title: Economic valuation of the mortality benefits of a regulation on SO2 in 20 European cities.
abstract: BACKGROUND
  Since the 1970s, legislation has led to progress in tackling several air pollutants. We quantify the annual monetary benefits resulting from reductions in mortality from the year 2000 onwards following the implementation of three European Commission regulations to reduce the sulphur content in liquid fuels for vehicles.
  
  
  METHODS
  We first compute premature deaths attributable to these implementations for 20 European cities in the Aphekom project by using a two-stage health impact assessment method. We then justify our choice to only consider mortality effects as short-term effects. We rely on European studies when selecting the central value of a life-year estimate (€ 2005 86 600) used to compute the monetary benefits for each of the cities. We also conduct an independent sensitivity analysis as well as an integrated uncertainty analysis that simultaneously accounts for uncertainties concerning epidemiology and economic valuation.
  
  
  RESULTS
  The implementation of these regulations is estimated to have postponed 2212 (95% confidence interval: 772-3663) deaths per year attributable to reductions in sulphur dioxide for the 20 European cities, from the year 2000 onwards. We obtained annual mortality benefits related to the implementation of the European regulation on sulphur dioxide of € 2005 191.6 million (95% confidence interval: € 2005 66.9-€ 2005 317.2).
  
  
  CONCLUSIONS
  Our approach is conservative in restricting to mortality effects and to short-term benefits only, thus only providing the lower-bound estimate. Our findings underline the health and monetary benefits to be obtained from implementing effective European policies on air pollution and ensuring compliance with them over time.
authors.affiliation: 1 Aix-Marseille School of Economics, Aix-Marseille University, CNRS & EHESS, GREQAM et IDEP, Marseilles, France olivier.chanel@univ-amu.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chanel
authors.affiliation: 2 School of Physics, Dublin Institute of Technology, Dublin, Ireland.
authors.forename: Susann
authors.initials: S
authors.lastname: Henschel
authors.affiliation: 2 School of Physics, Dublin Institute of Technology, Dublin, Ireland.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Goodman
authors.affiliation: 3 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece.
authors.forename: Antonis
authors.initials: A
authors.lastname: Analitis
authors.affiliation: 4 St. George's, University of London, London, UK.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Atkinson
authors.affiliation: 5 French Institute for Public Health Surveillance, InVS, Saint-Maurice, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Le Tertre
authors.affiliation: 6 Institute for the environment, Brunel University, London, UK.
authors.forename: Ariana
authors.initials: A
authors.lastname: Zeka
authors.affiliation: 5 French Institute for Public Health Surveillance, InVS, Saint-Maurice, France.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Medina
mesh_terms: D000393:Air Pollutants / Q000191:economics / Q000633:toxicity*; D000397:Air Pollution / Q000191:economics / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D002947:Cities / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D004784:Environmental Monitoring / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D006801:Humans; D009026:Mortality; D013458:Sulfur Dioxide / Q000633:toxicity*
chemical_list: D000393:Air Pollutants; D013458:Sulfur Dioxide