
Sofia is one of the most polluted cities in Europe. It constantly breaches both World Health Organisation (WHO) and European Union (EU) air quality safety levels, increasing the risk of heart disease, lung cancer, respiratory diseases and stroke.

Dr. Alexander Simidchiev is a pulmonologist who for more than three decades has dedicated himself to the cause of lung health. His main interests are related to the prevention and epidemiology of major pulmonary diseases and the impact of air pollution as a preventable cause for human disease.
Measurements of particulates exceed the World Health Organization’s (WHO) safety limits for 97.2% of Bulgaria’s the population.
With the third highest mortality rate (per 100.000 population)1 from air pollution in the world, after North Korea, and Bosnia and Herzegovina, WHO estimates that poor air quality costs the equivalent of 29.5% of the country’s GDP2 through reduced productivity and the costs to the country’s health services.
Bulgaria’s main sources of PM10, and fine particle pollution PM2.5 (particles 2.5 microns or smaller) are household burning of fossil fuels or biomass, and transport. Production of electricity by burning of coal in thermal power plants and other industrial processes are a major contributor to unhealthy air. Coal plants are responsible for almost all of the country’s sulfur-dioxide and the majority of nitrogen-oxides emissions, causing smog and acid rain.
In 2017, Bulgaria was the first country to be sentenced by the EU Court of Justice to take action to improve air, and the country is still facing potential high fines. The country is also out of step with EU goals to reduce greenhouse gas emissions. In 2017, Bulgaria ranked third in the EU in growth of carbon dioxide emissions. Today, health practitioners are coming together to raise the importance of safe, clean air for their patients and the climate.
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[1] http://www.who.int/gho/publications/world_health_statistics/2017/en/
[2] http://www.euro.who.int/en/media-centre/events/events/2015/04/ehp-mid-term-review/publications/economic-cost-of-the-health-impact-of-air-pollution-in-europe