The Impact of Air Pollution on our Health

Learn about the impact of air pollution on our health and who is most at risk.
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Dr Elsa Cassar

Tue 25 July 2023

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The main impacts of air pollution on the body are on the respiratory system and the cardiovascular system. Given that the population of Malta is exposed to high levels of air pollution, this is a significant public health concern.

What do the statistics tell us?

  • It is estimated that more than 500 people die prematurely in Malta every year due to air pollution1
  • Air pollution is believed to have accounted for 4% of all deaths in Malta in 20192
  • Malta exceeds the EU limit values for ozone and particulate matter (PM10)3
  • Air pollution is within the top 10 risk factors driving death and disability in Malta4

1. The impact on our lungs

Air pollution is a significant risk factor for respiratory diseases, namely asthma, bronchitis and lung cancer. Air pollutants irritate the airways causing inflammation and airway constriction, potentially worsening symptoms in individuals with asthma and chronic bronchitis. Asthma cases have been on the rise in recent years, with air pollution being a contributing factor. In fact, approximately 9% of those above the age of 16 are affected by asthma in Malta5.

Long-term exposure to air pollution, particularly fine particulate matter (PM2.5) and toxic chases, has also been found to increase the risk of lung cancer. Long-term exposure to PM2.5 was found to be associated with a 15% higher risk of lung cancer for every 5 micrograms per cubic meter increase in exposure to PM2.5. The same study estimated that air pollution contributes to around 3.2 million new cases of lung cancer every year6. This is especially significant in Malta, where lung cancer is the leading cause of cancer-related deaths in Malta7.

2. The impact on our hearts

Air pollution is also increasingly being recognised as a significant risk factor for cardiovascular disease, especially when it comes to fine particulate matter (PM2.5) and toxic gases. Long-term exposure to air pollution has been found to increase the risk of heart attacks, strokes and other adverse cardiovascular outcomes, such as in the following ways:

  • Fine particulate matter can enter the bloodstream, causing inflammation and formation of blood clots.
  • Nitrogen dioxide can contribute to contraction of blood vessels, which increases the risk of high blood pressure and atherosclerosis (narrowing of blood vessels).

Studies have shown that air pollution reduces life expectancy by a number of years and is responsible for 19% of cardiovascular mortality, amounting to more than 3 million deaths per year globally8.

3. The impact on our mental health

It is increasingly being recognised that air pollution is a risk factor for mental health issues, such as depression, anxiety, and cognitive decline.

A study published in Environmental Health Perspectives found that higher levels of air pollution were significantly associated with increased risk of depression and worse symptom severity. They estimated that reducing PM2.5 levels to below the WHO target could prevent around 178,000 new cases of depression annually in the United States alone!9

4. Who is most vulnerable?

While air pollution affects everyone, some groups are more vulnerable than others.

4.1 Children

Children’s bodies are still developing and therefore they are at increased risk of the harms of air pollutants and their bodies are less equipped to excrete these toxins. A key WHO report found that 1 in 10 deaths in children under five years of age was caused by air pollution, in a world where over 90% of children are exposed to toxic levels10.

4.2 Pregnancy

Several studies have shown that exposure to air pollutants during pregnancy increases the risk of preterm birth, low birth weight, and developmental issues in children.

4.3 Elderly

The elderly are more likely to have pre-existing conditions that make them more susceptible to disease and to infections. Moreover, the physiological changes that come with age place them at a higher risk to these pollutants. In summary, this results in exacerbation of respiratory and cardiovascular disease, increased hospitalisations, increased respiratory tract infections, and increased risk of premature mortality.



  1. Malta Association of Public Health Medicine, 2020
  2. State of Health in the EU, Malta Country Health Profile 2021
  3. State of the Environment Report - Chapter 2: Ambient Air, Environment & Resources Authority, Malta
  4. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
  5. European Health Interview Survey (EHIS) 2014
  6. Hamra, G. B., Guha, N., Cohen, A., & Laden, F. (2014). Outdoor particulate matter exposure and lung cancer: a systematic review and meta-analysis. Environmental health perspectives, 122(9), 906-911.
  7. International Agency for Research on Cancer, 2020
  8. Hadley MB, Vedanthan R, Fuster V. Air pollution and cardiovascular disease: a window of opportunity. Nat Rev Cardiol. 2018;15(4):193-4.
  9. Power, M. C., et al. (2015). The Association between Air Pollution and Subclinical Brain Metabolism in the Framingham Heart Study. Stroke, 46(12), 3337-3341.
  10. Air pollution and child health: prescribing clean air, WHO, 2019