Health Burden and Driving Force Changes Due to Exposure to PM_2.5 and O₃ from 2014 to 2060 in a Typical Industrial Province, China

While air quality in China has improved significantly in recent years, the population is becoming increasingly vulnerable to air pollution due to the aging population. In this study, we assessed premature deaths attributable to long- and short-term exposures to PM2.5 and O-3, as well as their driving forces in Shandong from 2014 to 2060 based on county-level near-real-time air pollutant concentration datasets and projected concentrations of PM2.5 and O-3. We found that the concentrations of PM2.5 and O-3 in most districts and counties from Shandong are still higher than the corresponding concentration limit of Grade II. Premature mortality caused by long- and short-term exposures to PM2.5 decreased by 13,045 and 8092 in 2020 compared with those in 2014, respectively. Furthermore, premature mortality attributable to short-term exposure to O-3 was 36.08% higher than that due to short-term exposure to PM2.5 in 2020. The results of the driving force analysis indicate that the health benefits brought about by the improvement in air quality have been offset by the changes in population age structure. In the future, the increase in O-3 concentration and population aging are the top two driving forces having adverse effects on the health burden. This study provides support for controlling the health risks of PM2.5 and O-3 pollution, especially for the development of dual-pollutant concentration targets and synergistic control strategies.