京津冀及周边地区“十四五”及中长期PM2.5污染控制目标的健康效益预估研究

京津冀及周边地区是我国最具有代表性的空气污染较严重的城市群，为探究重污染地区空气污染的疾病负担及其未来空气质量改善的健康效益，基于环境因子人群疾病负担评估的基本方法，评估了京津冀及周边地区“2+26”城市2015年的PM_2.5相关疾病负担，并对该地区在“十四五”及中长期PM_2.5污染控制目标下的未来PM_2.5疾病负担进行了预估研究，分析了PM_2.5污染控制目标带来的健康效益.结果表明:①2015年“2+26”城市PM_2.5所致超额死亡数为15.11×104例.②若不考虑人口变化，未来空气质量按“十四五”及中长期PM_2.5污染控制目标改善，预计到2025年、2030年和2035年“2+26”城市PM_2.5所致超额死亡数将分别降至11.49×104、10.62×104和9.85×104例，比2015年分别减少了23.96%、29.72%和34.79%.③分年龄段和分疾病对比发现，65岁以上老年人群PM_2.5相关超额死亡数的占比较高且有上升趋势，与PM_2.5相关的心脑血管系统疾病（中风和缺血性心脏病）的超额死亡数在PM_2.5相关超额死亡总数中占比最大，且有增加的趋势.研究显示，京津冀及周边地区“2+26”城市未来空气质量的改善将大幅降低空气污染相关疾病负担，带来显著的健康效益，但由于人口增长和老龄化的影响，未来较长时间内我国空气污染带来的疾病负担依然较重，应持续改善空气质量，并关注脆弱人群的健康防护，以进一步降低空气污染相关疾病负担. 

Health Benefit of '14th Five-Year' and Medium & Long-Term PM2.5 Control Targets in Beijing-Tianjin-Hebei and Its Surrounding Areas

The Beijing-Tianjin-Hebei and its surrounding areas (Beijing-Tianjin-Hebei Region) are one of the most representative urban agglomerations in China with heavy air pollution, especially the ambient PM_2.5 pollution. In order to estimate the disease burden of PM_2.5 in the Beijing-Tianjin-Hebei Region '2+26' cities and explore the health benefits of future air quality improvement, this study estimated the numbers of PM_2.5-related excess deaths in 2015, and in 2025, 2030 and 2035 under the '14th Five-Year' and Medium & Long-Term PM_2.5 control targets in this region, using the classical method of disease burden assessment of environmental factors. The health benefits of PM_2.5-control targets were estimated based on the above results. The results show that the number of excess deaths caused by PM_2.5 in the Beijing-Tianjin-Hebei Region '2+26' cities in 2015 was 15.11×104. If the air quality improvements fully achieve the '14th Five-Year' and Medium & Long-Term PM_2.5 control targets, the PM_2.5-related excess deaths in the Beijing-Tianjin-Hebei Region '2+26' cities will be 11.49×104, 10.62×104 and 9.85×104 in 2025, 2030 and 2035, respectively, which are 23.96%, 29.72% and 34.79% less than 2015. The comparison between age groups shows that the proportion of PM_2.5-related excess deaths in the old groups (aged 65 or more) is much higher than in the young groups. The disease-specific comparison shows that the PM_2.5-related excess deaths from cardiovascular and cerebrovascular diseases (in this study: stroke and ischemic heart disease) have the largest proportion among the total excess deaths and presents increasing trends in future. Our research shows that the future air quality improvement in the Beijing-Tianjin-Hebei Region '2+26' cities will significantly reduce the PM_2.5-related disease burden and bring significant health benefits. However, due to the impact of population growth and aging, the overall PM_2.5-related disease burden will remain heavy in the future. China should continuously promote the prevention and control of air pollution in the Beijing-Tianjin-Hebei Region and at the same time, pay attention to the health protection of vulnerable population groups such as the elderly and the people with chronic diseases, especially those with cardiovascular and cerebrovascular diseases, so as to further reduce the burden of PM_2.5-related diseases.