In the present study, we conducted a risk assessment of urban population exposure to ambient particles (PM2.5, PM10), nitrogen dioxides (NO2), and tropospheric ozone (O3) in six Polish urban areas over the period 2015–2020. The main goals were to: i) evaluate the number of premature deaths attributed to ambient air pollutants, and to ii) assess the effectiveness of emissions control policies in reducing urban population exposure to air pollution, and thus related health effects. For that, we used air quality data from 15 urban monitoring stations and city-specific health data (relative risk values and baseline incidence). For all cities, the annual PM2.5, PM10, and NO2 mean concentrations exceeded the 2021 World Health Organization Air Quality Guidelines in 2015–2020. In all cities, the annual PM2.5 (- 0.5% to - 6.1% year−1), PM10 (- 1.6 to - 8.1% year−1), and NO2 (- 1.3% to - 4.5% year−1) mean concentrations declined over time, while O3 levels rose (+1.0% to + 4.2% year−1). Exposure to ambient PM2.5, PM10, NO2, and O3 has substantially contributed to mortality in the six studied cities: a total of 6700 deaths for non-accidental causes, 2310 deaths for cardiovascular diseases, and 500 deaths for respiratory diseases were reported. Between 2015 and 2020, the number of annual PM2.5-, PM10-, and NO2-related premature deaths decreased (respectively, by - 8.4, - 6.7, and - 2.1 deaths per 106 inhabitants) in line with cleaner air. The rising O3 levels led to an increase in annual O3-related premature deaths (+1.3 deaths per 106 inhabitants) over time. A major concern is related to the overrun of exposure metrics compared to the target values for human health. To date, human health is mainly threatened by PM2.5 and O3, particularly in Southern Poland.
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