Why Air Pollution Causes Fewer Deaths in Israel Than in Europe Despite Similar Levels

Air pollution remains one of the leading environmental health risks worldwide. Each year, fine particles, nitrogen dioxide, and ozone cause thousands of premature deaths and years of life lost. A recent analysis conducted in Israel between 2015 and 2023 reveals that these three pollutants are responsible for 4,500 to 6,200 premature deaths annually in the country. Fine particles, in particular, account for the majority of this toll, with up to 5,400 deaths per year during the most polluted years. However, compared to Europe, Israel records lower mortality rates and fewer years of life lost, despite often equivalent pollutant concentrations.

This difference is primarily explained by Israel’s demographic structure. The country has a much smaller proportion of people over the age of 65 than most European nations. Yet, it is the elderly who are most vulnerable to the effects of pollution. Thus, even though exposure levels to fine particles or nitrogen dioxide are similar to those observed in Greece, Italy, or Slovakia, the number of deaths per capita is much lower. For example, in 2020, Israel had a rate of 44 premature deaths per 100,000 inhabitants linked to fine particles, compared to 71 in Slovakia or 88 in Italy, where the population is older.

Men are more affected than women in almost all age groups, except for those over 85 and infants under one year old. The latter suffer the most severe consequences in terms of years of life lost, particularly due to ozone, whose effects are calculated from birth. The data also show that deaths increase with age, but infants, although few in number die prematurely, lose a much higher number of years of life due to their initially high life expectancy.

The study highlights that the reduction in nitrogen dioxide emissions has led to a significant decrease in pollution in recent years, thanks to technological advancements and measures targeting transportation and industry. Conversely, ozone follows an opposite trend, with a slight increase in concentrations and associated deaths. This phenomenon is explained by the decrease in nitrogen oxides in the air, which normally “consume” some of the ozone near urban areas. With fewer of these oxides, ozone persists and its impact on health increases, particularly affecting densely populated areas.

The main sources of pollution in Israel are waste fires, road traffic, and fossil fuel power plants. Forest fires and dust storms, which are frequent in the region, also worsen the situation, especially for fine particles. Their contribution varies greatly from year to year, making it more difficult to achieve a sustainable reduction in pollution.

Researchers emphasize the need to act on several fronts: improving public transportation to limit vehicle emissions, better managing waste to prevent illegal burning, and accelerating the transition to renewable energy. They also recommend strengthening alerts during pollution peaks, particularly to protect the elderly and vulnerable groups. In the long term, the aging of the Israeli population could worsen the health impact if pollution levels do not decrease.

Ozone poses a particular challenge because its formation depends on complex chemical reactions involving multiple pollutants. A comprehensive approach, considering all emissions, would therefore be more effective than regulations targeting a single type of pollutant. Israeli authorities already have regulatory tools, such as the Clean Air Law, but their enforcement needs to be strengthened to reduce exposure near residential areas.

Finally, the study reminds us that the economic and health costs of pollution are considerable, with expenses estimated at several billion per year. Improving air quality would not only benefit health but also the country’s economy. The results confirm that fine particles remain the most dangerous pollutant, closely followed by ozone, whose impact is growing with changes in emissions. Without decisive action, the burden of pollution will only increase as the population ages.

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About This Study

DOI: https://doi.org/10.1186/s13584-026-00753-4

Title: Premature mortality and years of life lost attributable to ambient air pollution in Israel, compared to Europe: analysis and implications

Journal: Israel Journal of Health Policy Research

Publisher: Springer Science and Business Media LLC

Authors: Ilan Levy; Itamar Grotto; Hagai Levine; Isabella Karakis