Environmental and Public Health Impacts of Shipping Emissions Following the IMO 2020 Sulfur Cap: A Systematic Literature Review

Tingting Zhao, Le Thi Nguyet, Yadong Li, Yuanyuan Meng, Maowei Chen

Maritime transport emits a range of atmospheric pollutants, including sulfur oxides (SOx), nitrogen oxides (NOx), particulate matter (PM), and volatile organic compounds (VOCs), which contribute to air pollution and are associated with adverse environmental and public health impacts. To mitigate these impacts, the International Maritime Organization (IMO), London, UK introduced the global sulfur cap (IMO 2020), which entered into force on 1 January 2020, limiting the sulfur content of marine fuels to 0.50% m/m. This study systematically reviews the environmental and public health impacts of shipping emissions following the implementation of IMO 2020. A systematic literature review was conducted in accordance with PRISMA 2020 guidelines using Scopus, Web of Science, PubMed, and supplementary sources. Following a structured screening process, 67 studies published between 2020 and 2025 were included and analyzed through descriptive, bibliometric, and thematic synthesis approaches. The reviewed studies consistently reported substantial reductions in sulfur dioxide (SO2) emissions, sulfate aerosols, and shipping-related particulate matter following IMO 2020. These reductions were associated with improved air quality in major maritime and port regions and reduced population exposure to harmful pollutants. However, the reviewed evidence also identified ongoing challenges, including emissions of ultrafine particles and volatile organic compounds, secondary pollutant formation, contamination associated with scrubber washwater discharge, and reduced sulfate aerosols contributing to positive radiative forcing. Overall, the reviewed evidence suggests that sulfur-related air pollution generally declined following the entry into force of IMO 2020, although these observations should be interpreted alongside other concurrent developments that influenced global shipping activities during the study period. This review synthesizes current evidence on the environmental and public health impacts of IMO 2020, identifies emerging knowledge gaps, and provides an evidence base to support future shipping emission policies and research.