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT binzhaoprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT jinhanmoprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT chenhuangprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT chunxiaosuphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT chanjuansunphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhijunzoumsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT haolimsc theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT yuexiasunphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT huaqianprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xiaohongzhengphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xiangangzengprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT jianguoguophd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhongmingbuphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT corinnemandinphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT ottohanninenphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT johnsjiscd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT louisebweschlermat theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT haidongkanprofmd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhuohuizhaoprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT yinpingzhangprofphd theburdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT ningruiliuphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT weiliuphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT furongdengprofmd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT yumengliuphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xuehuangaomm burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT linfangphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhuoruchenmph burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT haotangmph burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT shijiehongmsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT minyipanmsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT weiliumsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xinyuehuophd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT kangqiguomsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT fangfangruanphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT wenlouzhangmsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT binzhaoprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT jinhanmoprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT chenhuangprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT chunxiaosuphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT chanjuansunphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhijunzoumsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT haolimsc burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT yuexiasunphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT huaqianprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xiaohongzhengphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT xiangangzengprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT jianguoguophd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhongmingbuphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT corinnemandinphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT ottohanninenphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT johnsjiscd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT louisebweschlermat burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT haidongkanprofmd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT zhuohuizhaoprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017
AT yinpingzhangprofphd burdenofdiseaseattributabletoindoorairpollutantsinchinafrom2000to2017