201906中国石油消费总量控制的 健康效应分析ANALYSIS ON THE HEALTH BENEFIT FROM AN OIL CAP IN CHINA油控研究项目真实成本课题组执行报告EXECUTIVE REPORT本课题属于中国石油消费总量控制和政策研究项目（下文简称油控研究项目）子课题之一。中国石油消费总量控制和政策研究项目( 油控研究项目 )中国是世界第二大石油消费国和第一大石油进口国。石油是中国社会经济发展的重要动力，但石油的生产和消费对生态环境造成了严重破坏；同时，石油对外依存度上升也威胁着中国的能源供应安全。为应对气候变化和减少环境污染，自然资源保护协会（ NRDC）和能源基金会中国（ EF China）作为协调单位，与国内外政府研究智库、科研院所和行业协会等十余家有影响力的单位合作，于 2018 年 1 月共同启动了“中国石油消费总量控制和政策研究”项目（简称油控研究项目），促进石油资源安全、高效、绿色、低碳的可持续开发和利用，助力中国跨越“石油时代”，早日进入新能源时代，为保障能源安全、节约资源、保护环境和公众健康以及应对气候变化等多重目标做出贡献。自然资源保护协会（ NRDC）是一家国际非盈利非政府环保机构，拥有逾 140 万会员及支持者。自 1970 年成立以来，以环境律师、科学家及环保专家为主力的 NRDC 员工们一直为保护自然资源、公共健康及环境而进行不懈努力。 NRDC 在美国、中国、加拿大、墨西哥、治理、哥斯达黎加、欧盟、印度等国家及地区开展工作。请登录网站了解更多详情 nrdc。系列报告石油开采利用的水资源外部成本研究中国石油真实成本研究中国传统燃油汽车退出时间表研究3中国石油消费总量控制的健康效应分析油控研究项目系列报告中国石油消费总量控制的健康效应分析ANALYSIS ON THE HEALTH BENEFIT FROM AN OIL CAP IN CHINA执行报告EXECUTIVE REPORT主要作者潘小川 武子婷 王战油控研究项目真实成本课题组2019 年 06 月油控研究项目系列报告4目录Executive Summary 5专业术语表 7前言 81. 石油相关污染对人群健康的危害 91.1 石油相关大气污染的健康危害1.2 石油相关水污染的健康危害1.3 塑料污染的健康危害2. 石油相关大气污染的健康成本核算 182.1 核算方法2.2 量化分析2.3 不确定性分析3. 结论及展望 323.1 主要结论3.2 政策建议3.3 展望参考文献 365中国石油消费总量控制的健康效应分析Executive SummaryBackgroundsPetroleum is an indispensable raw material and a basic form of energy in China. It has an important strategic position within the national economy and is closely related to industrial development and daily life. With the advancement of industrialization and the improvement of Chinas energy structure, total petroleum consumption continues to rise. The impact of petroleum extraction, refining and consumption on the ecological environment and public health cannot be underestimated. Some previous studies have showed that the extraction, refining and consumption of petroleum could release a large number of harmful pollutants into the atmosphere, freshwater bodies and oceans, endangering the lives and health of the public. However, few studies have comprehensively evaluated the health hazards caused by the petroleum industry chain, and there is a lack of data on economic losses caused by petroleum-related pollution. What are the health impacts and economic losses caused by petroleum-related pollution? This has become a central question that the relevant departments urgently need to address. Based on the above information, this study chose 2015 as the baseline year from which to evaluate the health impacts and economic losses of petroleum-related pollution qualitatively and quantitatively, and to provide scientific reference for formulating the national total petroleum consumption control policy.MethodsIn this study, we summarized the health hazards of petroleum-related air, water and plastic pollution to public health, and quantitatively evaluated the health costs of petroleum-related air pollution.In the first part, we gathered the extensive literature on petroleum-related air pollution, water pollution and plastic pollution, with a focus on the health impacts of petroleum-related pollution. We then conducted a literature review to summarize the health hazards caused by petroleum extraction, refining, manufacture and consumption.In the latter part, we collected air pollution data, health outcome data, pollutant apportionment data and statistical life value for 31 provinces and 74 cities in China. After integration exposure-reaction (IER) modeling and excessive mortality calculation, 油控研究项目系列报告6we evaluated the 2015 health costs of petroleum-related air pollution in 31 provinces and 74 cities.ResultsThe literature review showed that petroleum extraction, refining, manufacture and consumption could lead to serious air pollution, water pollution and plastic pollution, endangering the respiratory, cardiovascular, endocrine and nervous systems of the exposed population. In addition, some carcinogenic pollutants could significantly increase the risk of cancer.Our results showed that in 2015, the