Urban NO₂-pollution and health outcomes: Evidence from a natural experiment in Italy on the simulated benefits of the EU zero-emission-vehicles resolution

Background: The EU “Fit-For-55″ resolution provisions the banning of fossil-fuel-vehicle sales beyond 2035, sparking a heated debate due to its uncertain effectiveness in reducing CO₂ emissions globally. Nevertheless, the EU shift towards zero-emission vehicles has the potential to decrease urban nitrogen dioxide (NO₂) pollution that is closely linked to respiratory and cardiovascular diseases and to increased mortality. Objective: This paper aims to simulate the impact that the EU zero-emission-mobility policy is expected to have, post-transitional period, on urban NO₂ and health outcomes. Methods: The analysis exploits some unique features of Northern-Italy air-pollution data and the Italian Covid-19 lockdown that is leveraged as a natural experiment to mimic the fossil-fuel traffic abatement expected by the policy. Our estimates are obtained by developing a novel intertemporal-statistical-matching approach specifically suited for quasi-experimental evaluations in the context of air-pollution multivariate time series. Results: We find that the lockdown led to a mean NO₂ reduction of 13.62 μg/m³ (53 % from a baseline of 25.8 μg/m³), translating into a simulated reduction in the relative risk of total, cardiovascular, and respiratory mortality by 8.3, 7.5 and 3.8 percentage points, respectively. We also estimate impact heterogeneity, with log-linearly larger reductions in NO₂ and mortality risk at higher baseline-pollution levels. Conclusions: These results imply that the EU zero-emission mobility policy is expected to improve air-quality and public health in urban areas with high traffic density, though benefits may vary across regions due to differences in meteorological conditions and urban/orographic characteristics, supporting a spatially differentiated policy implementation.