Health and Environment Alliance | Addressing air pollution in cities can greatly lessen disease burden and health costs

6th May 2024

HEAL and its member Belgian Independent Health Insurance Funds (Mutualités Libres) organised an event under the auspices of the Belgian EU Presidency, on pathways for achieving clean air in cities. The conference took place on the eve of the European Parliament plenary vote on updated clean air standards and brought together over 300 participants. Decision-makers, scientists, NGOs and stakeholders gathered for a lively exchange on how to address air pollution in urban environments, sharing good practices and policy solutions. See the programme here.

Anne Stauffer, HEAL Deputy Director, reminded participants of the importance of binding laws on the EU-level such as the Ambient Air Quality Directives: “Many cities have taken initiative to reach healthy air in recent years. The revised EU clean air law will give much needed tailwind to address air pollution in EU’s urban environments. It has huge potential to improve health for everyone living in cities, but especially for those most at risk including pregnant people, children, the elderly, those already sick and those facing health inequalities.”

The event unveiled preliminary findings from the Independent Health Insurance funds study, presented by Luk Bruyneel – Lead of Scientific and Economic Matters at Mutualités Libres, showing that low emission zones in Brussels and Antwerp resulted in a rapid decrease of harmful air pollutants (black carbon, nitrogen dioxide, particulate matter PM2.5 and PM10) compared to cities without low emission zones.

Xavier Brenez, CEO of Mutualités Libres sees the reduction of air pollutants as common sense from the viewpoint of health insurers: “The air quality in Belgium is improving, but there is still a lot of work to be done. The impact of air pollution on our physical and mental health is enormous, as is the cost to our social security.”

Both the new study by Mutualités Libres and data gathered by the European Environment Agency in their European air quality in cities database clearly indicates that there are drastic inequalities when it comes to exposure to air pollution, with the most deprived neighbourhoods being the most polluted. However, these neighbourhoods stand to greatly benefit from the implementation of low emission zones. Further studies conducted in the United Kingdom, presented at the conference by Professor Rachel Aldred from the University of Westminster, clearly indicated low traffic neighbourhoods saw reduced car ownership and use, with a 70% reduction in traffic injuries and savings in healthcare expenditure.

Mark Nieuwenhuijsen, Director of ISGlobal’s Urban Planning, Environment and Health Initiative, presented the UBDPolicy project where HEAL is also a partner. The innovative EU-funded project is working on assessing the burden of disease in 1000 European cities when it comes to the health and socio-economic costs- and benefits related to air quality, and other urban factors. He stressed that since pollution in cities stem from a variety of sources, a multisectoral approach is needed to address it; in addition to low emission zones, implementation of green zones such as ‘superblocks’, which create networks of neighbourhoods by introducing low traffic and green spaces, can support better health for urban residents.

Researcher Zorana Jovanovic Andersen, from HEAL member organisation the European Respiratory Society reminded participants of the high cost of continuing business as usual: “Air pollution affects the lungs, but it also contributes to heart diseases, and cardiometabolic diseases; we now see a clear link with air pollution and diabetes, whereby air pollution causes inflammation in fat tissue that results in insulin resistance. We also know air pollution is carcinogenic, and can cause not only lung cancer, but there is evidence how it contributes to other cancers, which the EU Beating Cancer Plan notes. Air pollution also impacts the brain negatively from childhood to old age – causing increased difficulties focusing and in older age can cause dementia and increase risk of Parkinsons disease. Further it has a negative effect on mental health.”

One panel discussion among experts from organisations (Tim Cassiers from BRAL – Citizen Action Brussels, Renaud Leemans from Les Chercheurs d’Air, Marie-Charlotte Debouche from ClientEarth and Dr. Patricia Palacios from Société Scientifique de Médecine Générale) highlighted the important role of citizens, with strong links from awareness raising about air pollution resulting in citizen action, as exemplified by HEAL member BRAL – Citizen Action Brussels organisation, a movement working to address pollution in Brussels by bridging connections between people and organisations. Albeit there may be resistance to the impact of some measures to address air pollution in their daily lives, citizens do care about air quality and its impact on health. Doctors can also play a key role in awareness raising through informing their patients. But to succeed to address air pollution, citizens, medical professionals and organisations need support; the panellists called on Governments to set the right framework with policies.

Another panel discussion saw experts (Dorthe Nielsen from Eurocities, Jacek Kisiel from the city of Warsaw, Julia Poliscanova from Transport and Environment and Oskar Bonte from the Flemish Youth Council) working with cities elaborate on what kind of support is needed to ensure cities wanting to achieve clean air can do so. The need for awareness raising and political commitment came up again, as well as robust financing. All agreed that inclusion of vulnerable groups and their needs when planning and implementing actions to address air pollution is crucial for success.

Finally, the presenters underlined the importance of binding laws – with tools like the Ambient Air Quality Directives now in play there are no excuses for not taking strides towards clean air for better health.

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