number of excess deaths due to petroleum-related air pollution in 31 provinces was 195 thousand and the related economic losses were 150.68 (95%CI: 98.31, 229.19) billion yuan. The health costs per unit of petroleum consumption was 278.6 yuan/ton. In 74 representative cities, the health costs of petroleum-related air pollution were 88.89 (95%CI: 57.97, 135.16) billion yuan, and the economic losses of Beijing-Tianjin-Hebei Region, Yangtze River Delta Region and Pearl River Deltas Region accounted for 64.6% of the total economic losses in 74 cities.Uncertain analysis1. At present, there is no standard value for VSL in China. When calculating the health costs of petroleum-related consumption, different parameters can cause the results of the study to differ significantly.2. For the limited conditions of data, the air pollution data in our study was based on the national environmental monitoring sites and did not utilize individual exposure assessment.3. Due to the limitation of data conditions, our study failed to quantitatively evaluate the health cost of petroleum-related water and plastic pollution and underestimated the real health costs of petroleum.ConclusionPollutants discharged from petroleum extraction, refining and consumption processes have significant health impacts on the exposed population, creating a heavy burden of health problems and economic losses. The relevant government departments should formulate policies to control the total consumption of petroleum, focusing on strengthening the prevention and control of petrochemical and vehicle pollution in economically developed areas, so as to minimize the health cost for the public due to petroleum-related pollution.7中国石油消费总量控制的健康效应分析专业术语表英文缩写及英文名称中文名称术语解释OR (Odds Ratio)比值比、优势比病例组中暴露人数与非暴露人数的比值除以对照组中暴露人数与非暴露人数的比值。反映暴露对发病（死亡）是保护因素/有害因素/无作用因素。RR (Relative Risk)相对危险度反映暴露因素与发病（死亡）关联强度的指标。RR表明暴露组发病或死亡的风险是非暴露组的多少倍。RR值越大，表明暴露因素的健康效应越大，暴露因素与结局关联的强度越大。CI (Condence Intervals)置信区间指在某一置信水平上，参数真值的取值范围。油控研究项目系列报告8前言石油是我国不可或缺的基础能源和工业原料，在国民经济中具有重要的战略地位，与工业发展和人民日常生活密切相关。随着我国工业化的推进及能源结构的改善，石油消费总量持续上升。自 2014 年起，我国石油消费总量已超过 5 亿吨，是世界石油进口和消费量最大的国家之一。石油的开采、加工和消费过程会向大气、淡水和海洋中释放大量有害物质，危害生态环境和公众健康。已有研究表明，大规模的石油消耗产生了大量颗粒物、臭氧和氮氧化物等污染物，导致了严重的大气污染问题，危害人体的呼吸、心血管、神经、免疫和生殖等多个系统1。石油产业链带来的水污染问题也不容小觑，不仅严重危害了受污染流域周边居民的生命健康，导致心血管疾病、内分泌功能障碍甚至是癌症的发生，还破坏了水域生态系统，造成鱼虾等水生生物大量死亡，对我国的水产经济存在不良影响。此外，塑料污染问题也越来越受到社会各方面重视。塑料是重要的石油化工产品，在给人类生活带来极大便利的同时，也造成了严重的环境污染问题。大量被随意丢弃的塑料制品可在环境中降解为有害颗粒，通过生物链传递进入人体，引起一系列不良反应。石油相关污染带来的健康危害贯穿了整个产业链的所有环节，造成了沉重的疾病负担。然而，目前鲜有研究综合、系统的评估整个石油产业链带来的健康危害，也缺乏石油相关污染造成的经济损失数据。石油相关污染对人群健康存在哪些不良影响？造成了多大的经济损失？已经成为了国家有关部门迫切需要回答的问题之一。基于上述背景，本研究对石油相关污染的不良健康影响进行综述，并定量评估2015 年我国石油相关污染造成的健康经济损失，旨在揭示石油的真实成本，为合理有效控制石油消费总量、保障生态文明和公众健康提供重要的理论基础。1石油相关污染对人群 健康的危害油控研究项目系列报告10本章节主要介绍了石油加工、开采和消费过程产生的大气污染、水污染和塑料污染对暴露人群的健康效应，综述石油相关污染对人群健康的危害。1.1 石油相关大气污染的健康危害石油是重要的化工原料，其开采、加工和使用过程会向自然界释放多种大气污染物，包括颗粒物、一氧化碳、氮氧化物、挥发性有机物和臭氧等，对暴露人群的呼吸、心血管、神经、免疫和生殖等多个系统存在不良影响1，因此受到了社会各方面的高度重视。1. 颗粒物（ Particulate Matter）大气颗粒物是造成雾霾的元凶，根据其粒径大小可分为总悬浮颗粒物（ Total Suspended Particulate, TSP）、可吸入颗粒物（ Particulate matter less than 10 µm in aerodynamic diameter, PM10）和细颗粒物（ Particulate matter less than 2.5 µm in aerodynamic diameter, PM2.5），其中对人体健康影响较大的颗粒物主要为 PM10和 PM2.5。颗粒物成分较为复杂，具有较强的吸附能力，可以吸附各种金属粉尘、强致癌物和病原微生物，随气流进入人体呼吸道，透过肺泡达到体内其他器官，导致多种疾病发生。与 PM10相比， PM2.5粒径较小，更容易携带大量有害物质进入机体，因此引起的健康危害更大。自上世纪 80 年代以来，大量流行病学研究发现，短期暴露于 PM2.5可显著增加呼吸系统疾病、心血管疾病和癌症等疾病的死亡风险2；长期接触 PM2.5可能是我国成年人高血压3, 4和肺功能下降5, 6的重要原因。据全球疾病负担研究（ Global Burden of Diseases, GBD）估计， 2010 年我国室外颗粒物污染导致了 120 万人过早死亡及 2500 万伤残调整生命年损失7。呼吸系统影响：颗粒物随气流进入人体后，可破坏呼吸道的防御屏障，通过氧化应激和炎症反应对肺部造成损伤。一方面，颗粒物进入呼吸道底部后，会被巨噬细胞吞噬，在颗粒物的刺激下，巨噬细胞可释放一系列细胞因子和炎症因子，导致炎症的发生。另一方面，颗粒物可以吸附多种有害物质，直接诱导细胞氧化应激损伤。此外，颗粒物还可以携带大量的致病微生物进入人体，导致呼吸道感染的发生率显著增加。已经有大量流行病学研究发现大气颗粒物与呼吸系统疾病发生率和死亡率均存在正相关，北京市一项研究发现，大气 PM2.5浓度每上升 10 g/m³，下呼吸道感染的住院数增加 0.84%8。Chen 等9人的研究发现，大气颗粒物是哮喘发生的独立危险因素，与儿童咳嗽变异性