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The last “Air quality in Europe” report by the European Environmental Agency (EEA ) foresees almost five millions of years of life lost (YOLL) in the 28 EU Member States due to the high concentrations of PM2.5. YOLLs are an estimate of the average years that a person would have lived if he or she had not died prematurely, giving greater weight to deaths at a younger age and lower weight to deaths at an older age. For the 507.4 million inhabitants of EU, this means an average loss of more than 3 days each year.

“Air quality plans” according to Air Quality Directive 2008/50/EC Art. 23 are the strategic element to be developed, with the aim to reliably meet ambient air quality standards in a cost-effective way. This chapter provides a general framework to develop and assess such plans along the lines of the European Commission’s basic ideas to implement effective emission reduction measures at local, region, and national level. This methodological point of view also allows to analyse the existing integrated approaches.

This chapter provides a review, derived from the extended survey conducted within the APPRAISAL project, of the integrated assessment methodologies used in different countries to design air quality plans and to estimate the effects of emission abatement policy options on human health.

As already noted, the 2008 European Air Quality Directive (AQD) (2008/50/EC) encourages the use of models in combination with monitoring in a range of applications. It also requires Member States (MS) to design appropriate air quality plans for zones where air quality does not comply with the AQD limit values and to assess possible emission reduction measures to reduce concentration levels. These emissions reductions then need to be distributed in an optimal and cost effective way through the territory.

To evaluate in practice how IAM can be used to formulate and improve current air quality plans, this chapter reports on the application of one of the existing IAM tools, to two test cases: one for the Brussels Capital Region in Belgium and the other to the region of Porto in the North of Portugal. The two cases are representative for the two options that are available for the decision pathway in the IAM framework as presented in Chap. : the scenario evaluation and the optimisation. Before presenting the peculiarities and the results obtained for the two test cases, this chapter briefly describes the specific features of the IAM tool used, namely RIAT+.

Despite a general improvement expected for the next decade in EU, some urban areas and some regions will still struggle with severe air quality problems and related health effects. These areas are often characterized by specific environmental and anthropogenic factors and will require ad hoc additional local actions to complement medium and long-term national and EU-wide strategies to reach EU air quality objectives. These urban areas are also among the territories where most energy is consumed and most greenhouse gases (GHGs) are emitted.