The transformations of air pollution in the 20th century are well known. The century opened with urban atmospheres polluted by the combustion products of burning coal: smoke and sulfur dioxide. At the millennium these pollutants had almost vanished, replaced by the pollutants, both primary and secondary, a function of fossil-fuelled vehicles. However transitions in terms of health outcomes have been equally dramatic. Fine particulate matter causes notable cardiovascular problems such as increased incidence of stroke and heart attack, although the mechanism remains somewhat unclear. Cancer inducing air pollutants remain a concern, but in addition more recently there has been a rising interest in the presence of neurotoxins and endocrine disrupting substances in the environment.