Disease Burden from Coal Combustion and Other Major Sources in China

Reducing the health impacts of air pollution requires understanding the relative impacts of specific source sectors on pollution, especially in highly polluted countries such as China. Air quality management can lead to substantial health benefits and reductions in climate-forcing emissions. We combined chemical transport model simulations with high-resolution estimates of exposure to air pollution and the burden of disease to estimate deaths from major air pollution sources in 2013 and under four future scenarios for 2030. Scenarios included future energy mixes (including reductions in coal use) and pollution control measures.

Coal combustion (power plant, industrial, domestic heating and cooking) was the most important contributor to ambient particle (PM_2.5) pollution in China in 2013, responsible for 40% of population exposure.  Coal combustion caused 366,000 deaths in 2013 in China (more than high cholesterol, drug use or secondhand smoking), and was the 12th leading risk factor for mortality. Domestic biomass and coal combustion together caused 177,000 deaths, more than industrial coal (155,000 deaths), transportation (137,000), or coal combustion in power plants (86,500).

The impact of domestic combustion on ambient PM_2.5combined with impacts via household air pollution exposure, suggests that reductions in domestic emissions would lead to large reductions in disease burden and should be prioritized in future energy and air quality management strategies.

Compared to 2013, all future scenarios predict increases in deaths attributable to ambient PM_2.5 in 2030. Specifically, ambient PM_2.5 was projected to cause 0.99 - 1.3 million deaths in 2030. Projected mortality increases are due to population aging and increases in ischemic heart disease, stroke, COPD and lung cancer in the Chinese population.  These projections underscore the importance of population dynamics in determining future mortality due to ambient PM_2.5. PM levels must be substantially lowered to stabilize or reduce burden given demographic trends.

Even if coal combustion is reduced in the future all future scenarios predict that coal combustion’s contribution to ambient PM_2.5 and associated disease burden will increase, and even under the most stringent energy use and pollution control scenario, coal remains the single largest contributor to ambient PM_2.5 in 2030. Thus there is an urgent need for even more aggressive strategies to reduce emissions from coal combustion along with reductions from other sectors.