Vehicular Pollution: New Roadmap to Avoid Millions of Early Deaths and Cases of Childhood Asthma
Zero-emission vehicles powered by renewable energy could most likely avoid 1.9 million premature deaths, going up as much 2.4 million by 2040.

The International Council on Clean Transportation (ICCT), famous for busting Volkswagen’s Dieselgate, has a new ambition: Taking immediate action to shift to zero-emissions vehicles, significantly cutting ozone (O3) nitrogen dioxide (NO2) and PM2.5 pollution, and avoiding millions of cases of early death and paediatric asthma. Business-as-usual vehicle scenarios will lead to an increase. 

Because they breathe faster than adults, children are particularly vulnerable to emissions from vehicles. Toddlers are worse off because their shorter height means they’re closer to exhaust pipes. A new report has attempted to measure this and model various scenarios of controlling pollution from vehicles that would best protect children from asthma, and older people from air pollution-related chronic illnesses and premature deaths. 

The report, Global Health Benefits of Policies to Reduce On-Road Vehicle Pollution Through 2040, is by 10 authors, mostly associated with the ICCT. The group is perhaps best known for exposing Volkswagen for fudging on the true level of emissions from its popular diesel vehicles – known as the Dieselgate scandal. That cost the German auto giant billions of dollars and shifting producers away from the most health-harmful vehicle fuel. Now, the ICCT has turned its attention to the world’s vehicle fleet – analysing what would it take to reduce cases of early deaths and paediatric asthma over the next two decades. 

The authors say that their study, published in March as a Lancet pre-print, is the first of its kind to provide a globally consistent evaluation of this issue. They examined the impact of vehicular pollution at a one-kilometre resolution across 186 countries and territories that cover 99% of the global population. Fifteen emissions scenarios were evaluated representing different policy combinations. 

At one end is what the study calls the BASE scenario, where emission controls and policies analysed are as of March 2023, the time of this analysis. At the other end is the ALLZG scenario, the most ambitious one where all the best current and future technologies (like Euro 7 emission standard), are adopted for all sales of new internal combustion engines (ICE) in the world’s countries and territories. The ALLZG scenario also includes expedited rollout of zero-emission vehicles (ZEV), with renewable energy sources powering most of that shift. It further assumes countries would phase out older ICE vehicles, which don’t meet the most recent standards.  

Act to avoid premature deaths, children’s asthma

Children breathe faster and also are closer to the ground – thus more exposed to tailpipe emissions – ICCT.

Its conclusion is that the most ambitious ALLZG scenario could avoid 1.9 million premature deaths – and as many as 2.4 million between 2023 and 2040. People over the age of 65 would gain the biggest benefit in terms of avoided premature deaths. But in terms of illness, children would also benefit in a big way, especially in developing countries and urban areas. About 1.4 million cases of paediatric asthma could be avoided, with the projection rising to 1.7 million children – as many as half of them toddlers under the age of five. 

Under the business-as-usual scenario i.e. if government policies as of March 2023 remain in place, then annual deaths from transport-related emissions would increase from 182,000 annually in 2020 to 210,000 in 2040. Chronic obstructive pulmonary disease (COPD) or chronic lung disease, is the leading cause of air-pollution related premature deaths with cardiovascular disease, hypertension and cancer as other leading causes. 

Global South has the most to gain

Ozone concentrations are highest in African and Asian parts of the global south.

The study is preliminary and not peer-reviewed, the publishers point out. However, its data is broadly in line with trends and reality already observed especially about vehicular pollution.

Much of the Global South is way behind in controls. Many countries haven’t even implemented Euro 6, a diesel emission standard for vehicles first introduced in 2014 in the European Union, and a reference point for major manufacturers globally. It is also a truism that urban areas are more affected given the concentration of vehicles. Two-thirds of over 1.8 million new cases of paediatric asthma globally in 2019 occurred in urban areas. 

