Quantifying the impact of air pollution on the public’s health has become an increasingly critical component in policy discussion. Recent data indicate that more than 70% of the world population lives in cities. Several studies reported that current levels of air pollutants in urban areas are associated with adverse health risks, namely, cardiovascular diseases and lung cancer. IARC recently classified outdoor air pollution and related particulate matter (PM) as carcinogenic to humans. Despite the air quality improvements observed over the last few years, there is still continued widespread exceedance within Europe, particularly regarding PM and nitrogen oxides (NOx). The European Air Quality Directive 2008/50/EC requires Member States to design appropriate air quality plans for zones where air quality does not comply with established limit values. However, in most cases, air quality is only quantified using a combination of monitored and modeled data and no health impact assessment is carried out. An integrated approach combining the effects of several emission abatement measures on air quality, impacts on human health, and associated implementation costs enables an effective cost–benefit analysis and an added value to the decision-making process. Hence, this review describes the basic steps and tools for integrating health into air quality assessment (health indicators, exposure-response functions). In addition, consideration is given to two major outdoor pollutants: PM and NO₂. A summary of the health metrics used to assess the health impact of PM and NO₂ and recent epidemiologic data are also described.

The intensification of the human activity in urban areas as a result of the increasing population has contributed to the air pollution worsening in cities. To reverse this trend, the European Commission established a legal framework to improve the air quality. Thereby the Member States need to develop air quality plans (AQP) for zones and agglomerations where air quality limit values are exceeded, in order to implement pollution control strategies and meet the legal requirements. Understanding the reasons for the levels of air quality non–compliance as well as evaluating available and commonly used tools to predict the air quality and their effects, is crucial for the decision–making process on air quality management policies. Based on a compilation of regional and local AQP, a review of assessment capabilities and used modeling tools to evaluate the effects of emission abatement measures on the air quality and health was performed. In most cases, models are applied to estimate emissions and to assess the resulting air quality from both reference and emission abatement scenarios. Air quality’s impacts on the health and environment are rarely quantified. Regarding the air quality assessment, beyond the modeling, monitored data for validation of simulations are also used. Some studies, however, do not include the use of air quality models, considering the monitoring network as spatially representative of the study domain (e.g. Lisbon Region, Riga, Malta). In order to overcome methodological limitations for quantifying the impacts of emission abatement measures, economic evaluation techniques or even Integrated Assessment Methodologies (IAM) have been developed. IAM, already applied in some AQP or case studies, namely for Antwerp and London, are used for assessing how reductions in emissions contribute to improve air quality, reduce exposure and protect human health