Socioeconomic deprivation in the Antwerp, Brussels, and Ghent Low Emission Zones, with NO2 overlay for 2022. Credit: Environment International (2025). DOI: 10.1016/j.envint.2025.109515

A team of health and environmental researchers affiliated with multiple institutions in Belgium, working together due to a request from health insurer Mutualités Libres, has found that converting parts of cities to low-emission zones (LEZs) improves air quality. In their study, in the journal Environment International, the group compared air quality samples in LEZs with similar sites in other cities without LEZs.

Over the past several decades, as researchers have learned about air pollution damage to the human body, most particularly the lungs, have been working to make at least some parts of cities less harmful.

That has resulted in the development of parks and recreation areas, and more recently, LEZs, which are parts of the city where is banned or where only vehicles that meet certain standards (such as EVs) are permitted. In this new effort, management at Mutualités Libres wanted to know if LEZs were having the desired effect.

The researchers collected air samples from Brussels and Antwerp, which have recently put LEZs in place, and compared air quality from before and after the LEZs were defined, along with other parts of the city and other cities in Belgium.

The team found that levels of both particle pollution and nitrogen declined more rapidly in the LEZs than in other parts of the same city and similar parts of other cities. They also found that reductions could be observed as far away from the zones as 5 kilometers.

  • Antwerp, Brussels and Ghent Low Emission Zones and 17 control cities without LEZs with adjacent areas of 1 km, 1–2 km, and 2–5 km. Credit: Environment International (2025). DOI: 10.1016/j.envint.2025.109515

  • Percentage chronic use (≥90 daily defined doses) of medicines for diabetes, cardiovascular disease, obstructive airway diseases, antidepressants, and antithrombotic agents across the Antwerp and Brussels Low Emission Zones and control cities. Credit: Environment International (2025). DOI: 10.1016/j.envint.2025.109515

Officials with Mutualités Libres note that breathing polluted air not only leads to a host of health problems, it also leads to higher care costs. Particulate matter in car exhaust, they note, has been linked to many types of lung ailments from COPD to cancer. They also note that has been linked to an increased risk of diabetes.

The researchers showed that by comparing with data from patients covered by Mutualités Libres, they were able to see that use of antidiabetic drugs increased at a lower rate for people living in or near LEZs than in other parts of the same cities.

More information: Luk Bruyneel et al, Positive impact of the introduction of low-emission zones in Antwerp and Brussels on air quality, socio-economic disparities and health: a quasi-experimental study, Environment International (2025).

Journal information: Environment International