Applying data envelopment analysis to evaluate efficiency of low emission zone policies in European cities

Low emission zones reduced PM10 but not NO2 concentrations in Berlin and Munich, Germany

This paper bridges the gap between the literature on the pandemic’s effects on mobility and the literature on the impact of low emission zones (LEZ). Using data for large European cities in the period 2018–2021, we examine whether LEZs may explain differences in the recovery patterns of traffic in European cities after the shock of Covid. Controlling for several city attributes, we examine whether LEZ cities are less congested before and after the pandemic in comparison to non-LEZ cities. LEZs may have been more effective in reducing congestion after the pandemic because the fleet renewal process has slowed down or, alternatively, LEZs may be a proxy of unobservable factors related with attitudes of governments and citizens toward a sustainable mobility. Our results validate the traffic-mitigating role of the LEZ after the Covid-19 pandemic, although such result only holds for the pioneering LEZ cities. Hence, the traffic-mitigating role of the LEZ after the Covid-19 pandemic seems to be related to unobservable attributes that influenced the early decision to implement a LEZ. In this regard, we also find that LEZs may have induced a change in local attributes related to sustainable mobility given that we do not find differences between LEZs decided at the local or regional level.

Urban air pollution poses significant threats to public health, environmental sustainability, and economic stability, with vehicle emissions constituting the largest source of harmful contaminants in urban areas. Addressing these challenges and achieving climate neutrality requires a 90% reduction in transport-related emissions by 2050. As described in the article, Low Emission Zones (LEZs) and Zero Emission Zones (ZEZs) have emerged as key policy instruments aimed at restricting access for high-emission vehicles while promoting cleaner transport alternatives, including public transport, cycling, and walking. In the paper, LEZs are conceptualized as mechanisms designed to improve air quality, protect public health, advance climate objectives, and enhance social inclusion. The effective implementation of LEZs necessitates coordinated engagement among multiple stakeholders, including local authorities, motorists, businesses, environmental non-governmental organizations, public transport operators, residents, and vulnerable social groups. Case studies from London, Warsaw, and Cracow demonstrate diverse governance approaches and stakeholder dynamics, illustrating both the advantages and challenges associated with LEZ implementation. In the paper, the findings indicate that although LEZs contribute to measurable reductions in air pollutants, noise levels, and health risks, they also generate concerns related to equity, economic impacts, and public acceptance, thereby underscoring the need for transparent communication, phased implementation strategies, and targeted support measures to ensure long-term effectiveness and societal acceptance.

Review of the efficacy of low emission zones to improve urban air quality in European cities

Positive impact of the introduction of low-emission zones in Antwerp and Brussels on air quality, socio-economic disparities and health: a quasi-experimental study.

Sustainable e-commerce urban distribution in LEZ areas: A greening Metro-based solution (M4G: Metro For Goods)

