A health impact assessment published in Environmental Science and Ecotechnology estimates that full compliance with China's revised annual fine particulate matter (PM2.5) standard of 25 micrograms per cubic meter (µg m⁻³) would have averted approximately 233,668 premature deaths in 2024, a 16.1% reduction from observed levels. The study, conducted by researchers at Peking University Health Science Center and the Chinese Academy of Environmental Planning, provides the first disease-specific quantification of health benefits from China's 2026 National Ambient Air Quality Standards (NAAQS) revision, which lowered the annual PM2.5 limit from 35 to 25 µg m⁻³ with an interim 30 µg m⁻³ phase from 2026 to 2030.
The analysis integrated high-resolution PM2.5 data, gridded population estimates, and disease-specific exposure–response functions to quantify PM2.5-attributable deaths across mainland China from 2013 to 2024. It compared full-compliance scenarios for the 35, 30, and 25 µg m⁻³ standards across seven disease outcomes in the Global Burden of Disease 2023 risk set. Under the 25 µg m⁻³ scenario, mortality reductions were most pronounced for chronic obstructive pulmonary disease (COPD) at 22.8%, followed by stroke and lung cancer at 18.4% each, lower respiratory infections at 18.0%, and ischemic heart disease at 16.0%. Reductions were minimal for dementia (1.4%) and type 2 diabetes mellitus (1.1%), with the dementia estimate requiring caution due to weaker evidence.
The stricter limit would more than quadruple the number of deaths averted compared with the former 35 µg m⁻³ standard, which would have prevented 53,985 deaths in 2024. It would also expand the population above the regulatory threshold from 33% to 65%, meaning two-thirds of the population would live in areas exceeding the standard, underscoring the widespread nature of PM2.5 pollution. Nationally, the PM2.5-attributable fraction of mortality fell from 32.5% in 2015 to 22.6% in 2024, reflecting the success of clean air actions that cut population-weighted exposure from 62.8 to 29.7 µg m⁻³ over the same period.
Full compliance with the 35, 30, and 25 µg m⁻³ standards would increase PM2.5-specific progress toward the World Health Organization's 2040 halving target to 66.2%, 72.6%, and 83.4%, respectively. COPD would exceed the 50% halving benchmark under the 25 µg m⁻³ scenario, while dementia and type 2 diabetes would remain far behind. A sensitivity analysis using the Global Exposure Mortality Model confirmed the pattern, showing 3.9 times more deaths averted under the 25 µg m⁻³ standard than under 35 µg m⁻³.
The findings have significant implications for policymakers. The researchers recommend prioritizing regions with large populations and high PM2.5 exposure, where compliance with the 25 µg m⁻³ standard would yield the largest health gains. They also advocate pairing air-quality control with older-adult protection, clinical prevention, and chronic-disease management, as population aging can offset exposure-related improvements. Because abatement costs are rising, future standards should be evaluated by disease-specific health returns rather than compliance rates alone. The framework could inform other developing countries seeking to tighten PM2.5 limits while tracking progress toward the WHO 2040 halving target.
The study, supported by the National Natural Science Foundation of China, the Beijing Natural Science Foundation, and the Science and Technology Projects of Xizang Autonomous Region, is available at 10.1016/j.ese.2026.100781. Additional information about the research and its translation to policy can be found through http://chuanlink-innovations.com.
