Causes and Consequences of Air Pollution in North Macedonia

This rapid literature review collates available evidence on the causes and consequences of air pollution in the Republic of North Macedonia (here after North Macedonia). It draws on a diverse range of sources from multiple academic disciplines and grey literature. The literature highlights that North Macedonia is considered to have some of the worst air quality in the West Balkans, and consequently some of the worst globally. Air pollution is a significant problem in North Macedonian cities and urban centres with exposure to high levels of particulate matter (PM) a particular issue. The PM2.5 size fraction is the focus of many air pollution studies because it is associated with a range of adverse health outcomes, it is also the focus of this review. This review identifies a limited but expanding evidence base discussing air pollution in North Macedonia. Studies are principally focussed on the capital city (Skopje) and ambient (outdoor) air pollution. There is a limited literature that discusses air quality issues outside of the capital and a dearth of evidence on household (indoor) air pollution.