While the US Environmental Protection Agency (EPA) will still consider the health benefits of emissions regulations, it will no longer publish estimates of the economic costs of deaths, illness and disability from unsafe air pollution levels.

The US EPA, whose path-finding work on air pollution’s health impacts helped set standards internationally, will no longer put dollar amounts to the human health toll of the most hazardous air pollutants, PM 2.5 and ozone, in the course of setting new regulations or assessing the health harms of potentially polluting energy projects, the agency signalled on Monday. 

The sea change in four decades of policy was included in a new economic assessment of new emissions standards for gas turbines, which fine-tunes and strengthens slightly regulations on nitrogen oxide (NOx) emissions, but avoids setting explicit limits for emissions of fine particles, PM2.5, widely considered the most health-hazardous air pollutant.  

The costs to industry of the updated rule will amount to roughly $22.6 million annually, the assessment states. But it refrains from making any monetary estimate of health costs and benefits, stating:  

 “The EPA is no longer monetizing benefits from PM2.5 and ozone but will continue to quantify the emissions until the Agency is confident enough in the modeling to properly monetize those impacts.” 

A break from quantifying health benefits

Since the 1990s, the EPA included detailed health-related benefit estimates – such as the costs saved from avoiding hospitalizations from asthma attacks, fewer lost workdays and school absences, as well as assigning a monetized value to avoided premature deaths. 

Quantifying the health benefits in dollar terms allowed for a comparison between the costs and benefits of pollution mitigation and compliance with air quality regulations on an even playing ground, advocates have long maintained. 

Estimating savings in medical costs, productivity and avoided deaths – made clear that many air rules delivered billions in net benefits over a period of a decade or more, even when industry costs were substantial. 

The new policy falls into line with industry complaints that current economic models, used by scientists and health economists around the world, overstate the benefits of air pollution mitigation – while underestimating the costs to business.   

EPA calls past methods ‘erroneous’ 

The new EPA rule, which was first reported on by the New York Times Monday,  defended its change, describing its mission to “rectify this error.”

Dropping  the monetary benefit analysis, is meant to clarify “uncertainties” in past EPA assessments, according to the agency. 

Buried in the technical jargon of the agency’s newly released power plant emissions analysis and regulation is a shift from precedent in how the EPA will approach cost-benefit analysis. 

 “Historically, however, the EPA’s analytical practices often provided the public with a false sense of precision and more confidence regarding the monetized impacts of fine particulate matter (PM2.5) and ozone than the underlying science could fully support, especially as overall emissions have significantly decreased, and impacts have become more uncertain.”

It goes on to say: “Therefore, to rectify this error, the EPA is no longer monetizing benefits from PM2.5 and ozone but will continue to quantify the emissions until the Agency is confident enough in the modeling to properly monetize those impacts.”

Slippery slope to looser standards

In a post on X that followed on the New York Times story, EPA administrator Lee Zeldin said that the agency will continue to calculate health costs of air pollution – even if it doesn’t attach a dollar sign to those costs. 

“EPA will still be considering lives saved when setting pollution limits,” said Zeldin in his post. 

The turbine policy rule change, however, includes no analysis of health benefits or costs from alternative emissions strategies. 

However nuanced the arguments may be, critics also argue that dropping the economic assessment of the health costs and benefits of air pollution mitigation from the EPA toolkit ultimately weakens the policy case for stricter standards in an agency that has long been regarded as the gold standard. 

“By foregoing the opportunity to monetize the health impacts of air pollution, the EPA will lose insight which is key to inform sound financial and health-promoting decision making,” said Dr Marina Romanello, executive director of the Lancet Countdown commission on climate and health, in a statement to Health Policy Watch. “The quantification of health impacts alone is not sufficient – translating this into monetary terms is the key step to incorporate these impacts into decision making.”

This makes some in the field worry that the EPA could drop accounting for broader health impacts next.

“The adverse health impacts of soot and smog pollution are well documented and for decades, the EPA has accounted for them when setting safeguards,” said Amanda Leland, executive director of the Environmental Defense Fund in a social media post. “Now, the agency is set to stop factoring in those enormous health benefits while still counting costs to corporations.

“At a time when climate change is driving more of the pollution that makes us sick, this decision to ignore the data doesn’t make the problem go away—it only makes it harder to address.”

Dangerous global precedent 

And in the international space, clean air experts in Asia and elsewhere worry this shift could undermine emission standards in the Global South. 

“This sets a dangerous global precedent that could weaken the adoption of stronger environmental protections. It is crucial that this shift does not influence or undermine the air quality and emission standards currently taking shape across the Global South,” Anumita Roychowdhury, executive director, at the Centre for Science and Environment in New Delhi, told Health Policy Watch.

“It removes the primary justification for essential environmental standards. By focusing solely on industrial compliance costs, the EPA has created a regulatory environment where significant public health harms are ignored in favour of corporate profits.

“This decision to stop calculating the health impacts of air pollution and the associated life-saving benefits in the rule making process by the EPA places millions of Americans at risk,” Rowchowdhury said.

