Kiera Jefferson
Air pollution is a leading cause of death worldwide, with 8.1 million deaths attributed to it in 2021 alone. The impact of air pollution goes beyond these deaths, as millions more suffer from debilitating chronic illnesses. While the global death rate from air pollution has declined in recent decades, the number of deaths has remained stagnant. This means that as the global population grows, the risk for the average person has been decreasing. Air pollution is caused by a variety of sources, both indoor and outdoor, and is linked to an increased risk of diseases such as heart disease, stroke, lower respiratory infections, lung cancer, and chronic obstructive pulmonary disease (COPD). In 2021, China and India had the highest number of air pollution-related deaths, with more than two million recorded in each country.
| Characteristics | Values |
|---|---|
| Global deaths from air pollution | 8.1 million in 2021; 7 million in 2019; 10.2 million in 2012 |
| Global deaths from fossil fuel air pollution | 8.7 million in 2018; 8 million in 2018; 1 in 5 deaths worldwide |
| Global deaths from indoor air pollution | 2.4 billion people exposed; death rates have declined since 1990 |
| Global deaths from outdoor air pollution | More prominent in middle-income countries; industrial activities prominent in the Midwest, U.S. |
| Global deaths from ozone pollution | 489,518 in 2021 |
| Global deaths from NO2 pollution | Highest in densely populated urban areas, particularly in high-income countries |
| Global deaths from PM2.5 pollution | Responsible for 22% of infant deaths in Africa |
| Countries with highest death rates from air pollution | Low- and middle-income countries; China; India; U.S. (PA, OH, MI, IN, KY, WV, IL, NJ, WI) |
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What You'll Learn
Fossil fuel combustion
Air pollution is one of the leading risk factors for death worldwide, with recent studies showing it is responsible for approximately 8 million deaths per year. Fossil fuel combustion is a significant contributor to air pollution, with fine particulate matter (PM2.5) from the burning of fossil fuels causing approximately 8.7 million deaths globally in 2018. This figure is more than twice the previous estimate of 4.2 million deaths per year, which considered PM2.5 pollution from all sources, not just fossil fuel combustion.
The health impacts of fossil fuel combustion are well-known, with particulate matter containing toxins small enough to penetrate deep into the lungs. This can lead to respiratory conditions such as asthma, as well as lung cancer, coronary heart disease, strokes, and early death. The regions with the highest concentrations of fossil fuel-related air pollution, including Eastern North America, Europe, and Southeast Asia, have the highest rates of mortality. China and India alone account for nearly five million premature deaths due to fossil fuel pollution. Other hard-hit areas include Western Europe, parts of the US Northeast and Midwest, and Latin America.
The impact of fossil fuel combustion on health is particularly pronounced in low- and middle-income countries, where exposure to air pollution is highest. This is due in part to the reliance on solid fuels for cooking and the increase in outdoor air pollution as countries industrialize and shift from low to middle incomes. However, it is important to note that even in high-income countries, urban areas with high levels of NO2 from traffic exhaust can have significant health impacts.
The transition from fossil fuels to renewable energy sources has immediate health benefits. For example, in the United States, 350,000 premature deaths are attributed to fossil fuel pollution annually, with Pennsylvania, Ohio, and Michigan among the states with the highest number of deaths per capita. In India, fossil fuel pollution was responsible for nearly 2.5 million deaths in 2018, representing over 30% of total deaths among people over age 14. Additionally, thousands of children under age 5 die each year from respiratory infections attributed to fossil fuel pollution.
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Indoor air pollution
The health effects of indoor air pollution are profound. Exposure to pollutants can lead to respiratory and other diseases, increasing morbidity and mortality rates. Ischaemic heart disease, stroke, lower respiratory infections, lung cancer, diabetes, and chronic obstructive pulmonary disease (COPD) are among the leading causes of death attributed to indoor air pollution. It impairs immune response, reduces oxygen-carrying capacity in the blood, and inflames the airways and lungs.
The decline in death rates from indoor air pollution has been notable in recent decades. Since 1990, death rates have nearly halved, primarily driven by improvements in indoor air quality. This progress is largely attributed to initiatives promoting cleaner household fuels and technologies, as well as increased access to clean energy for cooking and improved ventilation. However, there is still a long way to go, as indoor air pollution continues to pose a significant risk to public health, especially in low- and middle-income countries.
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Outdoor air pollution
In 2019, outdoor air pollution was estimated to cause approximately 4.2 million premature deaths worldwide, making it the second-leading risk factor for death. The mortality is attributed to exposure to fine particulate matter, which leads to cardiovascular and respiratory diseases and cancers. Ischaemic heart disease and stroke are the most significant causes of outdoor air pollution-related deaths, accounting for 68% of the total. Other causes include chronic obstructive pulmonary disease (COPD), acute lower respiratory infections, and lung cancers.
