Assessment of short-term ozone-related mortality burden and health-related economic losses in a typical industrial city: a case study of Zibo, China

Background Given its status as a key region under China’s air pollution prevention and control framework, Zibo is experiencing severe O₃ pollution – a problem requiring prompt mitigation. Objective This study aimed to quantify the temporal variation of MDA8-O₃-P90 concentrations and the associated mortality burden and health-related economic losses in Zibo, a representative industrial city in Shandong Province, and to inform chronic disease prevention and O₃ pollution control strategies. Methods Based on Zibo’s 2014–2024 O₃ monitoring data, socioeconomic statistical indicators, and resident mortality surveillance data in Zibo from 2014 to 2024, this study applied the log-linear health impact assessment formula and the VSL model approach to estimate the number of deaths attributable to O₃ exposure and the associated economic losses for all-cause, cardiovascular, and respiratory mortality, and conducted scenario analyses under different O₃ control targets to evaluate potential health benefits and avoided economic losses. Results The results show that the annual MDA8-O₃-P90 concentration in Zibo from 2014 to 2024 ranged from 172 to 204 μg/m 3 , and the annual average concentration increase rate is 0.54%. O₃ pollution has caused serious health hazards and economic losses to the residents of Zibo: From 2014 to 2024, the health economic losses caused by O₃ pollution due to all-cause, cardiovascular diseases, and respiratory diseases totaled 11.23 (6.12–16.27) billion, 7.01 (2.62–11.31) billion, and 1.83 (1.09–3.42) billion respectively, accounting for 0.26%, 0.15%, and 0.04% of the local GDP, with the health losses caused by cardiovascular diseases accounting for the main part. If the annual MDA8-O₃-P90 concentration can be reduced to the primary-standard threshold of 100 μg/m 3 specified in Chinese national ambient air quality standard GB 3095–2012, the number of deaths caused by O₃ pollution in Zibo will decrease by 7,054, and the economic losses will decrease by 8.37 billion. Conclusion From 2014 to 2024, Zibo’s annual MDA8-O₃-P90 exhibited a fluctuating trend: it rose to a peak in 2019, decreased until 2021, and rebounded moderately afterwards. Both ozone-attributable mortality and economic losses in 2024 remained higher than in 2014. Substantial health and economic benefits would have been achievable if ozone concentrations had been reduced stricter policy targets.