Modern health care systems are characterized by pronounced prevention and cost-optimized treatments. This dissertation offers novel empirical evidence on how useful such measures can be. The first chapter analyzes how radiation, a main pollutant in health care, can negatively affect cognitive health. The second chapter focuses on the effect of Low Emission Zones on public heath, as air quality is the major external source of health problems. Both chapters point out potentials for preventive measures. Finally, chapter three studies how changes in treatment prices affect the reallocation of hospital resources. In the following, I briefly summarize each chapter and discuss implications for health care systems as well as other policy areas. Based on the National Educational Panel Study that is linked to data on radiation, chapter one shows that radiation can have negative long-term effects on cognitive skills, even at subclinical doses. Exploiting arguably exogenous variation in soil contamination in Germany due to the Chernobyl disaster in 1986, the findings show that people exposed to higher radiation perform significantly worse in cognitive tests 25 years later. Identification is ensured by abnormal rainfall within a critical period of ten days. The results show that the effect is stronger among older cohorts than younger cohorts, which is consistent with radiation accelerating cognitive decline as people get older. On average, a one-standarddeviation increase in the initial level of CS137 (around 30 chest x-rays) is associated with a decrease in the cognitive skills by 4.1 percent of a standard deviation (around 0.05 school years). Chapter one shows that sub-clinical levels of radiation can have negative consequences even after early childhood. This is of particular importance because most of the literature focuses on exposure very early in life, often during pregnancy. However, population exposed after birth is over 100 times larger. These results point to substantial external human capital costs of radiation which can be reduced by choices of medical procedures. There is a large potential for reductions because about one-third of all CT scans are assumed to be not medically justified (Brenner and Hall, 2007). If people receive unnecessary CT scans because of economic incentives, this chapter points to additional external costs of health care policies. Furthermore, the results can inform the cost-benefit trade-off for medically indicated procedures. Chapter two provides evidence about the effectiveness of Low Emission Zones. Low Emission Zones are typically justified by improvements in population health. However, there is little evidence about the potential health benefits from policy interventions aiming at improving air quality in inner-cities. The chapter ask how the coverage of Low Emission Zones air pollution and hospitalization, by exploiting variation in the roll out of Low Emission Zones in Germany. It combines information on the geographic coverage of Low Emission Zones with rich panel data on the universe of German hospitals over the period from 2006 to 2016 with precise information on hospital locations and the annual frequency of detailed diagnoses. In order to establish that our estimates of Low Emission Zones’ health impacts can indeed be attributed to improvements in local air quality, we use data from Germany’s official air pollution monitoring system and assign monitor locations to Low Emission Zones and test whether measures of air pollution are affected by the coverage of a Low Emission Zone. Results in chapter two confirm former results showing that the introduction of Low Emission Zones improved air quality significantly by reducing NO2 and PM10 concentrations. Furthermore, the chapter shows that hospitals which catchment areas are covered by a Low Emission Zone, diagnose significantly less air pollution related diseases, in particular by reducing the incidents of chronic diseases of the circulatory and the respiratory system. The effect is stronger before 2012, which is consistent with a general improvement in the vehicle fleet’s emission standards. Depending on the disease, a one-standard-deviation increase in the coverage of a hospitals catchment area covered by a Low Emission Zone reduces the yearly number of diagnoses up to 5 percent. These findings have strong implications for policy makers. In 2015, overall costs for health care in Germany were around 340 billion euros, of which 46 billion euros for diseases of the circulatory system, making it the most expensive type of disease caused by 2.9 million cases (Statistisches Bundesamt, 2017b). Hence, reductions in the incidence of diseases of the circulatory system may directly reduce society’s health care costs. Whereas chapter one and two study the demand-side in health care markets and thus preventive potential, chapter three analyzes the supply-side. By exploiting the same hospital panel data set as in chapter two, chapter three studies the effect of treatment price shocks on the reallocation of hospital resources in Germany. Starting in 2005, the implementation of the German-DRG-System led to general idiosyncratic treatment price shocks for individual hospitals. Thus far there is little evidence of the impact of general price shocks on the reallocation of hospital resources. Additionally, I add to the exiting literature by showing that price shocks can have persistent effects on hospital resources even when these shocks vanish. However, simple OLS regressions would underestimate the true effect, due to endogenous treatment price shocks. I implement a novel instrument variable strategy that exploits the exogenous variation in the number of days of snow in hospital catchment areas. A peculiarity of the reform allowed variation in days of snow to have a persistent impact on treatment prices. I find that treatment price increases lead to increases in input factors such as nursing staff, physicians and the range of treatments offered but to decreases in the treatment volume. This indicates supplier-induced demand. Furthermore, the probability of hospital mergers and privatization decreases. Structural differences in pre-treatment characteristics between hospitals enhance these effects. For instance, private and larger hospitals are more affected. IV estimates reveal that OLS results are biased towards zero in almost all dimensions because structural hospital differences are correlated with the reallocation of hospital resources. These results are important for several reasons. The G-DRG-Reform led to a persistent polarization of hospital resources, as some hospitals were exposed to treatment price increases, while others experienced reductions. If hospitals increase the treatment volume as a response to price reductions by offering unnecessary therapies, it has a negative impact on population wellbeing and public spending. However, results show a decrease in the range of treatments if prices decrease. Hospitals might specialize more, thus attracting more patients. From a policy perspective it is important to evaluate if such changes in the range of treatments jeopardize an adequate nationwide provision of treatments. Furthermore, the results show a decrease in the number of nurses and physicians if prices decrease. This could partly explain the nursing crisis in German hospitals. However, since hospitals specialize more they might be able to realize efficiency gains which justify reductions in input factors without loses in quality. Further research is necessary to provide evidence for the impact of the G-DRG-Reform on health care quality. Another important aspect are changes in the organizational structure. Many public hospitals have been privatized or merged. The findings show that this is at least partly driven by the G-DRG-Reform. This can again lead to a lack in services offered in some regions if merged hospitals specialize more or if hospitals are taken over by ecclesiastical organizations which do not provide all treatments due to moral conviction. Overall, this dissertation reveals large potential for preventive health care measures and helps to explain reallocation processes in the hospital sector if treatment prices change. Furthermore, its findings have potentially relevant implications for other areas of public policy. Chapter one identifies an effect of low dose radiation on cognitive health. As mankind is searching for new energy sources, nuclear power is becoming popular again. However, results of chapter one point to substantial costs of nuclear energy which have not been accounted yet. Chapter two finds strong evidence that air quality improvements by Low Emission Zones translate into health improvements, even at relatively low levels of air pollution. These findings may, for instance, be of relevance to design further policies targeted at air pollution such as diesel bans. As pointed out in chapter three, the implementation of DRG-Systems may have unintended side-effects on the reallocation of hospital resources. This may also apply to other providers in the health care sector such as resident doctors.

