Cleaner air for better health: a cost-benefit analysis of low emission zones
Abstract
Background: Exposure to traffic-related air pollution remains one of the leading modifiable contributors to urban disease burden in Europe. Low emission zones (LEZs) are an increasingly common policy strategy to reduce urban air pollution. This study quantifies the health and economic impacts of five LEZs across different European capitals (Brussels, Paris, Lisbon, Oslo and Tallinn) for the period 2023–2030 using a health impact modelling approach embedded in a cost-benefit analysis (CBA) framework.
Methods: We conducted a CBA of five LEZs. Road traffic emission reduction factors were applied to the air quality downscaling model uEMEP (250 × 250 m) to generate counterfactual ambient concentration maps of NO2, PM2.5, and PM10 across each LEZ area. Population and baseline health data were obtained from the Global Human Settlement population grid and the Global Burden of Disease (GBD) study. Health impacts were quantified in disability-adjusted life years (DALYs) using the healthiar R package, developed within the EU-funded BEST-COST project, applying exposure-response functions for relevant health outcomes such as ischaemic heart disease and lung cancer. Monetised health benefits were weighed against intervention costs across all five cities.
Preliminary Results: The five LEZs are expected to reduce ambient NO2, PM2.5, and PM10 concentrations across the study regions. These concentration changes are expected to translate into reductions in disease burden, expressed in DALYs, across the modelled health outcomes in each city. Results may differ across cities due to variation in LEZ design, local emission profiles, population characteristics, and baseline health status.
Conclusions: This study provides comparative evidence across diverse urban and policy contexts, informing evidence-based urban air quality policy in Brussels, Paris, Lisbon, Oslo, Tallinn, and other comparable European urban settings. Final results will be presented at the conference.
Key messages: • High-resolution modelling shows low emission zones reducing NO₂ and PM concentrations, yielding measurable health benefits across European cities.
• Cost-benefit analysis quantifies the health gains of low emission zones relative to implementation costs, informing evidence-based urban air quality policy.
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BibTeX
@article{bartholomeeusen2026cleaner,
title = {{Cleaner air for better health: a cost-benefit analysis of low emission zones}},
author = {M Bartholomeeusen and V Gorasso and L Vázquez Fernández and M Lepnurm and MJ Rueda López and IS Pimenta and L Rousseau and PM Nhat},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1284},
url = {https://doi.org/10.1093/eurpub/ckag169.1284},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Cleaner air for better health: a cost-benefit analysis of low emission zones
AU - M Bartholomeeusen
AU - V Gorasso
AU - L Vázquez Fernández
AU - M Lepnurm
AU - MJ Rueda López
AU - IS Pimenta
AU - L Rousseau
AU - PM Nhat
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1284
UR - https://doi.org/10.1093/eurpub/ckag169.1284
AB - Background: Exposure to traffic-related air pollution remains one of the leading modifiable contributors to urban disease burden in Europe. Low emission zones (LEZs) are an increasingly common policy strategy to reduce urban air pollution. This study quantifies the health and economic impacts of five LEZs across different European capitals (Brussels, Paris, Lisbon, Oslo and Tallinn) for the period 2023–2030 using a health impact modelling approach embedded in a cost-benefit analysis (CBA) framework. Methods: We conducted a CBA of five LEZs. Road traffic emission reduction factors were applied to the air quality downscaling model uEMEP (250 × 250 m) to generate counterfactual ambient concentration maps of NO2, PM2.5, and PM10 across each LEZ area. Population and baseline health data were obtained from the Global Human Settlement population grid and the Global Burden of Disease (GBD) study. Health impacts were quantified in disability-adjusted life years (DALYs) using the healthiar R package, developed within the EU-funded BEST-COST project, applying exposure-response functions for relevant health outcomes such as ischaemic heart disease and lung cancer. Monetised health benefits were weighed against intervention costs across all five cities. Preliminary Results: The five LEZs are expected to reduce ambient NO2, PM2.5, and PM10 concentrations across the study regions. These concentration changes are expected to translate into reductions in disease burden, expressed in DALYs, across the modelled health outcomes in each city. Results may differ across cities due to variation in LEZ design, local emission profiles, population characteristics, and baseline health status. Conclusions: This study provides comparative evidence across diverse urban and policy contexts, informing evidence-based urban air quality policy in Brussels, Paris, Lisbon, Oslo, Tallinn, and other comparable European urban settings. Final results will be presented at the conference. Key messages: • High-resolution modelling shows low emission zones reducing NO₂ and PM concentrations, yielding measurable health benefits across European cities. • Cost-benefit analysis quantifies the health gains of low emission zones relative to implementation costs, informing evidence-based urban air quality policy.
SN - 1101-1262
SN - 1464-360X
ER -