Bad air still leading global cause of early deaths, killed 7.9mn in 2023, study finds

In India, deaths linked to air pollution surged from 1.4 million in 2000 to 2 million in 2023

Air pollution remained the world’s deadliest environmental threat in 2023, contributing to 7.9 million deaths globally and exacerbating noncommunicable diseases and dementia, according to the sixth State of Global Air report released on Wednesday.

In 2023, 89% of all air pollution-related deaths in India were linked to NCDs, underlining the mounting health crisis. (AFP)

In India, deaths linked to air pollution surged from 1.4 million in 2000 to 2 million in 2023, with pollution now overtaking high blood pressure and poor diet as the leading risk factor for mortality in the country.

The report, released by the Health Effects Institute (HEI), an independent US-based nonprofit research organisation, in collaboration with the Institute for Health Metrics and Evaluation and the NCD Alliance, found that 86% of global air pollution deaths—6.8 million—were caused by noncommunicable diseases such as heart and lung disease, lung cancer, diabetes and dementia.

India’s alarming exposure levels

Three in four Indians live in areas where annual PM2.5 exposure exceeds the World Health Organization’s (WHO) least stringent interim target of 35 µg/m³, the report said. In 2023, 89% of all air pollution-related deaths in India were linked to NCDs, underlining the mounting health crisis.

The report highlighted that air pollution now contributes to seven out of 10 deaths from chronic obstructive pulmonary disease (COPD) and nearly one in five diabetes deaths.

Experts drew a distinction – Indians were previously more exposed to household air pollution, a factor that has now been addressed.

“While the health impacts due to environmental risk factors such as unsafe water and sanitation have reduced significantly since 2000, the burden due to ambient PM2.5 has increased between 2000-2023,” said Pallavi Pant, HEI’s head of global initiatives. “As a result of focussed interventions aimed at improving clean energy access, the number of deaths due to household air pollution have declined significantly. However, the number of deaths due to ambient PM2.5 and ozone have increased during the same time.”

Global NCD burden escalates

Globally, deaths from NCDs linked to air pollution rose from 5.99 million in 2000 to 6.8 million in 2023—an increase of nearly a million deaths. These diseases, which include heart disease, diabetes, cancer, stroke and COPD, are characterised by their long duration, progressive worsening and inability to transmit between individuals.

NCDs also accounted for 161 million healthy years of life lost globally, resulting in high healthcare utilisation, increased hospital admissions, emergency medical care needs, loss of productivity and income, and significant mental health burdens for affected individuals, their caregivers and families.

Dementia link emerges

For the first time, the SoGA report included data on air pollution’s effects on dementia. In 2023, dementia related to air pollution resulted in more than 625,000 deaths worldwide and nearly 12 million healthy years of life lost.

“The data presented in the State of Global Air report highlight the significant impacts of poor air quality on the health and wellbeing of billions of people around the world, especially those living in Asia and Africa,” Pant said. “Growing momentum on air quality management across those hard-hit locations, including expansion of air quality monitoring, adoption of air quality regulations and sector-specific interventions are yielding improvements for those most impacted.”

Policy recognition grows

In 2018, the United Nations High-Level Meeting on Noncommunicable Diseases added air pollution to the five most important risk factors for prominent NCDs, alongside tobacco use, unhealthy diets, physical inactivity and harmful alcohol use. A year later, the World Health Assembly included air pollution in its NCD framework.

Alison Cox, policy and advocacy director at the NCD Alliance, emphasised the urgency of implementation. “Win-win solutions for air pollution and NCDs exist, with added benefits for climate, physical activity, nutrition and many other global development priorities,” she said. “These policies are effective and deliver a strong return on investment—for the sake of our people and the planet we need to implement them faster.”

The report’s air pollution estimates are derived from PM2.5 and ozone data from ground monitoring stations, satellite observations and global chemical transport models. Household air pollution data comes from WHO and other surveys combined with studies measuring indoor and personal household exposures. Health impacts are calculated using disease and death rates, exposure information, population demographics and the risk of death or disability associated with air pollution exposure.