Road transport is a significant contributor to air pollution, especially through the emission of particulate matter, nitrogen oxides, and carbon monoxide. Air pollution caused by transportation is associated with a range of chronic health conditions, including asthma, respiratory infections, cardiovascular diseases, and premature death.

Transport also plays a significant role in the prevention and control of noncommunicable diseases through air quality and people’s activity levels.

Transport-related air pollution must be addressed across sectors such as transportation, urban planning, energy, environment, and public health.

From a health perspective, minimizing exposure to transport-related air pollution involves personal choices, public education, and policy initiatives. Individuals can opt for walking, cycling, or using public transit. At the same time, various government agencies can work together to introduce policies that promote cleaner vehicles and support sustainable transportation systems.

What can be done by the health sector? Public awareness campaigns play a crucial role in addressing air pollution by educating communities about the associated health risks and encouraging behavior change. These campaigns help individuals make informed decisions—such as reducing outdoor activity during high pollution days, using cleaner transportation options, or supporting air quality regulations.

Designing compact cities with well-integrated public transport networks minimizes the need for private vehicles and encourages walking and cycling.

Research over the past few decades has played a critical role in sharpening our understanding of air pollutants and their impact on public health. This includes findings that air with particulate matter that is 2.5 micrometers or smaller in diameter, or about 30 times smaller than the width of a human hair, is strongly associated with cardiovascular and respiratory morbidity and mortality.

Despite these advances, further research is needed to fully understand the health impacts of other pollutants and serious long-term health risks, including neurological damage, kidney disease, and cancer. However, epidemiological data linking exposure levels to specific health outcomes remains limited in many low- and middle-income countries.

What can the transport sector do? Enhancing vehicle emission and fuel quality standards along with fuel efficiency measures can significantly cut down vehicle emissions. Shifting to electric vehicles—including cars, buses, and trucks—can eliminate tailpipe emissions. Enhancing the use of low and zero-emission public transportation can lead to a significant reduction in overall emissions.

Designing compact cities with well-integrated public transport networks minimizes the need for private vehicles and encourages walking and cycling.

Several major cities have demonstrated notable progress in reducing air pollution through targeted interventions. For example, the London Low Emission Zone has contributed to measurable improvements in air quality by restricting high-emission vehicles and promoting cleaner alternatives.

The large-scale electrification of public buses in the People’s Republic of China, particularly in cities like Shenzhen, provides a compelling model of how rapid investment in electric public transport can significantly cut urban emissions. This is complemented by extensive metro networks, which are fully electric and serve as a low-emission backbone for urban mobility.

Jakarta, while still grappling with the growing use of private vehicles, has significantly expanded its public transportation system. This includes improvements to trains, buses, and local minibuses known as Angkots, along with better integration of walking and cycling access to transit terminals. More recently, the city has begun promoting the electrification of its bus fleet and other feeder modes.

Breaking the vicious cycle with the right mix of policies, strategic infrastructure investment, and sustained public engagement, cities can make significant strides toward achieving cleaner air and healthier populations.

A coordinated, multi-sectoral approach—one that integrates environmental goals with urban planning and public health priorities—is essential to building more livable, resilient cities for the future.

This blog post was based in part on research related to ADB's 1st INSPIRE Health Forum : Inclusive, Sustainable, Prosperous and Resilient Health Systems in Asia and the Pacific.