Casal, B., Rivera, B., Currais, L. (2023) Evidence of the adverse effects of air pollution on the population´s health in Spain: analysis of the economic costs of premature deaths. Cadernos de Saúde Pública. Reports in Public Health, Aug 11;39(7):e00145922


 What is known about the subject?

The World Health Organization estimates that around 4.2 million deaths were attributable to outdoor air pollution in 2016. In Europe, estimates suggest that air pollution is one of the major causes of premature death and disease, and constitutes the most important environmental and modifiable health risk. Furthermore, evidence available confirms that air pollution significantly affects the health of the population, with a considerable economic impact in terms of increased premature mortality and morbidity.

A wide variety of epidemiological studies support the hypothesis that exposure to particulate matter (PM) negatively affects human health. Such effects, mostly analysed using mortality rates, are well documented for the cardiovascular and respiratory system. Likewise, there is evidence suggesting a link between the exposure to PM and the cerebrovascular system, neurodevelopment and cognitive function, as well as metabolic diseases such as obesity and diabetes mellitus, which at the same time are risk factors for cardiovascular diseases.


What does this study add to the existing literature?

This is the first study combining cross-sectional data to evaluate the relation between mortality rates and PM concentrations across Spanish regions, with an estimation of the economic impact of premature deaths due to PM exposure. The study carries out an estimation of welfare and labour productivity losses due to premature mortality caused by respiratory and cerebrovascular diseases. The economic cost of premature deaths was evaluated using the Willingness to Pay approach to quantify welfare losses, and the Human Capital method was used to estimate losses in labour productivity. Based on 10,342 premature deaths in 2017, welfare losses amount to €36,227 million /3.1% of Spanish GDP). The economic value on current and future production losses reaches €229 million (0.02% of Spanish GDP).


What are the implications of the findings?

From a social perspective, air pollution is a public health concern that has enormous consequences on health and a massive economic impact in terms of losses in productivity and quality of life due to premature deaths. In this regard, exposure to air pollution should be a priority for public decision-makers. Findings emphasise the need to implement or strengthen different types of public policies, to reduce air pollution. Measures should include regulatory, fiscal and health policy recommendations. It is important to highlight the need to involve the different sectors of society, from the different levels of government to industry and individual behaviours.



Luis Currais
Full Professor of Foundations of Economic Analysis
Faculty of Economics and Business
University of A Coruña