With the rapid advancement of industrialization without effective supervision, industrial aquatic toxic metal (TM) emissions pose threats to human health in China. Due to differences in socioeconomic development, the regional disparity of industrial aquatic TM emissions is obvious nationwide. In this study, the human health impacts (HHIs) of industrial aquatic TM emissions (i.e., mercury (Hg), cadmium (Cd), hexavalent chromium (Cr(VI)), lead (Pb), and arsenic (As)) in the 31 provinces of China were evaluated based on the ReCiPe method, and the driving factors affecting HHIs from 2000 to 2015 were decomposed using the logarithmic mean Divisia index (LMDI) method. The results showed that the HHIs gradually decreased, with more than an 80% decrease from 2000 to 2015. The order of the TMs contributing to the national HHIs in 2015 was as follows: As (79.5%) > Cr(VI) (19.6%) > Hg (0.4%) > Pb (0.2%) = Cd (0.2%), and 21 (68%) provinces were dominated by industrial aquatic As emissions. Economic development is the major driving factor of the increase in HHIs, while the HHI strength and wastewater discharge intensity are the key driving factors causing reductions in the HHIs. Hunan, Inner Mongolia, Hubei, and Jiangxi accounted for approximately 55% of the total HHIs in 2015. Some suggestions for reducing HHIs based on the local realities of different provinces were put proposed considering two aspects: economic strategy and technical capability.
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