Air　pollution　has　been　a　severe　issue　in　China.　Exposure　to　PM2.5　has　adverse　health　effects　and　causes　economic　losses.　This　study　investigated　the　economic　impact　of　exposure　to　PM2.5　pollution　using　monthly　city-level　data　covering　88.5　million　urban　employees　in　2016　and　2017.　This　study　mainly　focused　on　three　expenditure　indicators　to　measure　the　economic　impact　considering　lower　respiratory　infections　(LRIs),　coronary　heart　disease　(CHD),　and　stroke.　The　results　show　that　a　10　µg/m3　increase　in　PM2.5　would　cause　total　monthly　expenses　of　LRIs,　CHD,　and　stroke　to　increase　by　0.226%,　0.237%,　and　0.374%,　respectively.　We　also　found　that　LRI,　CHD,　and　stroke　hospital　admissions　increased　significantly　by　10%,　8.42%,　and　5.64%,　respectively.　Furthermore,　the　total　hospital　stays　of　LRIs,　CHDs,　and　strokes　increased　by　2.49%,　2.　51%,　and　1.64%,　respectively.　Our　findings　also　suggest　heterogeneous　impacts　of　PM2.5　exposures　by　sex　and　across　regions,　but　no　statistical　evidence　shows　significant　differences　between　the　older　and　younger　adult　subgroups.　Our　results　provide　several　policy　implications　for　reducing　unequal　public　health　expenditures　in　overpolluted　countries.　[Figure　not　available:　see　fulltext.]　©　2023,　Higher　Education　Press.