Does the new EU Air Quality Directive really protect health? A nationwide case study in Spain

Abstract

In 2021, the World Health Organisation publishes a Guide on Air Quality in which guide values are established, which are not mandatory, and which are considerably more restrictive than those existing in the previous Guide are (2006). At the same time, in October 2024, the European Union drafted a Directive establishing limit values, which, once transposed by the Member States, will be mandatory. This Directive is less restrictive than the WHO 2021 Directive of 2021 is.

The aim of this study is, using dose-response functions for each Spanish province, to calculate how many short-term emergency hospital admissions for all causes ICD-9: 1-799 and ICD-10: A00-R99 are attributable to NO₂, PM10 and PM2.5 at provincial level in Spain in the period 2013-2018 and what their reduction would be if the regulations established by the EU and the WHO guideline values were applied.

The results obtained indicate that 38 790 hospital admissions/year are attributed to NO₂, PM10 and PM2.5 pollution in Spain each year, at a cost of 548 million €. A figure of 478 admissions would reduce these hospital admissions (1.23 %) if the regulations established by the EU were complied with and by 4 496 (11.59 %) if the values established by the WHO were complied with.

In other words, compliance with the EU limit values would have little impact on a decrease in attributable emergency hospital admissions, but compliance with the WHO guideline values would lead to savings of more than €63 million at the national level.