More than 330,000 Europeans died due to air pollution in 2023

Air pollution remains one of the greatest threats to the health of Europeans. According to the latest report by the European Environment Agency (EEA), 333,000 cases of premature death in 2023 were linked to exposure to particulate matter, ozone, and nitrogen dioxide. The Western Balkans is among the most affected regions, with more than 22,000 premature deaths caused by air pollution, despite an average 50% decrease in PM2.5-related mortality between 2005 and 2023.

The European Environment Agency has published the report Harm to human health from air pollution in Europe: burden of disease status, 2025.

The report analyses three pollutants—particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3)—and their contribution to premature mortality and health impacts in 41 European countries.

In 2023, Europeans were exposed to concentrations of these pollutants far exceeding the levels recommended by the World Health Organization (WHO). Recommended maximum concentrations are 5 micrograms of PM2.5 per cubic metre of outdoor air, 60 micrograms for O3, and 10 micrograms per cubic metre for NO2.

The number of premature deaths in the EU linked to fine particulate matter decreased by 57% between 2005 and 2023

The number of premature deaths associated with fine particulate matter in the EU fell by 57% between 2005 and 2023, surpassing the EU Zero Pollution Action Plan target for 2030, set at 55%. The revised Ambient Air Quality Directive (AAQD), which entered into force last year, brings the EU’s limit values more in line with WHO recommendations.

Still, 95% of residents in European cities remain exposed to levels above these guidelines.

At the EU level alone, compliance with WHO guidelines in 2023 would have prevented 182,000 deaths linked to PM2.5, another 63,000 caused by ozone, and 34,000 resulting from NO2 exposure.

Across the 40 countries covered by the report, 206,000 deaths were attributed to PM2.5 concentrations above recommended levels. Turkey was excluded because the number of monitoring stations with available data was too low to create concentration maps. O3 exposure caused 71,000 deaths, and nitrogen dioxide caused 56,000.

Across the whole of Europe, a total of 333,000 people died prematurely.

People in Southeastern Europe suffer the greatest health impacts due to high pollution levels

Across all 40 countries, the highest number of PM2.5-related deaths in 2023 occurred in Italy, Poland, and Germany. However, the highest relative impact—measured in years of life lost per 100,000 inhabitants over 30 years—was recorded in Southeastern Europe. Years of life lost represent the estimated average number of additional years people would statistically live if they did not die before reaching life expectancy.

Residents of North Macedonia, Bosnia and Herzegovina, and Albania lost the most years of life. Among EU member states, Bulgaria ranked first, followed by Greece and Romania.

The highest absolute number of NO2-related deaths in 2023 was recorded in Turkey, Italy, and Germany. In terms of years of life lost, the greatest burden fell on populations in Turkey, Cyprus, Greece, Serbia, and Italy.

Germany, Italy, and France recorded the highest number of deaths linked to O3 emissions. The highest number of years of life lost per 100,000 inhabitants over 25 years occurred in Bosnia and Herzegovina, Montenegro, Albania, Croatia, and Hungary.

In the Western Balkans, particulate matter caused 22,426 premature deaths

In the Western Balkans, exposure to particulate matter caused 22,426 premature deaths. The highest number was recorded in Serbia (8,735), followed by Bosnia and Herzegovina (4,783), Albania (3,551), North Macedonia (2,667), Kosovo* (2,135), and Montenegro (555).

However, significant progress has been recorded since 2005. Mortality linked to PM2.5 fell the most in North Macedonia (57.2%), followed by Kosovo* (55.3%), Montenegro (53.6%), Albania (53.2%), and Serbia (50.2%). The smallest improvement was observed in Bosnia and Herzegovina (34.8%). On average, across all six Western Balkan countries, mortality associated with PM2.5 decreased by 50.72% during this period.

Air pollution can cause dementia

In addition to premature mortality, the report analyses diseases linked to air pollution and their impact on quality and length of life.

According to the findings, PM2.5 contributes the most to the burden of ischaemic heart disease, stroke, diabetes, lung cancer, chronic obstructive pulmonary disease (COPD), and childhood asthma. For NO2, the greatest health impacts occur in diabetes, followed by stroke, COPD, and asthma in both children and adults. Ozone exposure is linked to 7,000 deaths from COPD—the only disease included in the analysis for this pollutant.

Each additional 10 micrograms of PM2.5 per cubic metre increases the risk of dementia by 17%

For diseases caused or worsened by pollution, such as asthma, the primary impact is reduced health and well-being. For others, such as ischaemic heart disease and lung cancer, the result is premature death.

New evidence shows that air pollution may also cause dementia, whose burden is estimated to be greater than that of other relevant diseases. Research conducted this year by scientists at the University of Cambridge found that the risk of dementia increases by 17% for every additional 10 micrograms of PM2.5 per cubic metre of air.