BackgroundTraffic-related air pollution (TRAP) is associated with adverse health outcomes across the life course. In children, long-term exposure to TRAP is associated with asthma, acute lower respiratory infections and reduced...

Concentrations of ambient fine particles (PM10: particles with an aerodynamic diameter ≤ 10 µm) are still exceeding current air quality standards in many European cities. In Munich (Germany), low emission zone and transit bans for heavy-duty vehicles were introduced in 2008 aiming at reduction of traffic emissions contribution to PM10. The effects of those measures on PM10 mass concentrations in Munich were investigated with a semiparametric regression model for modeling PM10 levels adjusted for time, background pollution, public holidays and wind direction. The reduction of PM10 concentration after the introduction of the measures was larger at a traffic monitoring site (13.0 %, 19.6 % in summer, and 6.8 % in winter) and smaller in urban background (4.5 %, 5.7 % in summer, and 3.2 % in winter). The effect was most pronounced on Fridays and on the weekends in summer.

Elemental carbon as an indicator for evaluating the impact of traffic measures on air quality and health

Health effects of low emission and congestion charging zones: a systematic review

Urban air pollution is a challenge in several European cities. For most Norwegian cities, the major challenge is the reduction of the NO2 annual mean concentration in order to comply with the limit value in the European Directive 2008/50/EC, but also too many high NO2 hourly values occur during strong inversions in cold winter periods. In Oslo, the main contributor to NO2 concentration levels is diesel exhaust and hence the proposed measures in this study are targeting road traffic. An extensive array of individual and grouped measures were constructed and we studied the change in traffic and NO2 concentrations by performing consecutive modelling studies which included traffic, emissions, and dispersion models. These measures were intended for permanent and temporary action. They included increases of the tolls that give access to the inner parts of the city, the establishment of low emission zones (LEZs), allowing for temporary free public transport, odd-even driving, defining priority lanes for low emission vehicles, and imposing higher parking fees. We concluded that the most efficient measures were the creation of LEZs and the increase of parking fees. We also explain how the findings from this work have helped to implement Norwegian air quality control policies.

The paper outlines some preliminary results of an ongoing study on 'conditions of success in sustainable transport policies in cities'. The study consists of a comparative analysis of five case studies dealing with relatively successful European cities in three countries: Zurich, Basle (Switzerland), Amsterdam, Groningen (The Netherlands) and Freiburg (Germany). Having in mind the ongoing deterioration of traffic-related environmental problems in cities, the paper proceeds in a three-step approach: by describing the trends of transport of persons and the environment in general and of forerunner cities in particular, the opportunities and limits of sustainable urban transport developments are detected in a first step. In a second step, the degrees and patterns of environmentally oriented policy changes in relatively successful cities are outlined. The third step focuses on the reasons and ways policy windows open up for fundamental environmentally oriented changes of transport policies. It is argued that 'macro-windows' for such changes only open up due to strong and enduring forces originally from outside the local political system. Social crises and impressive political mandates were identified as important external factors that influenced the 'greening' of urban transport in the relatively successful cities. However, an open macro-window is only conceived as a political opportunity for change, a necessary but not sufficient condition. Whether or to what extent these opportunities are utilized depends on further factors.

In 2010, half of the world's population lived in cities, reaching three quarters in Europe.1 ,2 Health inequalities tend to be more marked in urban areas because they include neighbourhoods...

Background In many cities worldwide, a Low Emission Zone has been introduced with the aim to improve livability of urban areas and foster sustainable mobility habits. However, a limited or absent public support has proven to hinder the implementation of such intervention or negatively impact its effectiveness. Objective This paper aims to understand factors prompting and hindering acceptability of a Low Emission Zone in a medium-sized city. Methods The study area was the city of Padova (Italy), where a potential future shift from the current limited traffic zone toward a Low Emission Zone was investigated. A mobility questionnaire administered to stakeholders of the intervention area. Data collected were used as input of an integrated set of statistical models. A factor analysis was implemented to highlight the underlying structure of respondents’ opinion about the Low Emission Zone. A cluster analysis was used to define stakeholders' profiles, and an ordinal logit model was developed to identify factors affecting the support of the new regulation. Results Results pointed out profiles of both supporters and opposers to the measure. To effectively improve public support, potential benefits of the current Limited Traffic Zone and how the Low Emission Zone aims to enhance them could be highlighted. As expected, the highest opposition could stem from car users, who should be targeted with specific strategies to increase their acceptability level. Conclusions The analysis highlighted how policy makers and local authorities can foster the widest support of the new Low Emission Zone and thus broadening its potential benefits.