Air quality key to preventing over 100,000 premature deaths in Europe

European cities could avoid over 100,000 premature deaths if they meet new World Health Organisation air guidelines, a study has found.

Cities in Spain and Italy currently have the highest levels of quality-related mortality, while cities in Scandinavia have the lowest.

ISGlobal researchers released a similar study in The Lancet in January 2021 before the WHO updated its guidelines this September.

The original study showed that European cities could avoid up to 51,000 premature deaths a year by following WHO guidelines, which have been in place since 2005.

The updated results show that adhering to the new air-quality guidelines for particles smaller than 2.5mm in diameter (PM2.5) would result in a 113 per cent increase in the number of avoidable deaths on 2005 guideline levels, avoiding 109,188 premature deaths each year.

For nitrogen dioxide (NO2) emissions, achieving the new recommended levels could prevent up to 57,030 premature deaths, 56,130 more than the 900 avoidable deaths estimated for the former recommended levels of NO2.

Going further, meeting the lowest levels of PM2.5 and NO2 observed in any city could prevent 125,000 and 79,000 annual premature deaths respectively.

“Even though there is no safe exposure threshold below which air pollution becomes innocuous, these new results show how the new WHO global air-quality guidelines offer a much better framework for protecting human health and prevent a large number of deaths," said ISGlobal researcher Sasha Khomenko, first author of the study.

The effect of meeting the new guidelines is much more noticeable in the case of NO2.

Among the cities with the highest mortality attributable to this pollutant, Madrid would go from avoiding 206 annual deaths if the previous WHO recommendations were met to avoiding 1,966 using the new targets.

Antwerp in Belgium would go from 22 avoidable annual deaths to 254; Turin from 34 to 562; Paris from 185 to 2,135; Milan from 103 to 1,864 and Barcelona from 82 to 1,554.

Europe facing long road to achieve clean air
One statistic that shows how far European cities have to go to achieve clean air is the percentage of the population living in areas with concentrations of air pollutants higher than those recommended by the WHO.

Almost all of Europe's urban population lives in an area that exceeds the WHO's guidelines on air quality: 99.8 per cent for PM2.5 and 99.7 per cent for NO2.

“Since the current levels of air pollution in European cities are putting more than 100,000 lives at stake every year, the EU should align its legislation to match the WHO recommendations”, said Mark Nieuwenhuijsen of ISGlobal, senior author of the study.

“In turn, local, regional and national governments should set the reduction of air pollution as a priority.

"We urgently need to reduce fossil fuel use, remove private cars and add more green spaces in our cities. This will not only reduce air pollution but also contribute to climate action, which is one of our highest priorities for humankind.”