Urban residential energy switching in China between 1980 and 2014 prevents 2.2 million premature deaths

Summary Exposure to air pollution by burning solid fuels (such as coal) for residential cooking and heating in China has caused significant health impacts in the past. The government has implemented measures to replace coal with relatively clean energy sources (e.g., natural gas). However, the scale and scope of health benefits associated with such energy switching in an urban context, when considering both ambient and indoor air quality, remain unclear. Here we used an atmospheric chemical transport model showing that relatively clean energy use increased from 2% to 71% from 1980 to 2014, and although annual premature deaths attributed to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) from urban residential sources increased from 136,000 (87,000–194,000) to 202,000 (117,000–302,000) during the same period, this was primarily due to population growth, urbanization, aging, and background mortality rate changes. In the absence of energy switching, there would have been 2.2 million additional premature deaths. The results provide solid evidence on health benefits of energy switching, suggesting further switching to cleaner energy for expanded health-climate co-benefits.