Plant-Level Health Benefits from Decarbonizing the Iron and Steel Industry in China

-attributable premature deaths linked to ISI emissions, and the health burdens varying by 77,500-fold across individual plants. Blast furnace-basic oxygen furnace (BF-BOF) processes impose 3.8 times higher mortality intensity than electric arc furnaces (EAFs) (172 vs 45 deaths per 1000 Gg steel produced), with 80% of mortality concentrated in 21% of plants─predominantly large BF-BOF complexes in densely populated eastern China. Strategically relocating 30 Tg eastern BF-BOF capacity (3.6% of the national total) to scrap-based EAFs in low-carbon southwestern power grids could prevent 12,300 (IQR: 9500-16,100) annual deaths (8.4% reduction), generating USD 24.5 (IQR: 20.0-30.4) billion in combined climate-health benefits. Natural gas-based direct reduced iron-electric arc furnace (DRI-EAF) integration offers a scrap-independent alternative, achieving ∼50% lower mortality than BF-BOF. These findings advance targeted strategies to optimize health outcomes during ISI decarbonization in China.