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. Air pollution concentrations have been decreasing in many cities in thedeveloped countries. We have estimated time trends and health effectsassociated with exposure to NOx , NO2 , O3 , and PM 10 (particulate matter) in the Swedish cities Stockholm, Gothenburg, andMalmo from the 1990s to 2015. Trend analyses of concentrations have beenperformed by using the Mann–Kendall test and the Theil–Sen method. Measuredconcentrations are from central monitoring stations representing urbanbackground levels, and they are assumed to indicate changes in long-termexposure to the population. However, corrections for population exposure havebeen performed for NOx , O3 , and PM 10 inStockholm, and for NOx in Gothenburg. For NOx and PM 10 , the concentrations at the centralmonitoring stations are shown to overestimate exposure when compared todispersion model calculations of spatially resolved, population-weightedexposure concentrations, while the reverse applies to O3 . Thetrends are very different for the pollutants that are studied; NOx and NO2 have been decreasing in all cities, O3 exhibits an increasing trend in all cities, and for PM 10 ,there is a slowly decreasing trend in Stockholm, a slowly increasing trend inGothenburg, and no significant trend in Malmo. Trends associated with NOx and NO2 are mainly attributed to local emissionreductions from traffic. Long-range transport and local emissions from roadtraffic (non-exhaust PM emissions) and residential wood combustion are themain sources of PM 10 . For O3 , the trends are affected bylong-range transport, and there is a net removal of O3 in thecities. The increasing trends are attributed to decreased net removal, as NOx emissions have been reduced. Health effects in terms of changes in life expectancy are calculated basedon the trends in exposure to NOx , NO2 , O3 , and PM 10 andthe relative risks associated with exposure to these pollutants. Thedecreased levels of NOx are estimated to increase the life expectancyby up to 11 months for Stockholm and 12 months for Gothenburg. Thiscorresponds to up to one-fifth of the total increase in life expectancy(54–70 months) in the cities during the period of 1990–2015. Since theincreased concentrations in O3 have a relatively small impact on thechanges in life expectancy, the overall net effect is increased lifeexpectancies in the cities that have been studied.

Trends in air pollutants and health impacts in three Swedish cities over the past three decades