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Background: Lisbon has about 500,000 inhabitants and it’s the capital and the main economic hub of Portugal. Studies have demonstrated that exposure to Particulate Matter with an aerodynamic diameter&lt;2.5 μm (PM 2.5 ) have strong association with health effects. Researchers continue to identify new harmful air pollutants effects in our health even in low levels. Objectives: This study evaluates air pollution scenarios considering a Health Impact Assessment approach in Lisbon, Portugal. Methods: We have studied abatement scenarios of PM 2.5  concentrations and the health effects in the period from 2015 to 2017 using the APHEKOM tool and the associated health costs were assessed by Value of Life Year. Results: The mean concentration of PM 2.5  in Lisbon was 23 μg/m 3  ± 10 μg/m 3  (±Standard Deviation). If we consider that World Health Organization (WHO) standards of PM 2.5  (10 μg/m 3 ) were reached, Lisbon would avoid more than 423 premature deaths (equivalent to 9,172 life years’ gain) and save more than US$45 million annually. If Lisbon city could even diminish the mean of PM 2.5  by 5 μg/m 3 , nearly 165 deaths would be avoided, resulting in a gain of US$17 million annually. Conclusion: According to our findings, if considered the worst pollution scenario, levels of PM2.5 could improve the life’s quality and save a significant amount of economic resources. Implications:  The manuscript addresses the health effects and costs of air pollution and constitutes an important target for improving public policies on air pollutants in Portugal. Although Portugal has low levels of air pollution, there are significant health and economic effects that, for the most part, are underreported. The health impact assessment approach associated with costs had not yet been addressed in Portugal, which makes this study more relevant in the analysis of policies aimed to drive stricter control on pollutants’ emissions. Health costs are a fundamental element to support decision-making process and to orientate the trade-offs in investments for improving public policies so that to diminish health effects, which can impact the management of the local health services and the population’s quality of life, especially after the pandemic period when resources are scarce.

Health impact assessment of air pollution in Lisbon, Portugal