Shipping-related pollution decreased but mortality increased in Chinese port cities

The maritime industry boosts the prosperity of port cities but also exacerbates premature death associated with air pollution. In recent years, Chinese port cities have undergone profound multifaceted transformations on emissions control and demographic characteristics, leading to an unclear relationship between shipping emissions and health burden. Here we built a comprehensive evaluation framework to investigate the impacts of ships in Chinese port cities from 2016 to 2020. We found shipping-related fine particulate matter (PM_2.5) decreased across all port cities under shipping sulfur emissions control. However, nationwide shipping-related mortality associated with long-term PM_2.5 exposure increased by 11.4% to 48,300 deaths in 2020. A trend of mitigation was observed in coastal cities, but a trend of aggravation in port cities along inland rivers due to varying antagonisms between shipping emissions reductions and regional demographic changes. Population clustering in port cities necessitates further locality-specific control of shipping emissions.