Air pollution is the single largest environmental health risk in Europe and a major cause of premature death and disease. Latest estimates by the European Environment Agency (EEA) show that fine particulate matter (PM 2.5 ) continues to cause the most substantial health impacts.
Most Europeans live in areas, especially cities, where air pollution can reach high levels. Both short- and long-term exposure to air pollution can lead to a wide range of diseases, including stroke, chronic obstructive pulmonary disease, trachea, bronchus and lung cancers, aggravated asthma and lower respiratory infections. The World Health Organization (WHO) provides evidence of links between exposure to air pollution and type 2 diabetes, obesity, systemic inflammation, Alzheimer’s disease and dementia. The International Agency for Research on Cancer has classified air pollution, in particular PM2.5, as a leading cause of cancer. Another global review found that chronic exposure can affect every organ in the body, complicating and exacerbating existing health conditions.
Children and adolescents are particularly vulnerable because their bodies, organs and immune systems are still developing. Air pollution damages health during childhood and increases the risk of diseases later in life, yet children can do little to protect themselves or influence air quality policies.
Health impacts of air pollution
EEA, “Healthy environment, healthy lives ,” 2019
Note: Particulate matter with a diameter of 2.5 µm or less (PM2.5), particulate matter with a diameter of 10 µm or less (PM10), ozone (O3), nitrogen dioxide (NO2), benzo[a]pyrene (BaP) and sulphur dioxide (SO2).
Fine particulate matter (PM2.5) is the air pollutant driving the most significant health problems and premature mortality. Residential, commercial and institutional energy consumption was the principal source of particulate matter in 2023. The manufacturing and extractive industry and transport were also significant sources, while agriculture was an important source of PM10. Between 2005 and 2023, emissions of particulate matter, PM10 and PM2.5, fell by 36% and 38%, respectively.
In 2021, the World Health Organization (WHO) published new air quality guidelines following a systematic review of the latest scientific evidence demonstrating how air pollution damages human health. The European Union (EU) has also set standards for key air pollutants in the ambient air quality directives (AAQD). The standards in the revised AAQD 2024/2881 are more closely aligned with the WHO recommendations. This revised Directive came after the European Commission committed in the European Green Deal, to further improving air quality and to aligning EU air quality standards more closely with the WHO recommendations. This commitment was echoed in the zero pollution action plan, which set a vision for 2050 to reduce air, water and soil pollution to levels no longer considered harmful to health and natural ecosystems. In addition, the zero pollution action plan introduced targets for 2030, two of which focus on air and aim to:
- reduce the health impacts of air pollution (premature deaths) by more than 55%, compared to 2005;
- reduce the share of EU ecosystems where air pollution threatens biodiversity by 25%, compared to 2005.
Stricter air quality standards would also contribute to the objectives of Europe’s Beating Cancer Plan. Air pollution is a known cause of cancer in Europe; in particular, lung cancer (EEA, 2022).
In 2023, 94.4% of the urban population was exposed to concentrations of fine particulate matter above the health-based guideline level set by the World Health Organization.
182,000 premature deaths
due to fine particulate matter above WHO-guideline level
The EEA estimates that, in 2023, approximately 182,000 premature deaths were attributable to PM2.5 in the 27 EU Member States. In 2023, premature deaths attributed to exposure to fine particulate matter fell by 57% in the EU-27, compared to 2005. This meant that the EU-27 met the zero pollution action plan related target for 2023.
Inequalities in exposure and vulnerability to air pollution in Europe
Air pollution affects people in different ways. Older people, children and those with pre-existing health conditions are more sensitive to the health impacts of air pollution. In addition, the most deprived people in society often have poorer health and less access to high-quality medical care, increasing their vulnerability.
There is strong evidence linking lower socio-economic status to increased exposure to air pollution. In large parts of Europe, poorer people are more likely to live next to busy roads or industrial areas and thus, face higher levels of exposure to air pollution. At the same time, exposure patterns vary across European cities. In some cities, wealthier people live in central, polluted areas, while in other European cities central areas are inhabited by poorer communities.
In Europe, regions characterised by lower GDP per capita are found to have higher levels of PM2.5 and tend to occur in Eastern and South-eastern Europe. This pattern is largely driven by the combustion of low-quality solid fuels (e.g. coal and wood) in low-efficiency ovens for domestic heating in those areas. The higher population exposure to PM2.5 in particular regions, translates into higher numbers of premature deaths attributed to air pollution.
Mapping mortality attributed to PM2.5 against regional wealth in Europe
Besides premature death, air pollution also causes morbidity. People live with diseases related to exposure to air pollution; this is a burden in terms of personal suffering as well as significant costs on the healthcare sector. For instance, in 2023, exposure to PM2.5 led to 99,002 years lived with disability (YLDs) due to chronic obstructive pulmonary disease in 40 European countries. At the same time, exposure to NO2 led to 135,037 YLDs due to diabetes mellitus (also known as Type 2 diabetes) in 41 European countries. There is also a significant burden due to dementia (293,195 YLDs in 2023 in 40 European countries)
The interactive map viewer shows the spatial distribution of population-weighted concentrations of PM2.5 (as an indication of population exposure) across Europe and the associated mortality. The viewer also allows to display data against GDP per capita as a proxy for the average socio-economic characteristics of the population in each region. The data is presented for NUTS3 regions (between 150,000 and 800,000 inhabitants).
Interactive dashboard: Combined risks and inequalities
GDP per capita – Eurostat; Premature deaths, years of life lost and population-weighted concentrations are based on an EEA analysis of interpolated annual statistics of reported monitoring data from 2018 (see Map 9.1 in EEA, 2020) and the Geostat 2011 population grid data set.
