Consumption-based PM2.5-related premature mortality in the Beijing-Tianjin-Hebei region.

The Beijing-Tianjin-Hebei (BTH) region, which has a resource-dependent economy dominated by clusters of heavy industries, has long borne the highest PM2.5 pollution levels in China, prompting serious concerns about the region's disease burden. Pollution-intensive industries in the BTH region not only meet local consumer demands but also those of other places via the supply chain. In the present study, we combined a multi-region input-output model with adjoint source sensitivity modeling technique at a high resolution (0.25° × 0.3125°) to apportion PM2.5-related mortality risks in the BTH to consuming areas and sectors. The model predicted that exposure to ambient PM2.5 caused 0.12 million premature deaths (95% confidence interval: 0.08-0.15) in the BTH region in 2013. The adjoint source sensitivity results showed that only 46% of the total premature deaths were attributable to local consumption. The top contributors of local consumption were rural households and the agricultural sector in Hebei, and service sector in Beijing. Consumption of other domestic regions and international export accounted for 25% of the total premature deaths in the BTH, mainly to support consumption of manufacturing and construction products of these outer regions. Atmospheric transport of pollutants, mainly from the surrounding areas, accounted for the remaining 29% of total deaths in BTH. Our findings underline the consumption-based driven force of BTH's pollution and associated health impacts, which may facilitate the joint control actions among the BTH region and its surrounding areas from a comprehensive perspective.