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News article11 January 2023Directorate-General for Environment

European health burden attributable to air pollution fell over three decades from 1990 to 2019

Issue 592: Air pollution is one of the greatest environmental health risks worldwide according to the World Health Organisation.

European health burden attributable to air pollution fell over three decades from 1990 to 2019
Photo by SvedOliver, Shutterstock

Recent research looks at pollution levels and associated health impacts across Europe from 1990 to 2019. The researchers report that deaths attributable to air pollution dropped over the period in both absolute and relative terms and argue that further progress should be a priority.

Air pollution is considered the fourth biggest global health risk factor, contributing significantly to the two leading causes of death worldwide (ischemic heart disease and stroke). Although air pollution levels have fallen across Europe in recent decades, more than 0.5 million deaths were attributed to this cause across the region in 20131. This study explored the changing impact of air quality on human health in 43 European countries between 1990 and 2019.

The study drew on data from the multinational Global Burden of Diseases, Injuries, and Risk Factors Study, an ongoing research programme originally commissioned by the World Bank in 1990. The researchers analysed data on 43 European countries, including Russia and Iceland. To evaluate air quality, they focused on the concentration of particulate matter less than 2.5 microns in diameter in outdoor air, referred to as ambient PM2.5, which is known to have substantial health impacts. They considered this in the context of three health metrics – years of life lost (years of potential life lost due to premature death), disability-adjusted life years (DALYS) (years of healthy or productive life lost due to death or disability) and overall deaths. The quantity of each of these attributable to air pollution was calculated based on risk factors estimated according to age, sex, location and year. They also considered two socio-economic metrics: gross national income (per capita economic value produced by the country’s economy) and the socio-demographic index (a measure of development including income, education and fertility factors).

The researchers report that 90.4% of deaths attributable to air pollution over the period were associated with ambient PM2.5. They say that average population-weighted exposure to PM2.5 in European countries fell by 33.7% between 1990 and 2019 to 13.8 microgrammes per cubic metre (µg/m3). However, they note that this still exceeds the 2005 World Health Organisation global air quality guideline of 10 µg/m3 2. Total deaths attributable to air pollution in Europe fell by 42.4% to 368 006 over the period, they say, with deaths in the EU dropping by 43.9%. The proportion of deaths that were attributable to air pollution fell by 44.4%, according to the researchers, from 6.3% to 3.5% of all deaths in Europe. Years of life lost due to air pollution decreased by 63%, they say, to 24 917 years per 100 000 people.

The researchers also modelled the relationship between air quality and health outcomes. They report that, according to the model, a 10% increase in ambient PM2.5 would lead to an increase of 16.7% in years of life lost. In contrast, they note that a 10% increase in indoor air pollution from burning solid fuels such as wood and coal would lead to an increase of only 1.4% in years of life lost.

The researchers say that socio-economic factors had a substantial effect on air-pollution related health impacts. Countries in the low socio-demographic index bracket lost 11 times as many DALYS to ischemic heart disease and stroke attributed to air pollution in 2019 as countries in the high index bracket, they report. Similarly, countries in the lowest group for gross national income lost 11 times more DALYS to ischemic heart disease attributed to air pollution than those in the highest group, and 25 times more DALYS to stroke attributed to air pollution.

These results show that Europe has made considerable progress over the last three decades in reducing ambient PM2.5 levels and associated health burdens, according to the researchers. They say that more than 85% of European countries had fewer deaths attributable to air pollution in 2019 than in 1990. However, they note that in 2019 nearly three quarters of European countries still had PM2.5 levels exceeding the 2005 global air quality guidelines issued by the World Health Organisation. The researchers argue that, despite the progress made to date, air-quality improvements should remain a priority issue across Europe, especially in countries with a lower socio-economic index, to further reduce health and economic impacts.

Further information

WHO also recognised in its 2021 global air quality guidelines that ultrafine particles (UFP) (i.e. particulates with a diameter less than or equal to 0.1 μm) are an emerging but unquantifiable risk and, therefore, the air pollution figures may be an underestimation of the global burden – since any long-term damage caused by UFPs penetrating the alveolar, brain and placenta barriers and reaching organs in people, animals and foetuses are not accounted for (such as cancers in addition to the lungs, Alzheimer’s disease and dementia etc).


  1. These statistics are from: European Environment Agency (2016). Air quality in Europe: 2016 Report. European Environment Agency. Available from: Air quality in Europe — 2016 report — European Environment Agency ( [Accessed 3 October 2022]
  2. This figure is taken from the 2005 World Health Organisation global air quality guidelines, i.e. 10 µ/m³ for PM2.5 annual mean, which was subsequently revised to 5 µg/m³ in the 2021 WHO global air quality guidelines: World Health Organization (2021). WHO global air quality guidelines. Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. World Health Organization. Available from: [Accessed 15 November 2022]


Juginović, A., Vuković, M., Aranza, I. and Biloš, V. (2021) Health impacts of air pollution exposure from 1990 to 2019 in 43 European countries. Scientific Reports 11: 22516. Available from:

To cite this article/service:

Science for Environment Policy”: European Commission DG Environment News Alert Service, edited by the Science Communication Unit, The University of the West of England, Bristol.

Notes on content:

The contents and views included in Science for Environment Policy are based on independent, peer reviewed research and do not necessarily reflect the position of the European Commission. Please note that this article is a summary of only one study. Other studies may come to other conclusions.


Publication date
11 January 2023
Directorate-General for Environment

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