Air Pollution Mortality in Greece: Population Ageing Identified as Key Driver in New EU Study

The Groundbreaking EU Study on Greece's Air Pollution Crisis

A groundbreaking new study published in Science of The Total Environment has spotlighted a critical intersection of environmental and demographic challenges in Greece: the escalating mortality from air pollution driven primarily by the country's rapidly ageing population. Titled 'The future health burden of air pollution in Greece and the associated drivers,' this research, led by scientists from Aristotle University of Thessaloniki and the Max Planck Institute for Chemistry, projects that even as air quality improves, deaths linked to fine particulate matter (PM_2.5) and ground-level ozone (O₃) could double by 2090. This analysis, recently highlighted by the European Commission's Directorate-General for Environment, underscores the urgent need for integrated policies that address both pollution control and the health vulnerabilities of an older demographic.

The study employs advanced climate models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) using the GFDL-ESM4 earth system model, bias-corrected with satellite observations. Researchers assessed excess mortality using the Global Burden of Disease (GBD) methodology, incorporating Shared Socioeconomic Pathways (SSPs) that forecast different futures based on emissions, economic growth, and population dynamics. These scenarios range from optimistic strong mitigation (SSP1-2.6) to pessimistic high-emission pathways (SSP3-7.0), revealing stark disparities in outcomes.

Current Air Pollution Landscape in Greece

Greece faces persistent air quality issues, particularly in urban centers like Athens and Thessaloniki. Fine particulate matter, PM_2.5—tiny particles less than 2.5 micrometers in diameter that penetrate deep into the lungs and bloodstream—remains a primary concern. In 2000, PM_2.5 exposure was linked to approximately 7,900 premature deaths annually (about 76 per 100,000 population), while O₃, a key component of photochemical smog, contributed around 440 deaths. These figures represent roughly 5% of total mortality when focusing on major non-communicable diseases.

Sources of PM_2.5 in Greece include domestic heating with wood and biomass (accounting for nearly 47% of emissions), road transport, industrial activities, and transboundary pollution. Wildfires, increasingly frequent due to climate change, exacerbate summer peaks, while shipping in ports like Piraeus adds to urban burdens. Ground-level O₃ forms from reactions between nitrogen oxides (NO_x) and volatile organic compounds (VOCs) under sunlight, peaking in warmer months. Cities like Athens frequently exceed EU annual PM_2.5 limits of 25 μg/m³, with recent 2025 data showing episodes where levels hit hazardous thresholds during winter inversions and Saharan dust incursions.

The European Environment Agency (EEA) reports that Greece's urban population exposure to PM_2.5 contributes significantly to the EU's overall air pollution health burden, with cardiovascular and respiratory diseases as leading causes of attributable deaths.

Projections Under Climate and Socioeconomic Scenarios

The study's projections paint a sobering picture. By 2090, PM_2.5-related mortality is expected to double nationwide under SSP1-2.6 and SSP2-4.5 scenarios, reaching over 16,000 deaths per year, despite pollutant concentrations dropping from 18 μg/m³ to 10-12 μg/m³. Under SSP3-7.0, the increase is 1.7-fold to about 13,400 deaths. Confidence intervals for 2000 baselines span 4,300-13,000 deaths, highlighting uncertainty in exposure-response functions.

For O₃, outcomes diverge sharply: stringent controls in SSP1-2.6 reduce levels below the theoretical minimum risk exposure level (TMREL) of 32.4 ppb, slashing mortality to near zero. However, under SSP2-4.5 and SSP3-7.0, deaths exceed 1,000 annually (10 per 100,000), a 130%+ rise driven by residual exposure and demographics.

• SSP1-2.6 (sustainability, 2°C warming): Strong mitigation yields cleanest air but ageing offsets gains.
• SSP2-4.5 (middle road, 2.7°C): Modest improvements insufficient against demographics.
• SSP3-7.0 (regional rivalry, 3.6°C): Higher emissions compound risks.

