Disease-Specific Health Risks Reshape Priorities for Rare-Earth Emissions

Abstract Rare-earth elements (REEs) support energy and technological transitions, yet the history and health relevance of their industrial release remain poorly resolved. We reconstructed emissions of 15 REEs from 13 industrial sectors across China during 1990–2023 and integrated biological networks, human-study evidence and multicity hospitalization records. Annual REE emissions rose from 11.8 t in 1990 to 123.2 t in 2014, then declined by 16.5% by 2023, with emissions concentrated in cement kiln co-processing and cerium (Ce). Biological network analysis identified Ce and gadolinium (Gd) as the elements with the highest disease connectivity, linking to cancer and neurological diseases through pathways including oxidative stress. During 2013–2017, each interquartile-range increase in Ce emissions from cement kiln co-processing solid waste was associated with a relative risk of 2.02 for circulatory disease hospitalization (95% CI, 1.11–3.67), whereas each interquartile-range increase in Ce emissions from coal-fired power plants was associated with a relative risk of 3.12 for respiratory disease hospitalization (95% CI, 1.29–7.53). This large-scale nationwide evidence strongly supported disease-specific, source-focused control and recovery rather than uniform management based on emissions alone.