Last fall, a startling new report revealed that air pollution caused an estimated 3.2 million premature deaths worldwide in 2010. Now, thanks to a new analysis by our friends at the Health Effects Institute (HEI), we understand that nearly 40 percent of the world's premature deaths attributable to air pollution (1.2 million people) occurred in China.

Particulate matter is now the fourth-leading cause of death in China, behind dietary risks, high blood pressure, and smoking.  And, unless current trends change, urban air pollution is projected to be the number one killer worldwide by 2050. (It's worth noting that this is problem is not unique to China—HEI also reports that roughly 800,000 people die prematurely every year in India and other South Asian countries).

©Gary Braasch 

Now, those who have been following Beijing's "airpocalypse" are beginning to wonder: what effect is China's pollution having on children and the elderly?

First, the kids.

The many reasons why air pollution affects children so strongly are well-understood.  There are developmental reasons—their lungs are still growing, and the respiratory defenses that adults use to fight infections are still developing.  There are also behavioral reasons—children are more active and spend more time outdoors than adults, both of which mean that they take deeper breaths, bringing polluted air into the deepest recesses of their lungs.

Beijing Hutong ©Anthony Suen

In the early 2000s, NRDC supported an extensive study on the link between air pollution and children's health in China. Led by Dr. Frederica Perera, Director of the Columbia Center for Children's Environmental Health, a group of scientists examined two sets of women who delivered babies in Chongqing – a major city in Southwest China – before and after a heavily polluting coal-fired power plant was torn down.

Photo of Chongqing ©Deliang Tang

The study found that prenatal exposure to coal-burning emissions was associated with significantly lower average developmental scores and reduced motor development at age two.

Photo taken in Chongqing ©Deliang Tang

Conversely, the study found significant and immediate improvements in the health of the babies who were born after the closing of the power plant (full report available here). There have also been other studies with similar results, which Christina Larson of Bloomberg Businessweek captures in her article.

I remember visiting Chongqing in 2006 and meeting the children involved in the study. It broke my heart to realize that the children born before the power plant was torn down were starting life at a significant disadvantage and didn't even know it.

Here is me (in red) visiting the children in Chongqing ©Deliang Tang

Now, the elderly. 

Studies show that the elderly are particularly vulnerable to the adverse effects of air pollution. Here's why:  As people age, their bodies are less able to compensate for the pollution’s harmful impacts. This translates into aggravated heart disease and stroke, lung diseases such as chronic obstructive pulmonary disease and asthma, and diabetes.  All of this adds up to increased medication use, more visits to health care providers, more admissions to emergency rooms and hospitals, and more premature deaths.

China has come a long way, and has seized January's spate of air pollution as an opportunity to announce plans for new regulations on air quality and gasoline emission standards (though they haven't issued any regulations yet). The Ministry of Environmental Protection is also considering setting binding PM 2.5 targets.  And just last week, China announced that it will spend 100 billion yuan (US $20 billion) over the next three years to tackle Beijing's pollution problems.

It looks like China's new leaders may be ready to breathe new momentum into the country's environmental protection efforts. For example, Premier Li Keqiang vowed to clean up the environment and even encouraged the public to hold him personally accountable in his inaugural speech. However, it remains to be seen whether China's top leaders will be able to deliver on their promises.  Local officials and businesses consistently ignore or try to skirt the central government's environmental policies, in part because penalties for non-compliance are often too low to pressure factories into installing pollution-reduction technologies. Moreover, Beijing continues to rate the job performance of local officials primarily on GDP growth, rather than on environmental protection.

China must reform its incentive and promotion systems in order to thwart corruption and non-compliance, and China must act now.  The pollution just keeps getting worse:  China's official news agency reported this week that China has just suffered its smoggiest March in 52 years. In Beijing, two major air pollutants—nitrogen dioxide and particulate matter between 2.5 and 10 micrometers in diameter—increased by almost 30 percent during the first three months of 2013 compared to the same period from last year. We recently examined 24-hour averages of PM 2.5 levels during a "typical" week in China and found Beijing and Shanghai to consistently out-pollute two of the most polluted cities in the U.S., by far. 

PM 2.5 24-hour averages in micrograms/cubic3 (March 2013)

World Health Organization standard: 25 micrograms/cubic3

*Washington, D.C. data is preliminary only and not yet verified by QA/QC checks

China's environmental problems are reaching crisis-level on so many fronts: air pollution, water pollution, soil contamination, food safety. The public is becoming increasingly more aware and vocal about these problems. Recently, some Chinese officials are beginning to shift away from the "growth above anything else" mentality because they too have become victims of the worsening pollution and worry what it will do to the future of their children and their parents.

Perhaps the old Chinese saying that “the mountain is high and the Emperor is far away” is losing some of its meaning now that nobody in China can get far away from pollution anymore.

(This was coauthored by my colleague Christine Xu, and my former colleague Rich Kassel, now Senior Vice President at Gladstein, Neandross & Associates.)