Air pollution-related diseases: a snapshot of the “tremendous burden”

Air pollution-related diseases: a snapshot of the 'tremendous burden'

January 29, 2025

Stroke, asthma, lung cancer, diabetes... Long-term exposure to air pollution causes a "considerable burden" on health and the economy, with tens of thousands of new cases of illness each year in France, concludes a new study published on Wednesday.

It was already known that 40,000 deaths were attributable to fine particles each year. This time, Santé publique France (SpF) assessed, over the period 2016-2019 – therefore before the Covid pandemic – the impact of air pollution on the development of eight diseases with a proven link to exposure to fine particles and nitrogen dioxide.

Lung cancer, COPD, asthma, pneumonia and other acute lower respiratory tract infections (excluding influenza), but also stroke, heart attack, hypertension and type 2 diabetes were explored.

From one disease and pollutant to another, "between 12 and 20% of new cases of respiratory diseases in children (i.e. 7,000 to 40,000 cases). In adults, between 7 and 13% of new cases of respiratory, cardiovascular or metabolic diseases (4,000 to 78,000 cases)" are attributable each year to air pollution, according to this work.

"Certain populations are more vulnerable": children, more exposed to subsequent illnesses due to impaired breathing capacity, the elderly, pregnant women, outdoor workers or athletes, smokers, noted Sylvia Medina, coordinator of the Air and Health program of Public Health France, during a press conference.

"Reducing the levels of fine particles and nitrogen dioxide in ambient air" would prevent "tens of thousands of cases of illness," underlines the study conducted with several partner organizations.

Bringing concentrations back to the levels recommended by the World Health Organization (WHO) would prevent three-quarters of cases of diseases linked to exposure to fine particles (PM2.5) and would halve those linked to nitrogen dioxide (NO2). This would save 30,000 new cases of asthma in children aged 0 to 17.

– “Major economic weight” –

Although the impact of air pollution on premature births and the occurrence of neurodegenerative diseases such as autistic disorders or Parkinson's is established, current data do not yet allow them to be quantified, according to SpF. The same goes for ultrafine particles, Sylvia Medina said.

Although "we know that the most disadvantaged populations have a more fragile level of health and more difficulty accessing care", reported Guillaume Boulanger (Health, Environment and Work department at SPF), the researchers did not demonstrate, in Rennes, Strasbourg, Lyon and Paris, "that the most disadvantaged populations were more exposed to pollution".

On the other hand, the "major economic weight" of the impact of air pollution has been quantified, in partnership with the Aix-Marseille School of Economics. Result: "12.9 billion euros related to PM2.5, or approximately 200 euros per year and per inhabitant, and 3.8 billion euros for NO2, or 59 euros per year and per inhabitant."

This includes the consumption of medical resources (consultations, medications, hospitalizations, transport, etc.), resources lost by society (wages, reduced access to the job market, early retirement) and the loss of well-being for patients, explained economist Olivier Chanel.

A new European directive on air quality will tighten the thresholds for particles and nitrogen dioxide in 2030.

"This is a first step, which would remove 15% from the total burden of diseases taken into account in our study," Guillaume Boulanger told AFP. The French objective, however, remains to aim for the more ambitious WHO values.

Public policies, at the risk of being unpopular, must continue their efforts throughout the territory and on all sources of air pollutants, in particular road traffic but also wood heating, industry, emissions from the agricultural sector, the experts argued.

In recent years, the action has also been extended to court.

In June 2023, the State was thus ordered, for the first time, to compensate victims of air pollution by a court, which ruled that two children suffering from bronchiolitis and repeated ear infections had been made ill due, among other things, to exceeding pollution thresholds in the Paris region.

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