Transboundary air pollution and respiratory disease mortality: evidence from European countries Jonathan Spiteri and Philip von Brockdorff University of Malta, Msida, Malta Abstract Purpose – The aim of this paper is to quantify the impact of transboundary air pollutants, particularly those related to urban traffic, on health outcomes. The importance of focusing on the health implications of transboundary pollution is due to the fact that these emissions originate from another jurisdiction, thus constituting international negative externalities. Thus, by isolating and quantifying the impact of these transboundary air pollutants on domestic health outcomes, the authors can understand more clearly the extent of these externalities, identify their ramifications for health and emphasise the importance of cross-country cooperation in the fight against air pollution. Design/methodology/approach – The authors employ panel data regression analysis to look at the relationship between emissions of transboundary air pollution and mortality rates from various respiratory diseases among a sample of 40 European countries, over the period 2003–2014. In turn, the authors use annual data on transboundary emissions of sulphur oxides (SOx), nitrogen oxides (NOx) and fine particulate matter (PM 2.5 ), together with detailed data on the per capita incidence of various respiratory diseases, including lung cancer, asthma and chronic obstructive pulmonary disease (COPD). The authors consider a number of different regression equation specifications and control for potential confounders like the quality of healthcare and economic prosperity within each country. Findings – The results show that transboundary emissions of PM 2.5 are positively and significantly related to mortality rates from asthma in our sample of countries. Quantitatively, a 10% increase in PM 2.5 transboundary emissions per capita from neighbouring countries is associated with a 1.4% increase in the asthma mortality rate within the recipient country or roughly 200 deaths by asthma per year across our sample. Originality/value – These findings have important policy implications for cross-country cooperation and regulation in the field of pollution abatement and control, particularly since all the countries under consideration form a part of the UN’s Convention on Long-Range Transboundary Air Pollution (CLRTAP), a transnational cooperative agreement aimed at curtailing such pollutants on an international level. Keywords Transboundary air pollution, Respiratory disease mortality, Europe Paper type Research paper 1. Introduction Air pollution from urban traffic and transportation has emerged as one of the most pressing global public policy issues of our time. Apart from its clear negative impact on the natural environment, outdoor air pollution has also been consistently linked with a wide variety of health problems. For example, Cohen et al. (2005) estimate that urban traffic emissions of fine particulate matter (PM 2.5 ) are responsible for 0.8 million premature deaths globally each year and around 6.4 million years of life lost on aggregate. Similarly, the total economic cost of outdoor air pollution in terms of lives lost and illnesses is estimated at US$1.7 trillion annually in the OECD countries, about half of which can be directly attributed to urban traffic (OECD, 2014). In the wake of this alarming evidence, it comes as no surprise that countries around the world have sought to clamp down on urban emissions via a number of important legislative measures, including the European Emissions Standards which are imposed on new vehicles sold within the European Union (EU) and the EPA Emissions Standards in the United States. Air pollution and respiratory disease mortality JEL Classification — Q53, I18 The current issue and full text archive of this journal is available on Emerald Insight at: https://www.emerald.com/insight/0144-3585.htm Received 7 May 2020 Revised 15 September 2020 20 October 2020 Accepted 22 October 2020 Journal of Economic Studies © Emerald Publishing Limited 0144-3585 DOI 10.1108/JES-05-2020-0210