BMJ global health · 2026
Impact of ambient fine particulate matter (PM2.5) pollution on disease burden in BRICS from 1990 to 2023: evidence from the Global Burden of Disease Study 2023.
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Si Shangkun, Deng Shizhe, Zhang Yueyang, Wang Xingxin, Yue Gonglei, Sun Yiyang, Lu Hai, Li Junyang, Tao Feng, Lin Mengxuan, Dong Zhexu, Zhuo Bifang, Li Li, Pang Bo, Jin Xinyao, Meng Zhihong, Shi Jiangwei
Аннотация
BACKGROUND: Ambient fine particulate matter (PM2.5) pollution (APMP) is a leading global mortality risk factor. Its long-term trends, drivers and future burden trajectories in emerging economies remain inadequately understood. This study provides the first systematic assessment of spatiotemporal patterns, key drivers and projections to 2050 of APMP-attributable health loss in BRICS countries (Brazil, Russia, India, China and South Africa) from 1990 to 2023, benchmarked against global and Group of Seven (G7) trends.
METHODS: Using Global Burden of Disease 2023 data, this study analysed APMP-attributable deaths and disability-adjusted life years (DALYs) via absolute numbers and age-standardised rates. The multidimensional framework included joinpoint regression, age-period-cohort (APC) modelling, Das Gupta decomposition, disease spectrum ranking and Bayesian-APC projection.
RESULTS: In 2023, APMP caused 2.955 million deaths in BRICS (59% of the global total). Age-standardised mortality and DALY rates remained higher than global averages and increased since 1990, contrasting with sustained declines in the G7. Substantial heterogeneity existed: India's burden was heaviest and growing, China's remained high but stabilised, while Brazil and Russia achieved marked reductions. APC modelling revealed pronounced mortality increases in older ages (especially 95+ years in China and India). Decomposition identified population ageing as the key driver in BRICS, especially China; population growth and deteriorating epidemiological conditions under high exposure drove increases in India and South Africa. Leading APMP-attributable burdens in BRICS were ischaemic heart disease, chronic obstructive pulmonary disease and intracerebral haemorrhage, unlike in the G7 where Alzheimer's disease and other dementias ranked first. Projections indicate the BRICS burden will remain above the global average by 2050, with China and India continuing to bear severe burdens.
CONCLUSION: BRICS is the epicentre of global APMP-attributable burden. The widening gap with the G7 underscores divergent environmental health governance paradigms. Findings call for differentiated strategies within BRICS and enhanced transnational collaboration to curb APMP burden rises and bridge global environmental health equity gaps.
METHODS: Using Global Burden of Disease 2023 data, this study analysed APMP-attributable deaths and disability-adjusted life years (DALYs) via absolute numbers and age-standardised rates. The multidimensional framework included joinpoint regression, age-period-cohort (APC) modelling, Das Gupta decomposition, disease spectrum ranking and Bayesian-APC projection.
RESULTS: In 2023, APMP caused 2.955 million deaths in BRICS (59% of the global total). Age-standardised mortality and DALY rates remained higher than global averages and increased since 1990, contrasting with sustained declines in the G7. Substantial heterogeneity existed: India's burden was heaviest and growing, China's remained high but stabilised, while Brazil and Russia achieved marked reductions. APC modelling revealed pronounced mortality increases in older ages (especially 95+ years in China and India). Decomposition identified population ageing as the key driver in BRICS, especially China; population growth and deteriorating epidemiological conditions under high exposure drove increases in India and South Africa. Leading APMP-attributable burdens in BRICS were ischaemic heart disease, chronic obstructive pulmonary disease and intracerebral haemorrhage, unlike in the G7 where Alzheimer's disease and other dementias ranked first. Projections indicate the BRICS burden will remain above the global average by 2050, with China and India continuing to bear severe burdens.
CONCLUSION: BRICS is the epicentre of global APMP-attributable burden. The widening gap with the G7 underscores divergent environmental health governance paradigms. Findings call for differentiated strategies within BRICS and enhanced transnational collaboration to curb APMP burden rises and bridge global environmental health equity gaps.