Abstract There is a growing awareness that significant benefits for our health and environment could be achieved by reducing our use of cars and shifting instead to active transport, i.e. walking and bicycling. The present article presents an estimate of the health impacts due to a shift from car to bicycling or walking, by evaluating four effects: the change in exposure to ambient air pollution for the individuals who change their transportation mode, their health benefit, the health benefit for the general population due to reduced pollution and the risk of accidents. We consider only mortality in detail, but at the end of the paper we also cite costs for other impacts, especially noise and congestion. For the dispersion of air pollution from cars we use results of the Transport phase of the ExternE project series and derive general results that can be applied in different regions. We calculate the health benefits of bicycling and walking based on the most recent review by the World Health Organization. For a driver who switches to bicycling for a commute of 5km (one way) 5 days/week 46 weeks/yr the health benefit from the physical activity is worth about 1300€/yr, and in a large city (>500,000) the value of the associated reduction of air pollution is on the order of 30€/yr. For the individual who makes the switch, the change in air pollution exposure and dose implies a loss of about 20€/yr under our standard scenario but that is highly variable with details of the trajectories and could even have the opposite sign. The results for walking are similar. The increased accident risk for bicyclists is extremely dependent on the local context; data for Paris and Amsterdam imply that the loss due to fatal accidents is at least an order of magnitude smaller than the health benefit of the physical activity. An analysis of the uncertainties shows that the general conclusion about the order of magnitude of these effects is robust. The results can be used for cost-benefit analysis of programs or projects to increase active transport, provided one can estimate the number of individuals who make a mode shift.

Graphical abstract Results for mortality costs and benefits per individual who switches from car to bicycle for commuting to work (2⁎5km roundtrip, 5⁎46weeks/yr) in large cities of EU. Similar results for walking. Error bars indicate confidence intervals. Display Omitted Highlights ► We have evaluated the benefits of switching from car to walking or biking. ► Results are shown as annual monetary values per individual for typical scenarios. ► Most important is the life expectancy gain due to physical activity, about 1300€/yr. ► Effects of pollution and accidents are much smaller.