Former World Health Organization Chief Scientist Soumya Swaminathan echoed the sentiment, telling Health Policy Watch: “The EPA was a fine example of a science based agency, that led in environmental health regulations globally.”

Swaminathan is currently chair of the M S Swaminathan Research Foundation, as well as a Co-Chair of the Our Common Air, a global initiative. 

Air pollution costs US over $790 billion annually – previous EPA data  

You will find more infographics at Statista

Ground level ozone and particulate matter (PM2.5), the two leading air pollutants that cause health harms, together account for the majority of the 135,000 air pollution-related premature  deaths in the United States, according to the US State Department website.

As of the time of this publication, the State Department website still cited  previous EPA estimates of air pollution’s health costs and monetary benefits of cleanup, stating “The EPA estimates that for every dollar invested in cleaning the air, 30-90 dollars are returned in improved health and economic productivity. Reducing air pollution is an economic accelerant.”

“The World Bank found that air pollution costs the U.S. economy over $790 billion per year or approximately 5% of our GDP in economic welfare losses. Air pollution costs the world economy over $8.1 trillion per year, or 6.1% of global GDP,” the State Department website adds.  

PM2.5, typically emitted by power plants and car exhaust, travels deep into a person’s lungs and into the bloodstream. 

In the short-term, breathing polluted air can trigger asthma, coughing, and respiratory distress.  Chronic exposures lead to the build up of plaque on arterial walls, more blood clots, constricted blood vessels and higher blood pressure – all contributing to a heightened risk of heart attack and stroke as well as cancers. 

PM 2.5 pollution is also linked to a host of conditions starting from birth: pre-term birth and low birth weight, reproductive stress, heart disease and lung cancer, and even dementia and cognitive decline. 

“Air pollution is a silent killer,” said Romanello who also researchers climate change and health researcher at University College London. “This not only affects people’s health, but also the economy, making people sick, reducing their capacity to work, increasing health bills, and affecting the economy as a whole.”

Huge wins since 1970 Clean Air Act under threat?

The US saw huge wins in cleaning up its air following the passage of the landmark 1970 Clean Air Act.

While PM2.5 levels have declined sharply in past decades, hot spots remain. Ground-level ozone (O3), which forms when nitrogen oxide (NOx) emissions and other volatile organic compounds are exposed to sunlight, has remained a major problem – associated with asthma and other chronic respiratory issues, as well as reduced crop production.

Meanwhile, under the new administration of President Donald Trump, tensions between government and environmental groups escalated – including with the appointment of Zeldin as EPA administrator.  

In March 2025, the EPA unleashed the first in a series of sweeping regulatory changes on pollution emissions with Zeldin saying “[t]oday is the greatest day of deregulation our nation has seen. We are driving a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the US and more.” 

Some take a wait-and-see attitude on EPA policy change

Some experts noted that dropping the monetary value on the health benefits of air pollution regulation may not be as dramatic as advocacy groups warn.

“I’m not convinced yet that this will make a big difference – but it will likely mean more court cases with less complete information,” Michael Brauer, a Canadian expert affiliated with the University of Washington-based Institute for Health Metrics and Evaluation (IHME). IHME’s Global Burden of Disease assessments have regularly ranked air pollution as one of the world’s leading risks to health.  

“The Clean Air Act (CAA) still requires only consideration of public health, not cost, in setting national ambient air quality standards,” said Brauer. 

“Now, it looks like they will still do cost analyses, but just not quantify any benefits – still, none of this changes the basic CAA requirements.

“This does not preclude them from assessing health impacts and in the setting of standards for criteria air pollutants, public health protection and not cost is the requirement under the law.  Perhaps EPA will also raise questions about the mortality estimates themselves, but for now this is just about the costs assigned to health impacts which has always been somewhat controversial.

“Bottom line – more court cases  (and in at least some of these I’d expect that judges will want to know about costs and benefits and the EPA will not have the benefits part accounted for which may, in the end, work against changes in regulation),” said Brauer. 

Several US-based environmental health groups declined to comment publicly on the changes. The Trump administration has punished health advocacy and research institutions in the past with retaliatory funding cuts in response to criticism. In one of the most recent examples, the American Academy of Pediatrics was informed that some $12 million in federal research funds would be rescinded after it criticized HHS’s vaccine policy changes. Early in January, a federal judge ordered the funding be restored, deeming the cuts to be retaliatory. 

For Dr Maria Neira, former director of the Department of Public Health and Environment at the World Health Organization, the fact that the EPA still acknowledges its mandate to monitor the health effects of air pollution is a positive. “Protecting the health of people is one of the biggest, most beautiful and incredible missions for all of us to come together around,” said Neira, in a statement to Health Policy Watch. “Of course, we need to protect the economy, but the two things can be done together.”

This story was updated 14 January to inlcude additional expert reaction.

Chetan Bhattacharji and Elaine Ruth Fletcher contributed to this report.

Image Credits: Ella Ivanescu/ Unsplash, AP/Sierra Club.