Where in Europe is air pollution the deadliest?

Air pollution is a deadly public health threat, but some parts of Europe are at much higher risk than others.

Air pollution is linked to lung cancer, heart and respiratory diseases, stroke, poor birth outcomes, and more.

It’s particularly dangerous for older people, causing about 4 per cent of all deaths among adults ages 65 and older.

In 2021, the World Health Organization (WHO) updated its air quality guidelines, lowering the recommended threshold for annual concentrations of nitrogen dioxide and fine particulate matter (PM2.5) such as dust, smoke, and soot from exhaust.

This month, stricter air quality rules came into force that aim to bring the European Union closer to WHO standards by 2030, and oblige member states to monitor pollutants like fine particulate matter, black carbon, and ammonia.

The plan is “one of the biggest public health interventions for a generation,” Mark Nieuwenhuijsen, director of the Barcelona Institute for Global Health’s urban planning, environment, and health initiative, told Euronews Health.

Overall, exposure to PM2.5 caused about 239,000 premature deaths in Europe in 2021, while another 48,000 people died as a result of nitrogen dioxide exposure, according to the European Environment Agency.

Currently, all EU countries report nitrogen dioxide levels above WHO-recommended levels, but some are hit harder by air pollution than others.

Central and Eastern Europe have the highest death rates linked to PM2.5, according to a recent report from the European Commission and the Organisation for Economic Co-operation and Development (OECD).

“The biggest divide in Europe we see is east and west [and this] aligns very much with GDP and socioeconomic backgrounds of the two regions,” Zorana Jovanovic Andersen, an environmental epidemiology professor at the University of Copenhagen and member of the European Respiratory Society’s environment and health committee, told Euronews Health.

Nieuwenhuijsen’s research at the city level underscores the different challenges facing various parts of Europe.

Northern Italy, Poland, and the Czech Republic have seen elevated rates of PM2.5 mortality, which is mostly driven by residential sources, like burning coal to heat homes and the agricultural sector.

Meanwhile, NO2 mortality – which is mainly driven by car traffic and the industrial sector – was highest in major and capital cities in western and southern Europe.

‘Need to regulate air pollution’

Some countries are taking steps to curb their pollution levels, including Denmark, which could become the first country in the world to impose a carbon tax on livestock farming in 2030.

The updated EU directive, meanwhile, gives citizens with pollution-related health problems the right to take their government to court if it does not comply with EU air quality rules.

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Yet the report from the OECD and the European Commission said that while the EU is on track to curb PM2.5-linked deaths by 55 per cent by 2030, environmental risk factors such as air pollution and climate change are “growing threats to public health”.

That’s because scientists know more today about the health impacts of air pollution, and it appears to pose a risk to people at lower levels than previously recognised, Nieuwenhuijsen and Andersen said.

“Even if you reduce the air pollution levels quite considerably, you may not always reduce the health impacts as much,” Nieuwenhuijsen said.

Air pollution may be the top environmental health threat facing Europe, but it tends to overlap with other factors, such as a lack of green spaces, noise pollution, and extreme heat, all of which have an impact on human health.

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Given some of these challenges are harder to solve – such as climate change – Andersen said there is a stronger case for limiting air pollution in the name of protecting health.

“We have reduced the air pollution, and we know how to and a lot of countries are leading,” Andersen said.

“There are new challenges coming, so we need to regulate air pollution – the old problem”.