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Air pollution levels still too high across Europe

Foto fra Oslo: Colourbox

Air pollution in Europe remains well above recommended World Health Organization (WHO) levels, posing a significant threat to our health. 

According to the latest European Environment Agency (EEA) air quality health assessment published today, 253,000 deaths could have been avoided in the EU if the fine particulate matter concentrations had met WHO recommendations. Exposure to air pollution causes or aggravates certain diseases like lung cancer, heart disease, asthma, and diabetes, according to new estimates of health impacts.

Further measures to reduce air pollution to WHO guideline levels would prevent these 253,000 attributable deaths and also reduce the number of people who are living with the debilitating health effects of air pollution-related diseases such as diabetes and asthma.

The EEA briefing ‘Harm to human health from air pollution in Europe: burden of disease 2023’ assessment presents the latest information, estimated for the year 2021, of the harm to human health caused by three key air pollutants: fine particulate matter, nitrogen dioxide and ozone.

Attributable deaths remain too high

Between 2005 and 2021, the number of deaths in the EU attributable to fine particulate matter (PM2.5), one of the most damaging air pollutants, fell by 41%. Still, air pollution continues to be the top environmental health risk to Europeans (followed by other factors such as exposure to noise, chemicals and the increasing effects of climate-related heatwaves on health), causing chronic illness and attributable deaths, especially in cities and urban areas.

According to the latest EEA estimates, at least 253,000 deaths in the EU in 2021 were attributable to exposure to fine particulate matter (PM2.5) pollution above the WHO recommended concentration of 5 µg/m3. Nitrogen dioxide (NO2) pollution above the WHO recommended concentration of 10 µg/m3 led to 52,000 deaths. Both PM2.5 and NO2 estimations consider long-term exposure (annual). Short-term exposure to ozone (daily) led to 22,000 attributable deaths in the EU.

The figure shows years of life lost per 100 000 inhabitants (YLL rate) due to long-term exposure to PM2.5 concentration levels in 2021 across Europe. Source: ETC HE Report 2023/7: Health Risk Assessment of Air Pollution: assessing the environmental burden of disease in Europe in 2021

Air pollution also causes ill health and adds significant costs to health care systems. These WHO recommended concentrations are set based on the level of pollution above which there is strong evidence of associated health effects.

In Norway, it was estimated that 293 and 87 deaths were attributed to long-term exposure to PM2.5 and NO2, respectively. Short-term exposure to ozone is responsible for 79 deaths.

The assessment is done for individual pollutants to avoid larger uncertainties in the estimations, in particular double counting.

Health impacts of key air pollutants on disease

New in this year’s assessment is the quantification of the health burden associated with specific diseases to which air pollution contributes. The total health burden associated with each of these diseases depends not only on the attributable deaths linked to the disease but also on the health burden of living with the effects of the disease on a daily basis.

For some diseases, such as ischemic heart disease and cancer, the majority of the health burden is linked to mortality, but there is also a significant health burden associated with living with the debilitating health effects of living with diseases such as diabetes and asthma, typically over many years or decades. Therefore, when we consider the health effects of air pollution, it is important not only to focus on attributable deaths as an indicator but also on the long-term impacts that these diseases can have on the daily quality of life of European citizens as they cope with the long-term effects of diseases such as asthma.

Of the considered air pollution-related illnesses, for exposure to PM2.5, the greatest health burden is caused by ischemic heart disease (87 893 attributable deaths), followed by stroke (64 171 attributable deaths), diabetes mellitus (42 671 attributable deaths), chronic obstructive pulmonary disease (19 233 attributable deaths), lung cancer (18 334 attributable deaths) and asthma (< 10 attributable deaths). In the case of NO2 and the three diseases considered, the highest health burden was caused by diabetes mellitus (18 227 attributable deaths), followed by stroke (17 937 attributable deaths) and asthma (788 attributable deaths).

The EEA briefing’s findings were presented at the 4th Clean Air Forum 2023 in Rotterdam. Together with the briefing, the EEA also published country fact sheets where detailed burden of disease information at country level can be found. There is also a Norwegian fact sheet.