China's economic growth has significantly increased emissions of tropospheric ozone (O3) precursors, resulting in increased regional O3 pollution. We analyzed data from >1400 monitoring stations and estimated the exposure of population and vegetation (crops and forests) to O3 pollution across China in 2015. Based on WHO metrics for human health protection, the current O3 level leads to +0.9% premature mortality (59,844 additional cases a year) with 96% of populated areas showing O3–induced premature death. For vegetation, O3 reduces annual forest tree biomass growth by 11–13% and yield of rice and wheat by 8% and 6%, respectively, relative to conditions below the respective AOT40 critical levels (CL). These CLs are exceeded over 98%, 75% and 83% of the areas of forests, rice and wheat, respectively. Using O3 exposure–response functions, we evaluated the costs of O3-induced losses in rice (7.5 billion US$), wheat (11.1 billion US$) and forest production (52.2 billion US$) and SOMO35–based morbidity for respiratory diseases (690.9 billion US$) and non–accidental mortality (7.5 billion US$), i.e. a total O3-related cost representing 7% of the China Gross Domestic Product in 2015. © 2019 The Authors

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