One out of every six premature deaths in the world in 2015—about 9 million—could be attributed to disease from environmental pollution, according to a major new study released Thursday in the peer-reviewed Lancet medical journal. That’s 16 percent of all deaths worldwide. This toxic exposure is three times deadlier than AIDS, tuberculosis, and malaria combined, killing more than six times the number killed in traffic accidents, and fifteen times more than all wars and other forms of violence. It kills more people than smoking, hunger and natural disasters. In some countries, it accounts for as many as one in four deaths.
The poor and more vulnerable populations are disproportionately affected: nearly 92% of pollution-related deaths occur in low- and middle-income countries, taking the greatest toll in these countries’ most impoverished and marginalized communities. Children face the highest risks because small exposures to chemicals in utero and in early childhood can result in lifelong disease, disability, and premature death, as well as reduced learning and earning potential.
The nature of air pollution is changing. Ambient air pollution deaths have been increasing worldwide since 1990, and increases are most substantial in the most rapidly industrializing countries. Meanwhile, household air pollution has been declining worldwide since 1990, as liquefied petroleum gas and renewable sources of energy come to replace biomass—wood, straw, and dung—as fuels for household cooking and heating. As a result, household air pollution deaths in low-income countries are decreasing.
However, offsetting these gains are increases in ambient air pollution driven by the rapid expansion of megacities, globalization of industrial production, proliferation of pesticides and toxic chemicals, and growing use of motor vehicles. This leads to great economic losses, including medical expenditures—an estimated $21 billion US dollars globally in 2015—lost economic productivity resulting from pollution-related disease and premature death, and the cost of environmental degradation. These costs are largely invisible because they are spread across large populations over many years and destroy natural resources that too often are taken for granted.
Ambient air pollution also appears very likely to act as an important although not yet quantified risk factor for neurodevelopmental disorders in children and neurodegenerative diseases in adults. In the absence of aggressive control, ambient air pollution is projected to cause between 6 million and 9 million deaths per year by 2060.
The greatest numbers of deaths linked to pollution in 2015 were in India with 2.5 million, and China with 1.8 million.
Pollution is closely tied to climate change and biodiversity. Fossil fuel combustion in higher-income countries and the burning of biomass in lower-income countries accounts for 85% of airborne particulate pollution. Major emitters of carbon dioxide are coal-fired power plants, chemical producers, mining operations, and conventional, gasoline-powered vehicles. Accelerating the transition away from fossil fuels to cleaner sources of energy will reduce air pollution, improving both human and planetary health.
“There’s been a lot of study of pollution, but it’s never received the resources or level of attention as, say, AIDS or climate change,” said epidemiologist Philip Landrigan, dean of global health at the Icahn School of Medicine at Mount Sinai, New York, and the lead author on the report.
“Pollution is a massive problem that people aren’t seeing because they’re looking at scattered bits of it,” Landrigan said.
To reach its figures on the overall global pollution burden, the study’s authors employed methods outlined by the U.S. Environmental Protection Agency (EPA) for assessing field data from soil tests, as well as with air and water pollution data from the Global Burden of Disease (GBD), an ongoing study run by institutions including the World Health Organization (WHO) and the Institute for Health Metrics and Evaluation at the University of Washington.
The financial cost from pollution-related death, sickness, and welfare, the report claims, adds up to around $4.6 trillion dollars in annual losses—or about 6.2% of the global economy.
The report cites EPA research showing that the U.S. has gained roughly $30 dollars in benefits for every $1 dollar spent on controlling and limiting air pollution since 1970, when Congress updated and greatly expanded the federal mandate of the Clean Air Act of 1963, one of the world’s most comprehensive air quality laws, to be administered by the newly created Environmental Protection Agency, also established that year. In 1990, additional amendments to the Clean Air Act were enacted by Congress, including a requirement that the EPA conduct “periodic, scientifically reviewed studies to assess the benefits and the costs of the Clean Air Act.” The first report in what became a series was released in October 1997, providing a detailed retrospective analysis of costs and benefits from the years 1970 to 1990, and showed that the overwhelming benefits obtained from compliance with the Clean Air Act far outweighed the costs of implementation. The EPA concluded that the total monetized health benefits from the Act during the 20-year period ranged between $5.6 and $49.4 trillion, with a central estimate of $21.7 trillion. The benefit-cost ratios were 43.4:1 for the central estimate and 11:1 and 97.8:1 for the extreme estimates. Removing lead from gasoline has earned the U.S. economy another $6 trillion cumulatively since 1980, according to studies by the U.S. Centers for Disease Control and Prevention.
“The claim that pollution control stifles economic growth and that poor countries must pass through a phase of pollution and disease on the road to prosperity has repeatedly been proven to be untrue,” the report states.
Experts say the 9 million premature deaths the study found was just a partial estimate, and the number of people killed by pollution is undoubtedly higher and will be quantified once more research is done and new methods of assessing harmful impacts are developed
Landrigan said the scale of deaths from pollution had surprised the researchers and that two other “real shockers” stood out. First was how quickly modern pollution deaths were rising, while “traditional” pollution deaths – from contaminated water and wood cooking fires – were falling as development work bears fruit.
“Secondly, we hadn’t really got our minds around how much pollution is not counted in the present tally,” he said. “The current figure of nine million is almost certainly an underestimate, probably by several million.”
This is because scientists are still discovering links between pollution and ill health, such as the connection between air pollution and dementia, diabetes and kidney disease. Furthermore, lack of data on many toxic metals and chemicals could not be included in the new analysis.