Plant-Level Health Benefits from Decarbonizing the Iron and Steel Industry in China.

Decarbonizing the iron and steel industry (ISI) reduces air pollutant emissions, yielding substantial public health cobenefits. Existing assessments fail to account for plant-level heterogeneity in production routes and geographic settings─critical determinants of health impacts─hindering the formulation of targeted decarbonization strategies that maximize health gains. Here, by integrating a facility-level emission inventory with inverse atmospheric modeling, we estimate that the Chinese ISI emits 1.56 Pg of CO2 and 0.85 Tg of PM2.5 annually, with 147,000 (IQR: 121,000-184,000) annual PM2.5-attributable premature deaths linked to ISI emissions, and the health burdens varying by 77,500-fold across individual plants. Blast furnace-basic oxygen furnace (BF-BOF) processes impose 3.8 times higher mortality intensity than electric arc furnaces (EAFs) (172 vs 45 deaths per 1000 Gg steel produced), with 80% of mortality concentrated in 21% of plants─predominantly large BF-BOF complexes in densely populated eastern China. Strategically relocating 30 Tg eastern BF-BOF capacity (3.6% of the national total) to scrap-based EAFs in low-carbon southwestern power grids could prevent 12,300 (IQR: 9500-16,100) annual deaths (8.4% reduction), generating USD 24.5 (IQR: 20.0-30.4) billion in combined climate-health benefits. Natural gas-based direct reduced iron-electric arc furnace (DRI-EAF) integration offers a scrap-independent alternative, achieving ∼50% lower mortality than BF-BOF. These findings advance targeted strategies to optimize health outcomes during ISI decarbonization in China.