The report says that regions and trade blocs that mainly consist of countries in the Global South – Middle East, ASEAN (Southeast Asia), SAARC (South Asia), and ECOWAS (Africa) – have the greatest potential for mitigating new paediatric asthma cases from road transport emissions. Disparities in road transport-attributable health burdens are projected to widen amongst countries with different levels of development, with populations in countries with lower social demographic indices (SDIs) experiencing the largest increases in road transport-attributable health burdens. 

In countries without Euro 6 equivalent standards, implementing these could achieve 64% and 71% of the total benefits of all emission control measures combined for avoidable premature deaths and new paediatric asthma cases respectively. 

Most of the savings in lives from ozone (O3) would be in the global south, according to the analysis, published in preprint.

Overall, more than nine out of 10 fatalities are attributable to air pollution and the majority of the associated economic losses are concentrated in low-income and middle-income countries, and disproportionally affect children, the elderly, and socially vulnerable individuals.

One child’s death by vehicular pollution

Ella Roberta Adoo Kissi Debrah, who died on 15 February 2013 of a fatal asthma attack. She was the first air pollution victim to have that written as a cause on her death certificate, posthumously.

While the awareness about the links between air pollution and asthma has grown significantly, it has remained a more marginal issue in the air pollution debate, at least until the case of nine-year-old Ella Roberta Adoo Kissi Debrah who suffered from chronic asthma and died in 2013. Hers became the world’s first case where a death was officially attributed to air pollution. Initially, her death was merely attributed to acute respiratory failure. But  following a public campaign led by her mother, Rosamund Kissi-Debrah, a 2020 court ruling determined that her death should be attributed to levels of NO2 above the legal limits in her south-east London neighbourhood.

“The principal source of her exposure was traffic emissions.” The Coroner informed the court that “excess levels of nitrogen dioxide and particulate matter, PM10 and PM2.5, were a health risk, especially to children with asthma. Kissi-Debrah went on to found the Ella Roberta Foundation, campaigning against air pollution in the name of her late daughter. 

Still need an integrated approach 

Sadiq Khan, Mayor of London, has led a high-profile campaign to cut air pollution.

Bolstered by growing public awareness, London’s Mayor Sadiq Khan, who took office in 2016, has led a dramatic policy shift leading to sharp reductions in vehicular pollution. 

In March 2024, the mayor’s office announced that the roadside nitrogen dioxide (NO2) concentration levels had fallen by 49% between 2016 and 2023. NO2 levels were lower than even the first year of the COVID lockdown. The pandemic, moreover, vividly demonstrated to the public how a drastic reduction in traffic could reduce NO2, PM10, sulphur dioxide and carbon monoxide emissions, which are a direct or indirect result of burning fossil fuels for transport. 

As part of the shift, London has, of course, electrified vast chunks of its transport and tightened emission norms in lines with many of the recommendations of the new ICCT-led report.  However, the UK city also has created and expanded an ultra-low emission zone in the central city, greened public spaces, and created more cycling and pedestrian routes to encourage shifts to non-motorized transport along with improving public transport.

So while the London experience demonstrates that changes in vehicle emission policies can make a big difference, it also illustrates that an integrated approach remains critical – although the benefits of greener transport, mode shift, and greener urban planning remain to be quantified at a global level.

Not only that, but the climate impacts of reducing emissions also need to be considered along with the direct air quality benefits, as demonstrated in another report by ICCT, published late last year. That report focused on how reducing greenhouse gas emissions from vehicles could help limit global warming exceeding the 1.5° Celsius target climate scientists say needs to be reached to avoid greater catastrophic fallouts from extreme weather to the destruction of delicate coral reefs. Globally, road vehicles currently account for more than 20% of the carbon emissions from human activities, considering both fuel production and combustion. 

But both reports are clear.  To cut air pollutants from vehicles, policy action needs to be very ambitious and needs to start immediately, especially in the Global South. The Global North, as decades of climate negotiations have shown, needs to step up and transfer both green tech and money to the effort as fast as possible. Lives are at stake. 

Image Credits: , ICCT , ICCT , ICCT/The Lancet , Mayor of London .

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.