Policies implemented in Europe since the 1970s to improve the air quality have resulted in decreases in emissions in many countries with corresponding reductions in concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2) and particulate matter (PM). We report here how much the air quality and associated health effects in the Netherlands have improved since 1980 and which countries, sectors and policies are responsible for this. To quantify the effects of emission reduction policies since 1980 we calculated the ambient concentrations of air pollutants in the Netherlands from 1980 to 2015, using two scenarios. A Baseline scenario with reported emissions in Europe and a World Avoided scenario which assumed that no air quality policies were adopted from 1980 onwards which would result in the growth in emissions of air pollutants. In the World Avoided scenario, the annual average PM2.5 concentration in the Netherlands increases from 59 μg m 3 in 1980 to 102 μg m 3 in 2015, while in reality (Baseline scenario) concentrations decreased to about 12 μg m 3 . The avoided PM2.5 concentration in 2015 accounts for more than half (56%) of reductions in emissions in sectors outside the Netherlands. Foreign (38%) and domestic (16%) industry is the main contributing sector, followed by agriculture (23%) and transport (15%). In 2015, the avoided concentrations of air pollutants correspond to about 700,000 avoided years of life lost in the Netherlands per year, with an associated number of avoided attributable deaths of about 66,000 per year, and an increase in average life expectancy of about 6 years. The corresponding avoided monetary health damage amounts to between € 35 and € 77 billion per year in 201