Chimney emitting smoke into the air

Toxic Truth

Pollution is responsible for one in six deaths each year — and it’s getting worse

It's a sobering finding, but scientists hope it will serve as a wake-up call.

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One of the world’s deadliest killers lurks all around us in the air we breathe and the products we consume. Yes, we’re talking about pollution.

And it’s not going away. A new report published Tuesday in The Lancet Planetary Health finds that pollution is still killing a staggering number of people worldwide, predominantly in lower- and middle-income countries. But pollution is a severe threat to the health of every single person on the planet, the report authors urge.

“People in the United States need to be concerned about these findings,” Philip Landrigan, a co-author of the report and director of Boston College’s Global Pollution Observatory, tells Inverse.

What’s new — The recent findings from the Lancet Commission on Pollution and Health are actually an update to a pollution report published five years ago, when the researchers first analyzed premature deaths from pollution.

The 2017 report found pollution was the most significant environmental risk factor globally for human mortality. Sadly, that fact hasn’t changed at all in the past five years — and in some ways has gotten worse — according to the new report, which uses data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to assess the impact of pollution on human health.

The report’s most damning conclusion: nine million people around the globe die prematurely due to pollution each year. The World Health Organization reports that there were 55.4 million deaths in 2019, meaning that pollution causes nearly one-in-six deaths worldwide. More than 90 percent of these deaths occur in lower- and middle-income countries, predominantly in parts of Asia and Africa.

“What [the report] shows is that the number of deaths caused by pollution has not changed in four years,” Landrigan says.

India and China lead the way, with more than 2 million pollution deaths occurring in each country in 2019. But the U.S. accounted for 215,000 pollution-related deaths each year, according to Landrigan. Pollution-related deaths in the U.S. average 43.6 deaths per 100,000 — considerably higher than other high-income countries like Finland, which averaged 29 deaths per 100,000 people.

A figure from the report compares pollution deaths to other causes of mortality.Fuller et al

“Air and water pollution have improved greatly since the formation of the EPA in the 1970s, but we still have a long way to go in the United States, and chemical pollution is silently getting worse,” Landrigan adds.

There are some bright spots in the report, which highlight that deaths from traditional pollution — such as household pollution related to lack of clean water or air pollution from cooking smoke — have declined due to significant government and charitable initiatives.

But on the other hand, rising pollution deaths from modern pollution resulting from industrialization have increased by 66 percent since 2000, effectively offsetting the reduction in deaths from traditional pollution.

Ambient or environmental air pollution is the leading cause of death, leading to 6.5 million deaths each year. The remaining deaths are due to lead poisoning — a significant problem for children — and chemical pollution. The report also found significant gender differences in pollution-related deaths. Women and children typically die from water pollution, whereas men perish more from air and lead pollution.

In sum: global pollution is a public health threat “greater than that of war, terrorism, malaria, HIV, tuberculosis, drugs, and alcohol,” according to the report.

Why it’s happening — In addition to highlighting the staggering death toll from pollution, the report also reveals how little the global community has failed to act on such a severe threat to public health since the last report in 2017. Rachael Kupka, report co-author and Executive Director of the Global Alliance on Health and Pollution, tells Inverse the response to the 2017 Lancet report has been “anemic.”

“We alerted the world to this really large problem five years ago. Not much has really happened,” Kupka says.

Mortality rates from pollution are on the rise in Southeast Asia and South Asia.Fuller et al

Absent urgent action by governments and bodies like the United Nations, the pollution problem will only worsen. According to Landrigan, deaths from air pollution are projected to double by 2050.

Compared to higher-income countries in North America and the EU, lower and middle-income countries have seen comparatively higher death rates from pollution. The reasons behind the rising pollution mortality rates in lower and middle-income countries are complicated, but have to do primarily with increased industrialization in these countries — including greater reliance on fossil fuels — and a lack of stringent monitoring of pollution, as well as insufficient international financing to curb pollution.

Pollution is also often seen as an environmental issue rather than a health issue. It lacks the significant funding and political attention given to other public health concerns, even though the latest Lancet report finds pollution is a “major risk factor” for non-infectious diseases on par with smoking, substance abuse, and unhealthy diets.

“We’re trying to draw attention to this fact and say that this is really an issue of public health scale, and it’s actually getting worse,” Kupka adds.

Lead poisoning can also cause serious cognitive damage in children. Children with lead concentrations exceeding five micrograms per deciliter of blood often score three to five points lower on IQ tests than children with lower blood levels. According to the report, more than 800 million children have blood lead concentrations that exceed these levels.

“For those children, his is actually a health emergency for them,” Kupka says.

Lead poisoning doesn’t just affect individuals but society at large. The report authors state that lead-related IQ issues contribute to global economic losses of nearly $1 trillion.

“We cannot continue to ignore pollution. We are going backward,” the report gravely cautions.

A figure from the study shows average blood lead concentrations in children around the world. Lead poisoning is one of the major contributors to pollution-related deaths. Fuller et al

What’s next — Despite the grim prognosis, there are ways forward to reduce the striking death toll from pollution, according to experts. The first thing: we need to draw way more attention and funding to the subject of pollution, and fast. There are few global agreements to specifically address pollution efforts, further hindering efforts to curb pollution.

“The greatest need is for policy-makers within countries and in the UN agencies to make pollution prevention a high priority and to put serious funding into pollution control,” Landrigan says.

In addition to greater funding, Kupka says that governments within lower- and middle-income countries need to be able to prioritize pollution “within their own development agendas.” One way to accomplish this is by bringing together leaders from various government ministries to discuss and tackle pollution — a model developed by the Global Alliance on Health and Pollution known as the Health and Pollution Action Plan.

But it will be hard to eliminate pollution-related deaths if we don’t target its key source: fossil fuels. The report’s authors are clear: we need to devote the same urgency to tackling pollution that we do to the climate crisis, recognizing that pollution — primarily from burning fossil fuels — also contributes to global warming.

“Lasting control of pollution — and prevention of the diseases that it causes — will require massive, government-supported transition away from gas, oil, and coal to clean renewable energy,” Landrigan concludes.