本研究補(bǔ)充了什么？本報(bào)告首次全面評(píng)估了中國(guó)國(guó)家和省級(jí)燃煤和其他主要空氣污染源造成的疾病負(fù)擔(dān)和預(yù)測(cè)負(fù)擔(dān)。?燃煤是造成環(huán)境PM2.5的最重要因素，占中國(guó)人口加權(quán)PM2.5的40%。鑒于煤炭燃燒對(duì)周圍PM2.5濃度的巨大影響，煤炭燃燒是中國(guó)疾病負(fù)擔(dān)的重要因素，2013年估計(jì)造成36.6萬(wàn)人死亡。?煤炭（155000人死亡）和非煤（95000人死亡）排放的工業(yè)來(lái)源是造成中國(guó)疾病負(fù)擔(dān)的最大部門因素，占2013年環(huán)境PM2.5死亡率的27%。?燃煤和生物質(zhì)家庭固體燃料燃燒也是中國(guó)疾病負(fù)擔(dān)的一個(gè)重要來(lái)源。2013年，國(guó)內(nèi)生物量和煤炭燃燒是造成環(huán)境PM2.5可歸因死亡率的第二大因素，其綜合影響（177000人死亡；2013年環(huán)境PM2.5可歸因死亡率的19%）大于工業(yè)煤（155000人死亡）、交通運(yùn)輸（137000人死亡），或者在發(fā)電廠燃燒煤炭（86500人死亡）。?在四種不同的能源效率和空氣污染控制方案下，人口加權(quán)平均PM2.5暴露量預(yù)計(jì)將顯著減少（BAU1、BAU2、PC1和PC2分別從2013年的54 g/m3降至2030年的50 g/m3、38 g/m3、38 g/m3和27 g/m3）。?盡管減少了這些空氣污染，但隨著人口老齡化，更容易感染與空氣污染最密切相關(guān)的疾病，預(yù)計(jì)到2030年，總體健康負(fù)擔(dān)將增加。?即使在最嚴(yán)格的能源使用和污染控制的未來(lái)情景下，到2030年，煤炭仍將是造成環(huán)境PM2.5和健康負(fù)擔(dān)的最大單一來(lái)源。這一發(fā)現(xiàn)突出表明，迫切需要采取更加積極的戰(zhàn)略，減少燃煤排放，同時(shí)減少其他部門的排放，這些戰(zhàn)略已開(kāi)始納入“十三五”規(guī)劃。?GBD地圖估計(jì)表明，工業(yè)和家庭部門的減排應(yīng)優(yōu)先考慮未來(lái)的能源和空氣質(zhì)量管理戰(zhàn)略。由于家庭燃燒也會(huì)因暴露于空氣污染而導(dǎo)致巨大的疾病負(fù)擔(dān)，因此減少家庭生物量和煤炭排放將特別有利于公眾健康。

WHAT THIS STUDY ADDS ? This report provides the first comprehensive assessment of the current and predicted burdens of disease attributable to coal-burning and other major sources of air pollution in China at the national and provincial levels. ? Coal-burning was the most important contributor to ambient PM2.5, responsible for 40% of population-weighted PM2.5 in China. Given the large impact of coal combustion on ambient PM2.5 concentrations, coal combustion was an important contributor to disease burden in China, causing an estimated 366,000 deaths in 2013. ? Industrial sources, from both coal (155,000 deaths) and noncoal (95,000 deaths) emissions, were the largest sectoral contributor to disease burden in China, responsible for 27% of the mortality attributable to ambient PM2.5 in 2013. ? Household solid fuel combustion, of both coal and biomass, is also an important source of disease burden in China. Domestic biomass and coal combustion were together the next greatest contributor to ambient PM2.5-attributable mortality in 2013 — with a combined impact (177,000 deaths; 19% of the mortality attributable to ambient PM2.5 in 2013) larger than that of industrial coal (155,000 deaths), transportation (137,000 deaths), or coal combustion in power plants (86,500 deaths). ? Under four different energy efficiency and air pollution control scenarios, population-weighted mean exposure to PM2.5 is projected to decrease significantly (from 54 g/m3 in 2013 to 50, 38, 38, and 27 g/m3 in 2030 for BAU1, BAU2, PC1, and PC2, respectively). ? Despite these air pollution reductions, the overall health burden is expected to increase by 2030 as the population ages and becomes more susceptible to diseases most closely linked to air pollution. ? Even under the most stringent energy-use and pollution-control future scenario, coal will remain the single largest source contributor to ambient PM2.5 and health burden in 2030. This finding highlights the urgent need for even more aggressive strategies to reduce emissions from coal combustion along with reductions in emissions from other sectors, strategies that are beginning to be incorporated in the Thirteenth Five-Year Plan. ? The GBD MAPS estimates suggest that emissions reductions in the industrial and domestic sectors should be prioritized for future energy and air quality management strategies. Because domestic combustion also leads to a large disease burden due to household air pollution exposure, reductions in domestic biomass and coal emissions would be particularly beneficial to public health.