The "Belt and Road Initiative" (BRI) proposed by China in 2013 aims to create more opportunities for common development and cooperation in accordance with infrastructure development and trade activities worldwide. Previous studies have evaluated the impacts of BRI countries on the economy or PM2.5 emissions but have overlooked the impacts caused by PM2.5 emissions, and have seldom combined economic impacts and PM2.5-related health impacts (PHI) for analysis. This study compared embodied PHI (EPHI) and embodied value added of BRI countries with those of China based on a global multiregional input-output model. First, it was found that considering the EPHI was beneficial for revealing existing problems that there were great differences between the embodied PM2.5 emissions and the EPHI between BRI countries and China. China imported embodied PM2.5 emissions from BRI countries (2,584,400 kg), but exported EPHI to them (132,864 disability-adjusted life year losses (DALY)). Second, it was revealed that the BRI countries as a whole were net EPHI importers (51,426.83 DALY) but net embodied value added exporters (gaining US$773,570,000). Finally, it was indicated that when considering EPHI intensity, there was a significant difference among BRI countries in gaining equal economic benefits from China (ranging from 0.12 DALY/104 US$ for Singapore to 2110.24 DALY/104 US$ for Ukraine). This study may promote policies regarding trade structure optimization in BRI countries and PHI mitigation, while maximizing economic benefits.

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