Urban air quality is a serious problem, with an estimated 40 million people in Europe exposed to exceedences of existing WHO air-quality guidelines, with prospects of further declines in air quality due to projected growth in motor vehicle traffic. Air-quality management strategies, underpinned by legislation are attempting to combat this problem. To support such strategies, assessment of the costs and benefits of remedial measures is required, including an assessment of the impact of urban air quality on human health. This paper describes a disease burden estimation approach, developed to assess 'health gain' from recreational water quality improvement, and its application to urban air quality and incidence of respiratory disease. The method represents an improvement over existing disease-burden estimation techniques applied to air quality, in that by considering the probability density function of pollutant concentrations, improved estimates of exposure and hence disease burden, and also 'health gain' from air-quality improvement, are possible. Estimations of mortality advanced by fine particulate matter (PM10) are presented for five UK cities. Implications of the method for disease burden and air-quality standards are discussed. The utility of integrating the disease-burden assessment model with linked dynamic models of land-use, vehicle movement and pollutant dispersion, as a means to identify remedial strategic planning initiatives, is highlighted. Copyright (C) 2000 Elsevier Science B.V.