Abstract Poor air quality has been described as the greatest “environmental risk to Public Health in the UK”, and disproportionately affects vulnerable groups including the elderly, children, and people with chronic illnesses.Walsall is an urban authority in the West Midlands. We implemented a real-time, local air quality monitoring system which provides more dynamic data than in modelled systems.We investigated the impact that air pollutants (PM2.5) had on acute care admissions for chronic obstructive pulmonary disease (COPD).From April 2016- November 2018, monthly PM2.5 levels ranged from 6.99-18.36 g/m3, and positively correlated with COPD admissions. Peak pollutant levels, observed in January 2017, precipitated an excess of 53 admissions compared to the baseline, representing an 11.3% increase. The estimated cost to the local NHS economy of these excess admissions during this single month was £123,483, non-inclusive of the wider social and economic costs. Thus, improvement of air quality and the resulting prevention of COPD admissions, will result in significant economic benefit to the healthcare economy.Some of the highest levels of pollutants were observed in areas of high deprivation, which also accounted disproportionately for COPD admissions. The link between clean air and better emotional and mental well-being is well-evidenced. Therefore, reducing air pollution is imperative to achieving a healthier and fairer society.Our current work involves expanding our data collection system and including other emission indicators to allow for enhanced modelling. Robust surveillance is imperative to developing informed strategies to tackle this important Public Health issue and achieve reduction targets. External funding details