Evaluating the Cost-Effectiveness of Air Pollution Mitigation Strategies: A Systematic Review

Bo Vandenbulcke (), Nick Verhaeghe, Lisa Cruycke, Max Lelie, Steven Simoens and Koen Putman
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Bo Vandenbulcke: Department of Public Health, Interuniversity Centre for Health Economics Research (i-CHER), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium
Nick Verhaeghe: Department of Public Health, Interuniversity Centre for Health Economics Research (i-CHER), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium
Lisa Cruycke: Department of Public Health, Interuniversity Centre for Health Economics Research (i-CHER), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium
Max Lelie: Department of Public Health, Interuniversity Centre for Health Economics Research (i-CHER), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium
Steven Simoens: Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, ON2 Herestraat 49, P.O. Box 521, 3000 Leuven, Belgium
Koen Putman: Department of Public Health, Interuniversity Centre for Health Economics Research (i-CHER), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium

IJERPH, 2025, vol. 22, issue 6, 1-44

Abstract: Air pollution is the world’s greatest environmental health risk. Pollutants that pose large health concerns are particulate matter (PM 2.5 and PM 10 ), ozone (O 3 ), carbon monoxide (CO), nitrogen dioxide (NO 2 ), and sulphur dioxide (SO 2 ). These compounds (especially PM 2.5 and PM 10 ) contribute to the onset of diseases, such as respiratory diseases (e.g., asthma, chronic obstructive pulmonary disease (COPD), or lung cancer) and cardiovascular diseases. Abatement interventions are implemented to reduce air pollution and thereby the risk of these diseases. This systematic review examined the published scientific evidence on the cost-effectiveness of strategies aimed at reducing or controlling air pollution and assessed the reporting quality of included studies. It employed rigorous data extraction and quality scoring procedures to ensure the reliability and validity of our findings. Overall, there is substantial evidence supporting the cost-effectiveness of interventions aimed at reducing air pollution. Seventy-four studies and four policy reports were included in this review. Predominantly, cost–benefit analyses have been reported ( n = 40), reflecting the multisectoral impacts and associated costs of air pollution. Only four cost–utility analyses were found, indicating the need for more research within this domain. Additionally, eight articles reported one or more non-economic results. Thirty-nine studies focused on particulate matter (PM), and eleven focused on nitrogen oxides (NOx). The quality assessment yielded moderate results. The heterogeneity of studies and moderate quality of reporting make it difficult to compare results and draw definitive conclusions.

Keywords: health economics; air pollution; cost-effectiveness; cost–benefit; cost–utility; systematic review (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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