Air pollution is the leading cause of the global burden of disease from the environment, entailing substantial economic consequences. International shipping is a significant source of NO_x, SO₂, CO and PM, which can cause known negative health impacts. Thus, this study aimed to estimate the health impacts and the associated external costs of ship-related air pollution in the Iberian Peninsula for 2015. Moreover, the impact of CAP2020 regulations on 2015 emissions was studied. Log-linear functions based on WHO-HRAPIE relative risks for PM_2.5 and NO₂ all-cause mortality and morbidity health end-points, and integrated exposure–response functions for PM_2.5 cause-specific mortality, were used to calculate the excess burden of disease. The number of deaths and years of life lost (YLL) due to NO₂ ship-related emissions was similar to those of PM_2.5 ship-related emissions. Estimated all-cause premature deaths attributable to PM_2.5 ship-related emissions represented an average increase of 7.7% for the Iberian Peninsula when compared to the scenario without shipping contribution. Costs of around 9 100 million € yr-1 (for value of statistical life approach - VSL) and 1 825 million € yr⁻¹ (for value of life year approach - VOLY) were estimated for PM and NO₂ all-cause burden of disease. For PM_2.5 cause-specific mortality, a cost of around 3 475 million € yr⁻¹ (for VSL approach) and 851 million € yr⁻¹ (for VOLY approach) were estimated. Costs due to PM and NO₂ all-cause burden represented around 0.72% and 0.15% of the Iberian Peninsula gross domestic product in 2015, respectively for VSL and VOLY approaches. For PM_2.5 cause-specific mortality, costs represented around 0.28% and 0.06%, respectively, for VSL and VOLY approaches. If CAP2020 regulations had been applied in 2015, around 50% and 30% respectively of PM_2.5 and NO₂ ship-related mortality would been avoided. These results show that air pollution from ships has a considerable impact on health and associated costs affecting the Iberian Peninsula.

空气污染是造成全球环境疾病负担的主要原因，会带来重大的经济后果。国际航运是 NO _x、SO ₂、CO 和 PM的重要来源，它们会对健康造成已知的负面影响。因此，本研究旨在估计 2015 年伊比利亚半岛船舶相关空气污染的健康影响和相关外部成本。此外，还研究了 CAP2020 法规对 2015 年排放量的影响。基于 WHO-HAPIE PM _2.5和 NO ₂全因死亡率和发病率健康终点相对风险的对数线性函数，以及 PM _{2.5 的}综合暴露-反应函数特定原因死亡率被用来计算疾病的超额负担。NO ₂船舶相关排放导致的死亡人数和寿命损失 (YLL)与 PM _2.5船舶相关排放相似。与没有航运贡献的情景相比，伊比利亚半岛由 PM _2.5船舶相关排放导致的全因过早死亡估计平均增加了 7.7%。估计 PM 和 NO ₂全因负担的成本约为 91 亿欧元 yr-1（对于统计生命年价值方法 - VSL）和 18.25 亿欧元^-1（对于生命年价值方法 - VOLY）疾病。对于 PM _2.5特定原因的死亡率，估计成本约为 34.75 亿欧元 yr ^-1（对于 VSL 方法）和 8.51 亿欧元^-1（对于 VOLY 方法）。对于 VSL 和 VOLY 方法，由 PM 和 NO ₂全因负担引起的成本分别占 2015 年伊比利亚半岛国内生产总值的 0.72% 和 0.15%。对于 PM _2.5特定原因死亡率，VSL 和 VOLY 方法的成本分别约为 0.28% 和 0.06%。如果在 2015 年应用 CAP2020 规定，PM _2.5和 NO ₂分别约为 50% 和 30%将避免与船舶有关的死亡。这些结果表明，船舶造成的空气污染对影响伊比利亚半岛的健康和相关成本有相当大的影响。