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Many studies have reported that air pollution, especially fine particulate matter (PM 2.5 ), has a significant impact on health and causes economic loss. Gansu Province is in the northwest of China, which is a typical economically underdeveloped area. However, few studies have evaluated the economic loss of PM 2.5 related to health effects in this province. In this study, a log-linear exposure-response function was used to estimate the health impact of PM 2.5 in 14 cities in Gansu Province from 2015 to 2017, and the amended human capital (AHC) and cost of illness (COI) method were used to evaluate the related economic loss caused by the health impact from PM 2.5 . The results show that the estimated total number of health endpoints attributed to PM 2.5 pollution were 1,644,870 (95%CI: 978,484-2,215,921), 1,551,447 (95%CI: 917,025-2,099,182) and 1,531,372 (95%CI: 899,769-2,077,772) in Gansu Province from 2015 to 2017, respectively. Correspondingly, the economic losses related to health damage caused by PM 2.5 pollution were 42,699 (95%CI: 32,380-50,768) million Chinese Yuan (CNY), 43,982 (95%CI: 33,305-52,386) million CNY and 44,261 (95%CI: 33,306-52,954) million CNY, which were equivalent to 6.45% (95%CI: 4.89%-7.67%), 6.28% (95%CI: 4.75%-7.48%), and 5.93% (95%CI: 4.64%-7.10%) of the region Gross Domestic Product (GDP) from 2015 to 2017, respectively. It could be seen that the proportions of health economic loss to GDP were generally high, although the proportion had a slight downward trend. The economic loss from chronic bronchitis and all-cause mortality accounted for more than 94% of the total economic loss. The health impact, economic loss and per capita economic loss in Lanzhou, the provincial capital city of Gansu, were obviously higher than other cities from the same province. The economic loss in Linxia accounted for the highest proportion of GDP. The health impacts in the Hexi region, including the cities of Jiuquan, Jiayuguan, Zhangye, Jinchang and Wuwei, were generally lower, but the economic loss and per capita economic loss were still higher. We also found that urbanization and industrialization were highly correlated with health economic loss caused by PM 2.5 pollution. In conclusion, the PM 2.5 -related health economic burden in Gansu Province was serious. As an economically underdeveloped region, it was very important to further adopt rigid and effective pollution control policies.

Health and Economic Loss Assessment of PM2.5 Pollution during 2015–2017 in Gansu Province, China