Evaluating the health impact of air pollution control strategies and synergies among PM2.5 and O3 pollution in Beijing-Tianjin-Hebei region, China

Since 2013, China has implemented a series of strict Air Pollution Control Strategies (APCS) to mitigate environmental and health risks associated with ambient fine particulate matter (PM2.5). However, while APCS sets clear targets for PM2.5 concentration, it lacks quantitative control over O3 levels. Most existing studies have focused on nation-wide health assessments. Therefore, by conducting a coupled framework using health assessment and decomposition method, the spatiotemporal variation in deaths attributable to PM2.5 pollution, as well as the role of APCS and the synergies between PM2.5 and O3 on PM2.5 concentration and health impacts in the Beijing-Tianjin-Hebei (BTH) region have been explored. The result showed that: (1) PM2.5 concentration in the BTH region decreased by 68.2%, with a reduction of 45,833 (95% Confidence Interval [CI]: 33,808, 50,069) deaths over the period. However, both concentrations and mortality remained high, indicating a need for faster reductions. (2) End-of-pipe control contributed the most to reducing PM2.5 concentrations and deaths, though the gaps between source control and end-of-pipe control is narrowing. (3) The synergistic effects of O3 and PM2.5 in reducing concentration and mortality have increased, becoming a significant driver of PM2.5-related health impacts. Our study emphasizes the future importance of implementing refined, diverse emission reduction measures and coordinating efforts to reduce both O3 and PM2.5 emissions, which are crucial for achieving the Sustainable Development Goals (SDGs) and advancing the "Beautiful China" and "Healthy China" initiatives.