Improved Asthma Symptoms, Air Pollution Linked to Electric Vehicle Use in California

The increasing numbers of people driving electric vehicles in California has been linked to a reduction in respiratory symptoms, such as asthma, and lower levels of air pollution.

Drivers choosing zero emission vehicles (ZEVs), otherwise known as battery electric, plug-in hybrid, or hydrogen fuel cell cars, have been increasing in California, with efforts to tackle climate change. However, little is known about the cobenefits of electric vehicles on respiratory issues and air pollution.

“When we think about the actions related to climate change, often it’s on a global level,” said the study’s lead author, Erika Garcia, PhD, MPH, an assistant professor of population and public health sciences at the Keck School of Medicine of the University of Southern California, in a statement. “But the idea that changes being made at the local level can improve the health of your own community could be a powerful message to the public and to policy makers.”

The results of this population-based study were published Science of The Total Environment.

The researchers compared total ZEV registration data, air pollution levels, and asthma-related hospital emergency visits across California from 2013 to 2019. Additionally, they compared these results with education attainment information.

The number of ZEVs increased by a mean (SD) 14.7 (14.7) per 1000 population in 2019 compared with 1.4 (2.1) per 1000 population in 2013.

In an adjusted model, an increase of 20 ZEVs per 1000 population was associated with a –0.41 ppb change in annual average nitrogen dioxide (NO2; 95% CI, –1.12 to 0.29) and a 3.2% (95% CI, –5.4% to –0.9%) decrease in annual age-adjusted rates of asthma-related emergency department (ED) visits.

Furthermore, the researchers found that ZEV adoption was considerably lower in ZIP codes with lower education attainment (P < .0001), which they called the “adoption gap.”

According to their estimates, ZIP codes where 17.1% of the population had bachelor’s degrees had an average increase of 0.70 (95% CI, 0.61-0.78) ZEVs per 1000 population, while ZIP codes where 47% of the population had bachelor’s degrees had an average increase of 3.55 (95% CI, 3.47-3.63) ZEVs per 1000 population.

Prior research shows that low-income populations with lower levels of education tend to live in areas with high levels of pollution, resulting in various respiratory diseases and poorer health outcomes. The researchers advocate for continued research, with a focus on underserved communities, where the burden of asthma-related ED visits and air pollution levels are the highest and the adoption of electric vehicles may not be an option for many individuals.

“The impacts of climate change on health can be challenging to talk about because they can feel very scary,” said the study’s senior author Sandrah Eckel, PhD, an associate professor of population and public health sciences at the Keck School of Medicine, in a statement. “We’re excited about shifting the conversation towards climate change mitigation and adaptation, and these results suggest that transitioning to ZEVs is a key piece of that.”


Garcia E, Johnson J, McConnell R, Palinkas L, Eckel SP. California's early transition to electric vehicles: observed health and air quality co-benefits. Sci Total Environ. February 2023. doi:10.1016/j.scitotenv.2023.161761

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