Report: Air Pollution a Major Driver of Ill Health Worldwide

Our global air pollution problem is headed in the wrong direction.

A woman walks on a city street while holding a cloth over her mouth and nose

Kinzica e Alessandro (Creative Commons)

Air pollution isn’t just a nuisance—it can be deadly.

Air pollution is now the world’s fourth leading risk factor for early death according to the new State of Global Air Report released this week. The report, published annually by experts at the Health Effects Institute and Institute for Health Metrics and Evaluation, summarizes our most current scientific understanding of the heavy burden that air pollution places on countries around the world. According to their data, 4.5 million deaths were linked to outdoor air pollution exposures in 2019, and another 2.2 million deaths were caused by indoor air pollution. Despite improvements in reducing global average mortality rates from air pollution, the world’s most populous countries, India and China, continue to bear the highest burdens of disease. This report is a sobering reminder that the climate crisis threatens to worsen air pollution problems significantly if we fail to act to cut carbon pollution.

A bar graph titled "Global ranking of risk factors by total number of deaths from all causes in 2019." Air pollution is highlighted as the 4th highest risk factor, at 6.67 million deaths.

Air pollution is identified as the world's fourth leading risk factor for early death in the new report.


Credit: State of Global Air Report

A global problem

As the report notes, deadly fine particle outdoor air pollution remains high across much of the world. Overall, more than 90% of the global population continues to live in areas where fine particulate matter levels do not meet the World Health Organization Guideline of 10 µg/m3 for healthy air:
A world map titled "Global map of population-weighted annual average PM2.5 concentrations in 2019"

The report shows that 90 percent of the global population is exposed to unhealthy air pollution levels.

The scientific evidence shows there’s no safe level of air pollution, and the report indicates that more than 90 percent of the global population is inhaling air that’s unhealthy.

The new report notes that, while average global air pollution exposures declined slightly over the last decade, there has been little sustained progress in the most polluted regions of the world. In India, for example, about 980,000 premature deaths in 2019 were linked to indoor and outdoor air pollution—up from 930,000 in 2018 and 890,000 in 2017. Because of the ways in which the global population is growing and aging, the burden of disease caused by exposure to air pollution has continued to rise.

Pollution continues to burden millions of Americans

It’s a common misconception that air pollution in the U.S. is no longer an issue of concern. In fact, the U.S. Environmental Protection Agency (EPA) estimates that more than 120 million people live in counties currently exceeding air pollution limits. All told, the new report links air pollution exposures in the U.S. to about 48,000 premature deaths in 2019 alone. As stark as that number is, it only tells part of the story. For example, people across the U.S. are currently stuck with huge medical bills for treating conditions like asthma, chronic obstructive pulmonary disease, and heart disease worsened by air pollution. A NRDC study estimated the annual health-related costs of ozone air pollution in Nevada at nearly $900 million.

The climate crisis worsens air pollution

Unfortunately, the air pollution problem is poised to worsen significantly in coming years due to the effects of climate change. Warmer weather favors the formation of ground-level ozone smog, and the types of stagnant conditions that cause pollution to smother entire regions for days on end are expected to become more frequent in a warmer world. Higher temperatures also spike demand for air conditioning which can worsen air pollution and health problems if fossil fuels are providing the power for cooling. At the same time, climate change-worsened wildfires generate giant plumes of toxic smoke that can spread far downwind—impacting regions as large as 50 times the area directly burned by the flames.

A large plume of smoke rises over a hillside, with RVs and pickup trucks parked in the foreground

The 2015 Canyon Creek fire burned more than 600,000 acres in Oregon.


Oregon Department of Forestry

We have solutions

Fortunately, the Clean Air Act provides the EPA with effective tools to clean up this deadly pollution. Unfortunately, however, amid a respiratory pandemic that disproportionately impacts low-income communities and communities of color already burdened with some of the nation’s most polluted air, the EPA has chosen to throw out these tools and double down on polluter-friendly policies.

For example, the current administration declined to strengthen outdated national standards for both particle pollution and ozone, which the report identifies as a top cause of death worldwide. These standards are legally required to “protect human health with an adequate margin of safety,” to protect the most vulnerable among us—children, older people, those with asthma and other pre-existing lung and heart conditions, and outdoor workers.

Rather than rushing through weak and outdated standards, EPA should use the best science and health data available to strengthen national standards for ozone and particle pollution. As the report shows, strengthened national standards translate into meaningful action - tens of thousands of lives saved. Analyses from prior EPA reviews bear this out: updated standards for ozone and particulate matter could avoid tens of thousands of air pollution-related deaths, hundreds of thousands of asthma attacks, and tens of thousands of respiratory symptoms in children each year once implemented.

In another egregious example of putting polluter interests first over the health of our communities, the current Administration has attempted to reopen illegal loopholes that allow polluters to emit unlimited amounts of pollution during periods of Startup, Shutdown, and Malfunction. In Texas, Industry self-reported over 174 million pounds of air pollution from these types of events in 2019 alone. Removing these loopholes once and for all would significantly reduce the pollution burdens borne by frontline communities, while driving down the levels of smog, soot, and toxic air pollution that all Americans are exposed to nationwide

There are almost too many examples to count where the current administration could have used the powerful tools available to it under the Clean Air Act to strengthen protections for all, but instead, time and time again, the administration has chosen to give polluters a free pass to pollute. As the report points out, cleaning up air pollution is not only a national, but a global imperative, and the EPA should use the powerful tools available to it under the law, along with the best science and health data, to make this a reality. The Clean Air Act works – a recent NRDC study shows that pollution reductions due to Clean Air Act programs will prevent up to 370,000 premature deaths in 2020, growing to up to 457,000 avoided premature deaths by 2030. And we know what the solutions are – we just need our government to act in our best interest, rather than the best interests of polluters.

Towards a clean air future

While this new report highlights the major harms inflicted by air pollution around the world in 2019, it also points out that things have headed in the wrong direction in recent years.

But there is hope: because the same fossil fuels that clog our skies and damage our bodies also fuel the climate crisis, aggressive actions to fight climate change and expand energy efficiency can also improve air quality and our health. The solutions to clear the air, promote health, and stabilize the climate are in hand, and now we must act.

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