Population Ageing: The Dominant Driver

Greece's demographic shift is accelerating faster than most EU peers. The average age rose from 42 in 2000 to around 46 in 2025, projected to hit 54-57 by 2090. Over-85s, the most vulnerable group, will surge substantially. By 2050, one in three Greeks will be over 65, straining healthcare amid low fertility (1.3 births per woman) and net migration losses. Population peaks near 10 million before declining to 8-9 million by mid-century.

The study decomposes mortality changes using a method from Geng et al. (2021), attributing shifts to three factors: population size, ageing (age-structure changes), and pollution levels. Ageing dominates, contributing the bulk of increases. For instance, in Attica under SSP1-2.6, ageing adds 6,000 PM_2.5 deaths, while pollution reductions subtract 2,700, netting a 200% rise to 8,800 total.

Older adults face heightened risks: PM_2.5 exacerbates ischemic heart disease (IHD), cerebrovascular disease (CEV), chronic obstructive pulmonary disease (COPD), lung cancer, lower respiratory infections (LRI), and diabetes mellitus (DM)—74% from IHD/CEV alone. O₃ primarily affects COPD.

Regional Hotspots: Attica and Central Macedonia

Over half of Greece's population resides in Attica (3.75 million, Athens metro) and Central Macedonia (1.9 million, Thessaloniki), bearing disproportionate burdens. Attica sees PM_2.5 deaths climb to 8,800 by 2090 under SSP1-2.6 (from 2,800 in 2000), with O₃ surging 160-250% under weaker scenarios. Central Macedonia faces similar O₃ hikes of 85-120%.

Urban density amplifies exposure: Athens' traffic, construction, and heating; Thessaloniki's industrial zones and port. Wildfires in 2025 scorched vast areas, spiking PM levels continent-wide.

Sources and EU Compliance Challenges

Major PM_2.5 contributors: residential combustion (46.6%), transport (20-25%), agriculture, and industry. O₃ precursors from vehicles and solvents. Greece struggles with EU Ambient Air Quality Directive limits, with Athens and Thessaloniki zones exceeding PM_2.5 annual means. The revised Directive 2024/2881 mandates transposition by 2026, targeting 10 μg/m³ PM_2.5 by 2030—aligned with WHO but ambitious.

EEA Greece Fact Sheet notes exceedances, urging biomass bans and electrification.

Research Excellence at Aristotle University of Thessaloniki

Lead author Dr. Dimitris Akritidis, a postdoctoral researcher at Aristotle University's Department of Meteorology and Climatology, collaborates with Prof. Prodromos Zanis and Aristeidis K. Georgoulias. Their work under the CLIMPACT network exemplifies Greek higher education's role in tackling global challenges. For those pursuing careers in atmospheric science or environmental health, opportunities abound in research jobs across Europe.

This publication builds on prior studies like Akritidis' ozone mortality analyses, positioning AUTH as a hub for air quality modeling.

Policy Implications and Solutions

The study calls for integrated strategies: stricter EU-aligned controls, phasing out solid fuels, expanding renewables, and urban green spaces. Public health measures include elderly alerts during peaks and vulnerability mapping. Greece's National Air Quality Plan must incorporate demographics.

• Accelerate electric vehicle adoption and low-emission zones.
• Invest in wildfire prevention and transboundary cooperation.
• Enhance healthcare for respiratory/cardiovascular risks in seniors.
• Promote academic careers in climate-health research.

Full Study

Stakeholder Perspectives and Future Outlook

EU officials emphasize demographic integration into Zero Pollution Action Plan goals, aiming 55% health impact reduction by 2030. Greek stakeholders highlight economic co-benefits: cleaner air boosts tourism, cuts healthcare costs (potentially billions annually).

Optimistic SSP1-2.6 shows mitigation works, but requires political will. For researchers, this opens doors in Europe jobs at unis like AUTH. Explore professor jobs or postdoc positions to contribute.

Looking ahead, Greece must balance ageing support with green transitions, leveraging higher ed innovation.

Photo by Leonhard Niederwimmer on Unsplash

Actionable Insights for Public Health and Academia

To mitigate risks: monitor personal exposure via apps, advocate low-emission policies. Academics, check higher ed jobs for roles advancing this research. Rate professors shaping the field at Rate My Professor or seek career advice. Post jobs at post-a-job to build teams.

This study not only warns but empowers proactive change.