Emerging evidence for the impact of Electric Vehicle sales on childhood asthma: Can ZEV mandates help?

Growing epidemiological studies indicate a significant fraction of asthma cases can be attributed to traffic- related air pollution (TRAP). Zero emission vehicle (ZEV) mandates - one of the most forward-looking climate policies in the United States - aim to reduce TRAP by mandating automakers to sell a certain fraction of Electric Vehicles (EVs) annually; however, their public health benefits are largely unknown. We conduct the screening step of the health impact assessment (HIA) of real-world EV sales to estimate the impact of ZEV mandates in reducing childhood asthma. Using publicly available US state and national datasets, we isolate the burden of childhood asthma attributable to TRAP from 2013 to 2019 and examine the influence of EV and non-EV vehicle sales and fleets on asthma incidence and prevalence using a generalized linear mixed model. Our analyses indicate that new EV sales have reduced asthma, with one asthma case prevented for every 264 (95% CI: 113-401) new EVs on the road. The rise of new childhood asthma cases from new car sales can be prevented when non-EV sales are replaced with EV sales at an annual market share of 21.4% (7.1-41.6%). Extending our analysis to the entire vehicle fleet, we project that when EVs reach 53.0% (35.5%-76.9%), childhood asthma due to tailpipe emissions can be eradicated completely. Screening results conclude that ZEV mandates implemented over the past decade are already exhibiting measurable public health benefits, suggesting that a broader adoption could significantly reduce the asthma burden, thus we recommend a full HIA for ZEV mandates to fully assess their potential.