Urban NO-pollution and health outcomes: Evidence from a natural experiment in Italy on the simulated benefits of the EU zero-emission-vehicles resolution.

Publication date: Jun 20, 2025

The EU “Fit-For-55″ resolution provisions the banning of fossil-fuel-vehicle sales beyond 2035, sparking a heated debate due to its uncertain effectiveness in reducing CO emissions globally. Nevertheless, the EU shift towards zero-emission vehicles has the potential to decrease urban nitrogen dioxide (NO) pollution that is closely linked to respiratory and cardiovascular diseases and to increased mortality. This paper aims to simulate the impact that the EU zero-emission-mobility policy is expected to have, post-transitional period, on urban NO and health outcomes. The analysis exploits some unique features of Northern-Italy air-pollution data and the Italian Covid-19 lockdown that is leveraged as a natural experiment to mimic the fossil-fuel traffic abatement expected by the policy. Our estimates are obtained by developing a novel intertemporal-statistical-matching approach specifically suited for quasi-experimental evaluations in the context of air-pollution multivariate time series. We find that the lockdown led to a mean NO reduction of 13. 62 μg/m^3 (53 % from a baseline of 25. 8 μg/m^3), translating into a simulated reduction in the relative risk of total, cardiovascular, and respiratory mortality by 8. 3, 7. 5 and 3. 8 percentage points, respectively. We also estimate impact heterogeneity, with log-linearly larger reductions in NO and mortality risk at higher baseline-pollution levels. These results imply that the EU zero-emission mobility policy is expected to improve air-quality and public health in urban areas with high traffic density, though benefits may vary across regions due to differences in meteorological conditions and urban/orographic characteristics, supporting a spatially differentiated policy implementation.

Concepts Keywords
Fossil Air-pollution
Italian EU zero-emission-mobility policy
Lockdown Health effects
Meteorological Impact heterogeneity
Intertemporal statistical matching
NO(2) abatement
Urban areas

Semantics

Type Source Name
disease MESH cardiovascular diseases
drug DRUGBANK Medical air
disease MESH Covid-19
disease IDO quality

Original Article

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