Date Published: July 3, 2018
Publisher: Public Library of Science
Author(s): Kai Chen, Arlene M. Fiore, Renjie Chen, Leiwen Jiang, Bryan Jones, Alexandra Schneider, Annette Peters, Jun Bi, Haidong Kan, Patrick L. Kinney, Jonathan Patz
Abstract: BackgroundClimate change is likely to further worsen ozone pollution in already heavily polluted areas, leading to increased ozone-related health burdens. However, little evidence exists in China, the world’s largest greenhouse gas emitter and most populated country. As China is embracing an aging population with changing population size and falling age-standardized mortality rates, the potential impact of population change on ozone-related health burdens is unclear. Moreover, little is known about the seasonal variation of ozone-related health burdens under climate change. We aimed to assess near-term (mid-21st century) future annual and seasonal excess mortality from short-term exposure to ambient ozone in 104 Chinese cities under 2 climate and emission change scenarios and 6 population change scenarios.Methods and findingsWe collected historical ambient ozone observations, population change projections, and baseline mortality rates in 104 cities across China during April 27, 2013, to October 31, 2015 (2013–2015), which included approximately 13% of the total population of mainland China. Using historical ozone monitoring data, we performed bias correction and spatially downscaled future ozone projections at a coarse spatial resolution (2.0° × 2.5°) for the period April 27, 2053, to October 31, 2055 (2053–2055), from a global chemistry–climate model to a fine spatial resolution (0.25° × 0.25°) under 2 Intergovernmental Panel on Climate Change Representative Concentration Pathways (RCPs): RCP4.5, a moderate global warming and emission scenario where global warming is between 1.5°C and 2.0°C, and RCP8.5, a high global warming and emission scenario where global warming exceeds 2.0°C. We then estimated the future annual and seasonal ozone-related acute excess mortality attributable to both climate and population changes using cause-specific, age-group-specific, and season-specific concentration–response functions (CRFs). We used Monte Carlo simulations to obtain empirical confidence intervals (eCIs), quantifying the uncertainty in CRFs and the variability across ensemble members (i.e., 3 predictions of future climate and air quality from slightly different starting conditions) of the global model. Estimates of future changes in annual ozone-related mortality are sensitive to the choice of global warming and emission scenario, decreasing under RCP4.5 (−24.0%) due to declining ozone precursor emissions but increasing under RCP8.5 (10.7%) due to warming climate in 2053–2055 relative to 2013–2015. Higher ambient ozone occurs under the high global warming and emission scenario (RCP8.5), leading to an excess 1,476 (95% eCI: 898 to 2,977) non-accidental deaths per year in 2053–2055 relative to 2013–2015. Future ozone-related acute excess mortality from cardiovascular diseases was 5–8 times greater than that from respiratory diseases. Ozone concentrations increase by 15.1 parts per billion (10−9) in colder months (November to April), contributing to a net yearly increase of 22.3% (95% eCI: 7.7% to 35.4%) in ozone-related mortality under RCP8.5. An aging population, with the proportion of the population aged 65 years and above increased from 8% in 2010 to 24%–33% in 2050, will substantially amplify future ozone-related mortality, leading to a net increase of 23,838 to 78,560 deaths (110% to 363%). Our analysis was mainly limited by using a single global chemistry–climate model and the statistical downscaling approach to project ozone changes under climate change.ConclusionsOur analysis shows increased future ozone-related acute excess mortality under the high global warming and emission scenario RCP8.5 for an aging population in China. Comparison with the lower global warming and emission scenario RCP4.5 suggests that climate change mitigation measures are needed to prevent a rising health burden from exposure to ambient ozone pollution in China.
Partial Text: Climate change threatens human health via multiple pathways, including both direct impacts from changes in temperature, precipitation, and frequency of extreme weather and indirect impacts mediated through both natural systems (e.g., air quality and disease vectors) and human systems (e.g., undernutrition and mental stress) . Climate change is expected to worsen ozone pollution in already heavily polluted areas through meteorological conditions conductive to the accumulation of air pollution and weather-sensitive natural and anthropogenic emissions of ozone precursors (e.g., more emissions owing to increased air conditioning usage in a warmer climate) [2–6]. Global and regional health impact assessments have found adverse impacts of climate change on ozone-related health burdens [7–17]. However, most of the regional studies have focused on developed countries [7–14], while few studies exist in the largest developing country—China [16,17]. In addition, previous studies applied coarse-scale ozone projections in China [16,17], which may bias ozone-related acute excess mortality in populous urban areas. Punger and West found that using coarse resolutions may lead to a small overestimation (<6%) in the US , whereas Fenech et al. found low but significant biases (−0.9% to +2.6%) in the attributable fraction of total mortality due to warm season ozone exposure in Europe . As China is the world’s largest emitter of greenhouse gases , and suffers from severe ambient ozone pollution , estimating the impact of climate change on ozone-related health effects is critical for understanding the indirect health impacts of climate change in China. This analysis was conducted in 104 Chinese cities (Fig 1A) where historical ozone concentrations, future ozone projections, population change projections, and baseline daily mortality counts were available. These 104 cities are distributed over 29 of the 31 mainland provincial administrative regions and included a total of 170 million people in 2010, accounting for approximately 13% of the total population of mainland China. In this study, we projected future ozone-related acute excess mortality in 104 Chinese cities using statistically downscaled ozone projections at a fine spatial resolution (0.25° × 0.25°). Future changes in ozone concentration and related non-accidental deaths from 2013–2015 to 2053–2055 exhibited different patterns in China under RCP4.5 and RCP8.5. Due to the impact of global climate and emission change, an increase in ozone-related deaths was estimated under RCP8.5, whereas a decrease was noted under RCP4.5. Cardiovascular mortality accounted for more than half of the mortality impacts from global climate and emission change. Population aging will likely amplify the ozone-related acute excess mortality burden under both RCPs. Furthermore, under RCP8.5, increased ozone concentrations (+15.1 ppb) in colder months (November to April) will lead to more ozone-related deaths (28.1%) than those avoided (−5.9%) due to decreased ozone concentrations (−4.2 ppb) in warmer months. Thus, deteriorating ozone air quality in colder months will make a growing contribution to the adverse health impacts of climate change in China. Overall, we have shown that the future mortality burden for the Chinese population of short-term exposure to ambient ozone pollution will increase under plausible scenarios of climate and emission change and population aging. Population aging contributes substantially to the future ozone-related acute excess mortality. People with cardiovascular disease may require more care in a changing climate. Cold season ozone may play a more important role than currently recognized in future changes of ozone-related mortality in China. The differences in the direction and magnitude of future changes in ozone-related mortality attributable to climate and emission change under RCP4.5 and RCP8.5 suggest that climate change mitigation actions, such as preventing atmospheric methane from doubling, are needed to prevent a rising health burden from exposure to ambient ozone pollution in China. The authors are solely responsible for the content of this paper and do not represent the official view of the EPA. Source: http://doi.org/10.1371/journal.pmed.1002598