Where is Albania located? If you live in these countries, you are breathing the most polluted air in Europe

Fine particles contributed to an estimated 239,000 deaths in Europe, but the burden was felt more deeply in some parts of the continent than others.

Air pollution is a deadly threat to public health, but some parts of Europe are at much higher risk than others.

Air pollution is linked to lung cancer, heart and respiratory diseases, strokes, poor birth outcomes and more.

It is especially dangerous for older people, causing about 4 percent of all deaths among adults aged 65 and older.

In 2021, the World Health Organization (WHO) updated its air quality guidelines, lowering the recommended threshold for annual concentrations of nitrogen dioxide and fine particulate matter (PM2.5) such as dust, smoke, and soot from exhaust.

In December, stricter air quality rules came into force, aiming to bring the European Union closer to WHO standards by 2030 and obliging member states to monitor pollutants such as fine particles, black carbon and ammonia.

The plan is “one of the biggest public health interventions in a generation,” Mark Nieuwenhuijsen, director of the Barcelona Institute for Global Health’s urban planning, environment and health initiative, told Euronews Health.

Overall, exposure to PM2.5 caused an estimated 239,000 premature deaths in Europe in 2021, while another 48,000 people died as a result of exposure to nitrogen dioxide, according to the European Environment Agency.

Currently, all EU countries report nitrogen dioxide levels above the levels recommended by the WHO, but some are hit harder by air pollution than others.

North Macedonia suffers the most pollution-related deaths, followed by Serbia. And neighboring Albania, Bulgaria and Montenegro all score very high, according to a recent report by the European Commission and the Organization for Economic Co-operation and Development (OECD).

A map shows air pollution-related death rates by country.

“The biggest divide in Europe that we see is east and west [and this], it matches very well with the GDP and the socio-economic background of the two regions,” said Zorana Jovanovic Andersen, a professor of environmental epidemiology at the University of Copenhagen and a member of the European Respiratory Society.

Nieuwenhuijsen's city-level research highlights the different challenges faced by different parts of Europe.

Northern Italy, Poland and the Czech Republic have seen high levels of PM2.5 mortality, which is largely driven by residential sources, such as burning coal for home heating and the agricultural sector.

Meanwhile, NO2 mortality – which is mainly driven by car traffic and the industrial sector – was highest in major cities and capitals in Western and Southern Europe.

“The need to regulate air pollution”

Several countries are taking steps to curb their pollution levels, including Denmark, which could become the first country in the world to impose a carbon tax on livestock in 2030.

The updated EU directive, meanwhile, gives citizens with pollution-related health problems the right to take their government to court if it fails to comply with EU air quality rules.

However, the report by the OECD and the European Commission said that while the EU is on track to curb PM2.5-related deaths by 55 percent by 2030, environmental risk factors such as air pollution and climate change are 'growing threats to public health'.

That's because scientists know more today about the health impacts of air pollution, and it appears to pose a risk to people at lower levels than previously known, Nieuwenhuijsen and Andersen said.

"Even if you significantly reduce air pollution levels, you may not always reduce health impacts," Nieuwenhuijsen said.

Air pollution may be the main environmental health threat facing Europe, but it tends to overlap with other factors, such as lack of green spaces, noise pollution and extreme heat, all of which have an impact on human health.

Given that some of these challenges are harder to solve – like climate change – Andersen said there is a stronger case for limiting air pollution in the name of protecting health.

"We have reduced air pollution and we know how to do it and many countries are leading the way," Andersen said.

"There are new challenges coming, so we need to fix air pollution – the old problem"/ Euro News.