High-level exposure to indoor air pollutants (IAPs), including volatile organic compounds (VOCs), has substantially contributed to the burden of disease in China over the past two decades. However, the source contributions to the indoor VOC-related health burden remain unknown. This study utilized a novel approach based on positive matrix factorization (PMF) of indoor multipollutant data to estimate the source-specific residential VOC concentrations and associated burden of disease. Indoor concentrations of 39 VOCs were collected repeatedly in different seasons from 2016 to 2017 in 249 residences across nine cities in China. In 2017, the disability-adjusted life years (DALYs) attributable to residential VOC exposure across nine provinces in China reached 134.2 (95% UI: 65.7 – 225.0) per 100,000, resulting in financial costs of 28.1 (13.8 – 47.1) billion CNY. Contributions to indoor VOC concentrations from six indoor sources and three outdoor sources were derived by PMF. The top three sources, i.e., wood building materials and furniture, outdoor vehicle exhaust, and cooking and indoor combustion, accounted for 42.7%, 25.9%, and 11.0% of the VOC-attributable DALYs, which suggests prioritizing controlling these sources in China. This approach can be extended to other IAPs and provide fundamental data for future cost-benefit analysis of source control interventions.

Synopsis This novel method leverages multi-seasonal and multi-room residential VOC measurements to identify emission sources, quantify source-specific exposure concentrations, and estimate source-specific health burden, thus prioritizing the sources needing control.

The authors have declared no competing interest.

This study was funded by The National Key Project of the Ministry of Science and Technology, China (2023YFC3708403), The New Chongqing YC Project (CSTB2024YCJH-KYXM0088), and The National Key Project of the Ministry of Science and Technology, China (Grant No. 2016YFC0700500).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Human Subjects Division (HSD) of University of Washington (UW) waived ethical approval for this work. The UW HSD determined that this study does not involve human subjects (IRB ID: STUDY00023774), and review and approval by the University of Washington Institutional Review Board (IRB) is not required.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors