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Abstract：
China is one of the largest producers and consumers of coal in the world. The National Action Plan on Air Pollution Prevention and Control in China (2013-2017) particularly aimed to reduce emissions from coal combustion. Here, we show whether the acute health effects of PM2.5 changed from 2013 to 2018 and factors that might account for any observed changes in the Beijing-Tianjin-Hebei (BTH) and the surrounding areas where there were major reductions in PM2.5 concentrations. We used a two-stage analysis strategy, with a quasi-Poisson regression model and a random effects meta-analysis, to assess the effects of PM2.5 on mortality in the 47 counties of BTH. We found that the mean daily PM2.5 levels and the SO42- component ratio dramatically decreased in the study period, which was likely related to the control of coal emissions. Subsequently, the acute effects of PM2.5 were significantly decreased for total and circulatory mortality. A 10 μg/m3 increase in PM2.5 concentrations was associated with a 0.16% (95% CI: 0.08, 0.24%) and 0.02% (95% CI: -0.09, 0.13%) increase in mortality from 2013 to 2015 and from 2016 to 2018, respectively. The changes in air pollution sources or PM2.5 components appeared to have played a core role in reducing the health effects. The air pollution control measures implemented recently targeting coal emissions taken in China may have resulted in significant health benefits.
摘要：
中国是世界上最大的煤炭生产国和消费国之一。《中国大气污染防治国家行动计划（2013-2017年）》特别旨在减少燃煤排放。这里,我们显示了PM2.5对健康的急性影响在2013年至2018年期间是否发生了变化,以及可能解释了在京津冀(BTH)和PM2.5浓度大幅下降的周边地区观察到的任何变化的因素.我们采用了两阶段分析策略,利用准泊松回归模型和随机效应荟萃分析，评估PM2.5对BTH47个县死亡率的影响。我们发现，在研究期间，平均每日PM2.5水平和SO42-组分比率急剧下降，这可能与控制煤炭排放有关。随后，PM2.5对总死亡率和循环系统死亡率的急性影响显著降低.从2013年至2015年和从2016年至2018年，PM2.5浓度增加10μg/m3分别与死亡率增加0.16％（95％CI：0.08，0.24％）和0.02％（95％CI：-0.09，0.13％）相关。空气污染源或PM2.5成分的变化似乎在减少健康影响方面发挥了核心作用。最近在中国实施的针对煤炭排放的空气污染控制措施可能会带来重大的健康益处。
