Capital city of North Macedionia – Skopje – regularly registered the most polluted cities in Europe, and sometimes in the world.

In 2018, levels of PM10 – tiny pollutant particles 10 nanometres in size that are harmful to human health – exceeded he European Union limits for a total of 202 days.

While North Macedonia is not part of the EU, it has entered accession negotiations and has some way to go to meet EU ecological air quality standards.

At present, the World Health Organization (WTO) has estimated that around 4,000 premature deaths a year in North Macedonia may be due to air pollution, and the economic cost to Skopje is thought to be between €570 and €1,470 million.