{
  "abstract": "Background Ambient fine particulate matter (PM 2.5) pollution (APMP) is a leading global mortality risk factor. Its long-term trends, drivers and future burden trajectories in emerging economies remain inadequately understood. This study provides the first systematic assessment of spatiotemporal patterns, key drivers and projections to 2050 of APMP-attributable health loss in BRICS countries (Brazil, Russia, India, China and South Africa) from 1990 to 2023, benchmarked against global and Group of Seven (G7) trends.Methods Using Global Burden of Disease 2023 data, this study analysed APMP-attributable deaths and disability-adjusted life years (DALYs) via absolute numbers and age-standardised rates. The multidimensional framework included joinpoint regression, age-period-cohort (APC) modelling, Das Gupta decomposition, disease spectrum ranking and Bayesian-APC projection.Results In 2023, APMP caused 2.955 million deaths in BRICS (59% of the global total). Age-standardised mortality and DALY rates remained higher than global averages and increased since 1990, contrasting with sustained declines in the G7. Substantial heterogeneity existed: India’s burden was heaviest and growing, China’s remained high but stabilised, while Brazil and Russia achieved marked reductions. APC modelling revealed pronounced mortality increases in older ages (especially 95+ years in China and India). Decomposition identified population ageing as the key driver in BRICS, especially China; population growth and deteriorating epidemiological conditions under high exposure drove increases in India and South Africa. Leading APMP-attributable burdens in BRICS were ischaemic heart disease, chronic obstructive pulmonary disease and intracerebral haemorrhage, unlike in the G7 where Alzheimer’s disease and other dementias ranked first. Projections indicate the BRICS burden will remain above the global average by 2050, with China and India continuing to bear severe burdens.Conclusion BRICS is the epicentre of global APMP-attributable burden. The widening gap with the G7 underscores divergent environmental health governance paradigms. Findings call for differentiated strategies within BRICS and enhanced transnational collaboration to curb APMP burden rises and bridge global environmental health equity gaps.",
  "authors": [
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Shangkun Si"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Shizhe Deng"
    },
    {
      "affiliations": [
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Yueyang Zhang"
    },
    {
      "affiliations": [
        "Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"
      ],
      "name": "Xingxin Wang"
    },
    {
      "affiliations": [
        "Qilu Hospital of Shandong University, Jinan, Shandong, China"
      ],
      "name": "Gonglei Yue"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China"
      ],
      "name": "Yiyang Sun"
    },
    {
      "affiliations": [
        "Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Hai Lu"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Junyang Li"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Feng Tao"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Mengxuan Lin"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Zhexu Dong"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Bifang Zhuo"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China"
      ],
      "name": "Li Li"
    },
    {
      "affiliations": [
        "Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Bo Pang"
    },
    {
      "affiliations": [
        "Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Xinyao Jin"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Zhihong Meng"
    },
    {
      "affiliations": [
        "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China",
        "National Clinical Research Center for Chinese Medicine, Tianjin, China",
        "Tianjin University of Traditional Chinese Medicine, Tianjin, China"
      ],
      "name": "Jiangwei Shi"
    }
  ],
  "title": "Impact of ambient fine particulate matter (PM2.5) pollution on disease burden in BRICS from 1990 to 2023: evidence from the Global Burden of Disease Study 2023",
  "uid": "bc3c24b1-274f-564d-8d19-6bc08cc739b3"
}