The effect of air pollution on health in Brussels, Liège and Antwerp

Air pollution is a danger to public health. By reducing levels of fine particles, we can prevent hundreds of people from dying from cardiac and respiratory disorders every year. That is one of the conclusions of NEHAP study 'Cities and Pollution’, which was presented in 2008. In this study the effects of air pollution on health were examined in 3 Belgian cities: Brussels, Antwerp and Liège. In a second phase of the project, the results were made known to the participating municipalities.

Why was this study carried out ?
Measuring the effect of air pollution on health outcomes, such as the number of deaths or hospital admissions, serves two purposes: on the one hand, the current pollution situation is assessed, and on the other hand, such a study provides decision makers at both local and regional level with a number of tools, allowing them to tackle air pollution more efficiently.


For many years, the European Union has been supporting theAPHEIS system (Air Pollution and Health: A European Information System), which makes it possible to measure the impact of air pollution on health. This methodology was also used in the Belgian NEHAP study ‘Cities and Pollution’.


This study mainly focused on measuring the levels of PM10. These fine particles have a diameter of less than 10 micrometer (the average diameter of a human hair is 70 micrometer). Fine particles smaller than PM10 can penetrate deep into the lungs.


The levels of PM10 were measured at monitoring stations. Air pollution data are public data. They are easy to obtain in the three cities.
Mortality data were obtained from death certificates.


Hospital admission data were obtained from the Federal Public Service of Health.


Organization of the study 
The study area included:

  • the 19 municipalities of the Brussels Capital Region, with a total population of 999.899
  • 10 municipalities in the Liège region (428.234 inhabitants)
  • 7 municipalities in the Antwerp region (567.728 inhabitants),


adding up to a total of nearly 2 million inhabitants.


The study was carried out in the year 2004.


Results of the study
In the 3 cities the impact of exposure to PM10 was estimated over a very short term (48 hours), a short term (40 days) and a long term.

  • The results of the very short term show us that: if the level of PM10 is reduced to 20μg/m³, 163 premature deaths(including 83 cardiovascular and 43 respiratory deaths) could be prevented annually.
  • The results of the short term show us that: if the level of PM10 is reduced to 20μg/m³, 331 premature deaths(including 194 cardiovascular and 140 respiratory deaths) could be prevented annually.
  • The results of the long term show us that: if the level of PM10 is reduced to 20μg/m³, 1079 premature deaths could beprevented annually.


The impact was the highest in Liège, although not significantly different from Brussels or Antwerp.


Infant mortality in Europe is low anyway, and consequently the number of deaths related to air pollution is also very low. The reduction of the levels of PM10 to 20μg/m³ would prevent 2,47 post neonatal deaths.


Regarding hospital admissions, reducing PM10 to 20μg/m³ would prevent 561 respiratory and 257 cardiac diseases.


Communication of the study 
In January 2008, the results of the study were presented to the decision makers of the different municipalities during an information session, which was attended by 13 municipalities. The importance of the results, as a support for the decision making process, was highlighted. However, communication to the decision makers was not as it should have been. In the future, a personalized presentation will be provided to the decision makers of every municipality, in order to increase interest in the study.


The study contains a number of recommendations for the future:

  • This kind of study should be repeated regularly for every big city in Belgium, in order to assess the impact of air pollution on public health, as    Belgium is one of the most polluted areas in Europe        in terms of fine particle                pollution.
  • The cost of these studies will be low. These days, data on mortality, hospital admissions and air pollution can be used in a highly efficient way to monitor the health impact of changes in air pollution.