The burden of outdoor air pollution is disproportionately borne by people in low- and middle-income countries, with 89% of the premature deaths occurring in these regions. The WHO South-East Asia and Western Pacific Regions have the highest number of deaths. This disparity is partly due to the industrialization and economic development that characterize these regions, which contribute to higher levels of outdoor air pollution.
While the death rate from total air pollution has declined in recent decades, the improvement is mainly driven by a reduction in indoor air pollution. Outdoor air pollution remains a significant challenge, and policies addressing sustainable land use, cleaner energy, transport, and industry are crucial to reducing its impact on public health.
To mitigate the health risks associated with outdoor air pollution, individuals can take precautions such as using air conditioning with recirculate mode, air purifiers, and wearing N95 pollution masks when outdoor air quality is poor. However, addressing the root causes of outdoor air pollution through policy interventions and global collaborative efforts is essential to protecting public health and ensuring a sustainable future.
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Air pollution in low-income countries
Air pollution is a significant health and environmental issue worldwide, with far-reaching consequences for people's health and well-being. It is one of the leading risk factors for death, contributing to about one in ten deaths globally in recent years. The impact of air pollution is not evenly distributed, and low-income countries bear a disproportionate burden of its adverse effects.
In low-income countries, air pollution is often the leading risk factor for death. This disparity is attributed to various factors, including indoor and outdoor pollution sources. Indoor pollution rates are typically high in low-income settings due to the widespread reliance on solid fuels, such as wood, animal dung, crop waste, and coal, for cooking and heating. The incomplete combustion of these fuels releases harmful pollutants like particulate matter, carbon monoxide, and nitrogen dioxide, posing significant health risks.
Outdoor air pollution is also a pressing concern in low-income countries. As these nations industrialize, outdoor pollution tends to increase due to factors such as residential energy use, vehicle emissions, power generation, waste incineration, and the development of industrial sectors. The lack of stringent air quality regulations and the prevalence of older, more polluting machinery and vehicles contribute to elevated outdoor pollution levels.
The combination of indoor and outdoor air pollution exacerbates health issues in low-income countries. Populations in these countries often experience higher prevalence rates of diseases negatively affected by air pollution exposure, such as asthma, respiratory infections, lung cancer, and chronic obstructive pulmonary disease (COPD). Additionally, socioeconomic inequalities are reinforced by air pollution, as ethnic minorities and low-income populations are often exposed to higher pollution levels, leading to adverse health outcomes and limited socioeconomic development prospects.
Addressing air pollution in low-income countries requires a multifaceted approach. Implementing policies that promote sustainable land use, cleaner household energy sources, improved waste management practices, and the adoption of cleaner technologies can effectively reduce pollution levels. Additionally, expanding access to clean energy for cooking, improving healthcare and nutrition, and raising awareness about the harms of air pollution are crucial steps in mitigating its impact on vulnerable populations in low-income countries.
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Air pollution in the US
Air pollution is a significant health and environmental issue worldwide, with low- and middle-income countries suffering the highest exposures. While global death rates from total air pollution have declined in recent decades, air pollution still contributed to 8.1 million deaths globally in 2021, making it the second leading risk factor for death.
In the United States, air pollution continues to be a pressing concern, affecting the health and well-being of millions of people. According to the "State of the Air" 2025 report by the American Lung Association, 46% of Americans, approximately 156 million people, live in areas with unhealthy levels of ozone or particle pollution. This represents a significant increase compared to the previous year's report, highlighting the worsening air quality across the nation.
One of the key contributors to air pollution in the US is emissions from various sources. Since 1970, the US has made significant strides in reducing emissions of common air pollutants, with a 78% decrease in the total emissions of the six principal air pollutants by 2023. However, despite these efforts, air pollution remains a pervasive issue. In 2023, about 66 million tons of pollution were emitted into the US atmosphere, contributing to the formation of ozone and particles, acid deposition, and visibility impairment.
Certain regions in the US are particularly affected by air pollution. The "State of the Air" report identified Bakersfield, California, as the worst metropolitan area for short-term particle pollution for the third consecutive year. Other cities, such as Fresno, California, and Phoenix, Arizona, also face high levels of soot and smog pollution. Communities of color are disproportionately impacted by air pollution, with Hispanic individuals being nearly three times as likely as white individuals to live in communities with failing grades for air quality.
Climate change and extreme weather events also play a significant role in exacerbating air pollution in the US. Extreme heat, drought, and wildfires contribute to increasing levels of ozone and particle pollution, posing risks to public health. The changing climate presents challenges to the efforts made by states and cities to improve air quality and protect the progress made in reducing emissions.
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Frequently asked questions
China and India had the highest number of air pollution-related deaths worldwide in 2021, with over two million recorded in each country. Together, these two countries accounted for approximately 55% of global deaths from diseases linked to air pollution.
In 2023, the world's most polluted countries based on PM2.5 concentrations were Bangladesh, Pakistan, and India, with average levels in each country more than 10 times above World Health Organization (WHO) recommended guidelines.
The major sources of outdoor air pollution include residential energy for cooking and heating, vehicles, power generation, agriculture/waste incineration, and industry.
