Source sector and fuel contributions to ambient PM2.5 and attributable mortality across multiple spatial scales

Ambient fine particulate matter (PM2.5) is the world’s leading environmental health risk factor. Reducing the PM2.5 disease burden requires specific strategies that target dominant sources across multiple spatial scales. We provide a contemporary and comprehensive evaluation of sector- and fuel-specific contributions to this disease burden across 21 regions, 204 countries, and 200 sub-national areas by integrating 24 global atmospheric chemistry-transport model sensitivity simulations, high-resolution satellite-derived PM2.5 exposure estimates, and disease-specific concentration response relationships. Globally, 1.05 (95% Confidence Interval: 0.74–1.36) million deaths were avoidable in 2017 by eliminating fossil-fuel combustion (27.3% of the total PM2.5 burden), with coal contributing to over half. Other dominant global sources included residential (0.74 [0.52–0.95] million deaths; 19.2%), industrial (0.45 [0.32–0.58] million deaths; 11.7%), and energy (0.39 [0.28–0.51] million deaths; 10.2%) sectors. Our results show that regions with large anthropogenic contributions generally had the highest attributable deaths, suggesting substantial health benefits from replacing traditional energy sources. Ambient fine particulate matter (PM2.5) is one of the most important environmental health risk factors in many regions. Here, the authors present an assessment of PM2.5 emission sources and the related health impacts across global to sub-national scales and find that over 1 million deaths were avoidable in 2017 by eliminating PM2.5 mass associated with fossil fuel combustion emissions.