PARIS • Dirty air in India and China. Tainted water in sub-Saharan Africa. Toxic mining and smelter operations in South America.
Pollution around the globe now contributes to an estimated nine million deaths annually - or roughly one in six - according to an in-depth new study published on Thursday in the Lancet.
If accurate, that means pollution kills three times more people each year than HIV/Aids, tuberculosis and malaria combined, with most of those deaths in poor and developing countries.
"Going into this, my colleagues and I knew that pollution killed a lot of people. But we certainly did not have any idea of the total magnitude of the problem," said Dr Philip Landrigan, dean of global health at the Mount Sinai School of Medicine and co-chair of the commission behind the report. "I think all of us were really surprised when we saw this."
The two-year project, which relied on data from researchers in more than 130 countries documenting the causes of disease and premature deaths in recent decades, found that poor air quality was the most significant pollution-related killer.
That includes both outdoor pollution tainted by mercury, arsenic and other harmful particulates, and household air dirtied by the burning of wood, dung and other organic materials.
The result: an estimated 6.5 million deaths in 2015 from heart disease, strokes, lung cancer and other respiratory problems. Water pollution, which includes everything from unsafe sanitation to contaminated drinking water, accounted for an additional 1.8 million annual deaths from gastrointestinal diseases and other infections, researchers found.
Pollution in the workplace also took a heavy toll on some of the world's poorest workers. From bladder cancer in dye workers to the lung disease pneumoconiosis in coal miners, researchers found that occupational exposure to various carcinogens and toxins was linked to about 800,000 deaths annually.
WIDER IMPACT THAN THOUGHT
Going into this, my colleagues and I knew that pollution killed a lot of people. But we certainly did not have any idea of the total magnitude of the problem. I think all of us were really surprised when we saw this.
DR PHILIP LANDRIGAN, dean of global health at the Mount Sinai School of Medicine and co-chair of the commission behind the report.
In 2015, the largest number of deaths attributable to pollution occurred in India and China, with an estimated 2.5 million and 1.8 million deaths respectively.
Other severely affected countries include Pakistan, Bangladesh and Kenya. Beyond the massive human toll, the authors of Thursday's report also focused on the financial toll caused by pollution-related health problems.
Researchers estimated the hit to national budgets at about 1.3 per cent of gross domestic product in low-income countries, compared with about 0.5 per cent in developed, high-income countries.
In addition, nations facing crippling pollution tend to spend much more on health care to treat diseases related to the problem. "When you're looking at developing countries, you really have to address this challenge if you want to move people out of poverty and into the middle class," said Ms Gina McCarthy, a former Environmental Protection Agency administrator who was not involved in the study but had studied its conclusions. "It is holding people back."
The startling conclusion that pollution accounts for 16 per cent of deaths worldwide is, of course, an estimate. But the findings build on previous studies, including a report last year from the World Health Organisation (WHO), detailing the extent to which pollution represents a public health crisis.
"If countries do not take actions to make environments where people live and work healthy, millions will continue to become ill and die too young," then WHO director-general Margaret Chan said last year.