Premature deaths due to exposure to fine particulate matter in Europe

Air pollution is a major cause of premature death (PD) and disease in Europe and is the largest environmental health risk. The single air pollutant deemed to cause the most severe impacts on human health is fine particulate matter (PM_2.5).

In the European Green Deal the European Commission committed to further improve air quality and to revise the EU’s air quality standards to align them more closely with the latest World Health Organization (WHO) recommendations on air quality. This objective was confirmed in the EU’s zero pollution action plan which sets the goal of reducing the number of premature deaths caused by PM_2.5 by a minimum of 55% by 2030, relative to those in 2005.

As shown in figure 1, between 2005 and 2020, premature deaths attributable to PM_2.5 exposure fell by 45% in the EU-27. This decrease can be explained by a decline in the concentrations of PM_2.5 and therefore a decrease in the exposure of the population to this air pollutant. For instance:

• annual mean PM_2.5 concentrations decreased on average by 22% in the decade 2009-2018 (in a total of 21 countries).

• the percentage of the EU-27 urban population exposed to concentrations above the EU annual limit value (25µg/m³) fell in 2020 to a minimum of less than 1%.

Nevertheless, exposure of the urban population to PM_2.5 concentrations above the 2021 WHO air quality guideline level of 5µg/m³ has declined slightly, from 100% in 2006 to 96% in 2020.

The improvements in the PM_2.5 concentrations are the result of national and regional policies that target, for instance, domestic heating, the main source of primary PM_2.5 (that is, particles directly emitted into the atmosphere, in contrast to secondary PM_2.5, formed in the atmosphere), and the implementation of the National Emission Reduction Commitments Directive, which contributed to a decline in the EU’s emissions of primary PM_2.5 by 32% between 2005 and 2020.

If air quality continues to improve, and the number of premature deaths continues to fall at a rate comparable to that of previous years, the zero pollution action plan target of a 55% decline in the number of premature deaths attributable to air pollution will be achieved by 2026. However, this estimation is based purely on the continuation of the observed trend and is not a projection, since it does not consider any recent or future policy developments taken to improve air quality since 2020.

Continuing to reduce concentrations of PM_2.5 at the current rate over the next decade will be challenging. To meet the target, Member States will need to fully implement their national air pollution control programmes and the measures needed to reach their 2030 climate and energy targets.

To allow comparison of the impact of air pollution on human health across the different regions of Europe, the number of premature deaths can be expressed per 100,000 inhabitants (see figure 2). Of the EU27 regions for which data are available, five regions in Bulgaria: Sofia (Stolitsa), Vidin, Montana, Plovdiv and Pleven have the highest relative number of premature deaths in 2020 with 216, 212, 176, 175 and 175 PD per 100,000 inhabitants, respectively. Two Croatian regions: Brodsko-posavska županija and Vukovarsko-srijemska županija follow with 172 and 164 PD per 100,000 inhabitants, respectively.

Outside of the EU, the Skopski region, North Macedonia, and Podunavska oblast, Serbia, had most relative premature deaths in 2020, with 265 and 263 per 100,000 inhabitants, respectively. In general, estimates suggest that regions in the Balkans have the highest numbers of premature deaths attributable to PM_2.5 per 100,000 inhabitants, especially regions in Serbia (where 14 regions out of 25 have more than 200 PD per 100,000 inhabitants) and Bulgaria (with the two regions mentioned above, out of 28 regions, with more than 200 PD per 100,000 inhabitants). This is the result of burning solid fuels for domestic heating and industry in these regions.

Within the EU, 15 Finnish NUTS3 regions (out of 19), and 13 Swedish NUTS3 regions (out of 21) had less than 1 PD per 100,000 inhabitants (most of them have population-averaged concentrations below 5µg/m³). Furthermore, the remaining four Finnish regions, six of the remaining Swedish regions, and all five Estonian regions have fewer than 10 PD per 100,000 inhabitants. Outside of the EU, the two Icelandic NUTS3 regions and six Norwegian NUTS3 regions (out of 11) had less than 1 PD per 100,000 inhabitants and four of the remaining Norwegian regions fewer than 10 PD per 100,000 inhabitants.