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Cleaner air could have saved at least 216,000 European lives in 2019

Foto/Photo: Colourbox

Air pollution continued to cause a significant burden of premature death and disease in Europe in 2019. A European Environment Agency (EEA) analysis, published today, shows that improving air quality to the levels recently recommended by the World Health Organization (WHO) could prevent more than half of the premature deaths caused by exposure to fine particulate matter.

The briefing “Health impacts of air pollution in Europe, 2021” presents updated estimates on how three key pollutants – fine particulate matter, nitrogen dioxide, ground-level ozone – affected Europeans’ health in 2019. The briefing also assesses the potential benefits of improving air quality towards new guideline levels recommended by the World Health Organization (WHO).

Key messages

  • In 2019, air pollution continued to drive a significant burden of premature death and disease in the 41 countries reporting to EEA (among them Norway). 373,000 premature deaths were attributed to chronic exposure to fine particulate matter (PM2,5) alone.
  • At least 58% or 216,000 of these deaths could have been avoided if all 41 countries had reached the WHO’s new air quality guideline level of 5 µg/m3 for PM2.5.
  • Air quality in Europe was better in 2019 than in 2018, which also resulted in fewer negative health impacts. The decline in pollution follows a long-term trend, driven by policies to reduce emissions and improve air quality.
  • As part of the European Green Deal, the EU Zero Pollution Action Plan sets a target to reduce the number of premature deaths due to exposure to fine particulate matter by more than 55% by 2030, as compared to 2005. According to EEA’s analysis, the EU is currently on track to reach the target, as the number of these deaths has decreased by about a third from 2005 to 2019.

“Investing in cleaner heating, mobility, agriculture and industry delivers better health, productivity and quality of life for all Europeans and especially for the most vulnerable. These investments save lives and also help accelerate progress towards carbon neutrality and strong biodiversity”, said Hans Bruyninckx, EEA Executive Director.

Aligning EU Directives and WHO guidelines

Air pollution is a major cause of premature death and disease and is the single largest environmental health risk in Europe. Heart disease and stroke are the most common causes of premature deaths attributable to air pollution, followed by lung disease and lung cancer.

The EU´s Ambient Air Quality Directives set standards for key air pollutants. These values take into account 2005 WHO guidelines as well as considerations of technical and economic feasibility at the time of their adoption.

The WHO has recently established new global air quality guidelines to protect public health. They reflect scientific evidence on the impacts of air pollution to human health, which shows that air pollution harms human health at even lower concentrations than previously understood.

Bringing the standards for PM2.5 concentrations closer to the 2021 WHO air quality guideline would mean significant health benefits for many European citizens. EU air quality standards are a crucial policy tool driving improvements in air quality. A closer alignment between EU air quality standards and WHO recommendations would thus represent an important step towards cleaner air in Europe.

Potential health benefits of reducing PM2.5

To meet limit values established by the EU and the WHO guidelines, EEA undertook a preliminary assessment of the potential health benefits by reducing fine particulate matter (PM2.5) air pollution across the EU.

The current EU limit value for PM2.5 is 25 µg/m3. If the new WHO air quality guideline for PM2.5 of 5 µg/m3 had been attained across Europe in 2019, the related premature deaths would have been 58% lower than in 2019 in both the EU-27 and all the European countries considered.

These calculations were done by Dr. Joana Soares and Dr. Cristina Guerreiro from NILU, in cooperation with the EEA, within the ETC/ATNI (European Topic Centre on Air Pollution, Transport, Noise and Industrial Pollution) framework.

Dr. Soares explains that for Norway, the number of premature deaths would have been 20% lower if the new WHO air quality guideline for PM2.5 of 5 µg/m3 had been attained in 2019.

Work is ongoing in the context of the revision of the EU ambient air quality directives to determine whether achieving PM2.5 concentrations of 5 µg/m3 is technically feasible across the EU, given the influence of geographical features in some areas.

“The Norwegian standard for PM2.5 is also currently under review and is proposed to be set to the old WHO guideline level of 10 µg/m3”, says Dr. Guerreiro.

Health impacts of air pollution in Europe and Norway in 2019

The EEA briefing also gives estimates of the mortality in 2019 linked to exposure to the air pollutants deemed most harmful for human health.

In 2019, in the 41 European countries reporting air quality data to EEA:

  • ca 373,000 premature deaths were attributed to exposure to PM2.5
  • ca 47,700 premature deaths were attributed to exposure to NO2
  • ca 19,070 premature deaths were attributed to exposure to O3

In Norway in 2019:

  • ca 1200 premature deaths were attributed to exposure to PM2.5
  • ca 30 premature deaths were attributed to exposure to NO2
  • ca 80 premature deaths were attributed to exposure to O3

Fine particulate matter, PM2.5
The greatest health risks in terms of premature deaths and years of life lost (YLL) attributable to PM2.5 exposure per 10,000 inhabitants are observed in central and eastern European countries (where the highest concentrations of PM2.5 are also observed). Those are Bosnia and Herzegovina, Serbia, Kosovo, North Macedonia and Bulgaria. The smallest relative impacts are found in countries situated in the north and north-west of Europe, where concentrations are lowest.

Nitrogen Dioxide, NO2
The greatest health risks in terms of premature deaths and years of life lost (YLL) attributable to NO2 exposure per 100,000 inhabitants, are observed in Greece, Romania, Italy, Bulgaria and Spain. The smallest relative impacts on health are found in the Nordic and Baltic countries.

Ozone, O3
The greatest health risks in terms of total premature deaths and years of life lost (YLL) attributable to O3 exposure were seen in Bosnia and Herzegovina, Montenegro, Albania, Croatia and Greece. The countries with the lowest relative impacts on health from O3 exposure were, in order of increasing rank, Iceland, Ireland, the United Kingdom, Norway and Finland.

Additional information on the data and the methodology used can be found in the Eionet ETC/ATNI-report 10/2021, Health risk assessments of air pollution.

Estimating the health risks of air pollution

Since 2019, NILU has supported EEA with estimating mortality due to exposure to air pollution, as part of the work done in the topic centre ET/ATNI. Mortality is both the most serious health outcome of air pollution, and the one for which scientific evidence is most robust. To attribute a health risk to exposure to air pollution, concentration-response functions are used. These functions are based on epidemiological studies and estimate the increase in risk per unit of concentration of a certain air pollutant. As an example, the function for fine particles (PM2.5) assumes a linear increase in the risk of mortality of 6.2% for a 10 µg/m3 increase in PM2.5.