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/m3Nitrogen dioxide pollution led to 52,000 deaths and short-term exposure to ozone led to 22,000 attributable deaths in the EU. Air pollution also causes ill health and adds significant costs on health care systems. These WHO recommended concentrations are set based on the level of pollution above which there is clear evidence of associated health effects.

Virginijus Sinkevičius
EU Commissioner for Environment, Oceans and Fisheries

The figures released today by the EEA remind us that air pollution is still the number one environmental health problem in the EU. The good news is that clean air policy works, and our air quality is improving. But we need to do better still, and bring pollution levels down further. That is why the EU must quickly adopt and implement the proposal for a revised Ambient Air Quality Directive that aims to align EU air quality standards more closely with WHO recommendations.

While we have made great strides over past years to reduce air pollution levels, our latest data and assessment show that the impacts of air pollution on our health remains still too high, resulting in deaths and illnesses which can be attributed to air pollution. The positive news is that authorities at European, national and local levels are taking action to reduce emissions through measures like promoting public transport or cycling in city centres, and through updated legislation.

Leena Ylä-Mononen
EEA Executive Director

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 attributable deaths, but for other diseases such as diabetes and asthma there is also a significant health burden associated with living with the debilitating health effects of these diseases, 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 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 fine particulate matter (PM2.5), the greatest health burden is caused by ischemic heart disease, followed by stroke, diabetes mellitus, chronic obstructive pulmonary disease, lung cancer and asthma. In the case of nitrogen dioxide and the three diseases considered, the highest health burden was caused by diabetes mellitus, followed by stroke and asthma.

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

Air quality app: check air data anywhere in the EU

European citizens can check real-time air quality data through different platforms, including the Air Quality Index app. The latest release of this app introduced new features where users can now check the air quality at any location in the EU, based on hourly updated information from more than 3,500 air quality monitoring stations in Europe together with Europe-wide modelling of air quality. The app comes in 24 European languages and includes a range of features to allow users to assess and interpret the air quality in their locality.

The European Air Quality Index App is free to download here:

Android PlayStore
Apple iOS

Note to editors

The EEA briefing 'Harm to human health from air pollution in Europe, burden of disease 2023' is part of the Air quality in Europe 2023 package.

The EEA has been estimating number of deaths attributable to exposure to air pollution since 2014. The EEA uses the recommendations for health impacts set out in the 2021 WHO air quality guidelines.

As with previous years, the health impacts of different air pollutants should not be added together to avoid double counting due to some overlaps in data. This is the case for both mortality and illness.

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