The health costs of air pollution from roads are higher in London than any other city in Europe, a study has found. Two other urban areas in the UK, Manchester and the West Midlands, have the 15th and 19th highest costs respectively among the 432 European cities analysed. The research puts a figure on the social costs of car emissions at local level at an unprecedented number of sites across 30 countries – the EU27 plus the UK, Norway and Switzerland. The costs measure the overall erosion of public welfare, defined as living a long and healthy life in a clean environment. The research quantifies the monetary value of premature death, hospital treatment, lost working days and other health costs caused by particulate matter, ozone and nitrogen dioxide. Indoor air pollution was not taken into account. Researchers at the consultancy CE Delft used Eurostat pollution and demographic data from 2018 and WHO recommendations. The study is published by the European Public Health Alliance (EPHA), a network affiliating healthcare NGOs across Europe. The 130 million inhabitants of the cities investigated by the study suffer more than £150bn of damage a year, with an average cost of £349m per city. Pollution-related deaths contribute 76% of the costs, with diseases accounting for the rest. However, costs are thought to be underestimated because several cities under-report their level of pollution. Diesel vehicles are one of the main contributors to the damage. In the wake of the Volkswagen emissions cheating scandal in 2015, diesel cars and lorries were found to exceed EU limits for emissions that are the primary source of nitrogen dioxide (NO2). Moreover, diesel models older than the Euro 6 standard generally emit more particulate matter (PM) than other fossil-fuel engines, and also make up the largest share of the European fleet. NO2, PM and ground-level ozone (O3) – also largely derived from diesel – are responsible for nearly 500,000 premature deaths across Europe every year. Researchers focused on these three contaminants and concluded that PM is responsible for the vast majority of the social costs (82.5% on average), compared with NO2 (15%) and O3 (2.5%). London suffers the highest social cost, at £10.32bn a year, well ahead of other European cities such as Bucharest (£5.75bn), Berlin (£4.75bn), Warsaw (£3.83bn), Rome (£3.76bn) and Paris (£3.18bn). City size, combined with pollution level, is a key factor contributing to total social costs. The larger the population affected by high pollution levels, the higher the proportion of people who lose working days and have a shorter life expectancy. The costs per capita and relative to income also vary among cities. On average, every European town dweller pays more than £1,156 a year, equating to 3.9% of household income. Poorer cities tend to lose a higher share of income, with losses reaching 10% in highly polluted and densely populated cities in central and eastern Europe, where wages are lower. In the UK, the cost per city dweller is £905, representing 2.7% of average annual income. London tops the list of UK cities with costs of £1,173 per person, while residents of Plymouth bear the lowest costs of the cities studied, at £562 per capita. The study shows that transport policies can influence the costs incurred by air pollution from roads. For example, a 1% higher average duration of the drive to work increases damage from PM10 by 0.29% and from NO2 by 0.54%. Many countries plan to bring in bans on the sale of diesel and petrol cars by 2030, including Germany, the Netherlands and Ireland, while the UK’s current target is 2035 and France has a target of 2040. This will reduce the levels of some pollutants, though electric cars still produce significant amounts of particulate pollution through tyre and brake wear. Air pollution levels in most cities around Europe are at illegal levels. In an attempt to reduce the pollution and the associated costs, many cities have also increasingly started to allocate more space for sustainable modes of transport such as walking and cycling, as well as increasing investment in public transport. This story was supported by the European Data Journalist Network