Air pollution, like a pandemic, kills millions every year

Globally, air pollution accounts for about 7 million premature deaths a year, according to the World Health Organization (WHO)—more than twice as many as alcohol consumption and more than five times as many as traffic accidents. (Some recent research puts pollution’s toll far higher than the WHO estimate.) A majority of those deaths are caused by outdoor air pollution; the rest are attributable primarily to smoke from indoor cookstoves. Most of the deaths occur in developing countries—China and India alone account for about half—but air pollution remains a significant killer in developed ones too. The World Bank puts the global economic cost at more than five trillion dollars annually.

In the United States, 50 years after Congress passed the Clean Air Act, more than 45% of Americans still breathe unhealthy air, according to the American Lung Association. It still causes more than 60,000 premature deaths annually—not counting the many thousands who have died because it made them more vulnerable to COVID-19. Pollution is a hidden killer; it doesn’t get listed on death certificates. Perhaps this year, Dominici said when we spoke, its intersection with frightening new threats—a raging virus and wildfires—would help us recognize the damage it has been doing all along.

But in December, when the U.S. Environmental Protection Agency formally decided not to tighten the national air quality standards for PM2.5, maintaining them at their current levels, it ignored Dominici’s research and that of its own scientists. They had calculated that lowering the annual standard by 25 percent would save 12,000 lives a year.

Air pollution’s brutal bottom line—the more there is, the shorter the lives of those who breathe it—was established most definitively by a landmark 1993 project known as the “Six Cities” study. People in the most polluted of six small American cities analyzed by Harvard researchers were 26% more likely to die prematurely than those in the cleanest of the six. Pollution was taking about two years off their life spans.

Dirty air, his committee reported, affects nearly all the body’s essential systems. It may cause about 20 percent of all deaths from strokes and coronary artery disease, triggering heart attacks and arrhythmias, congestive heart failure and high blood pressure. It’s linked to lung, bladder, colon, kidney, and stomach cancers and to childhood leukemia. It harms kids’ cognitive development and raises older people’s risk of contracting dementia or dying of Parkinson’s disease. It’s been credibly tied to diabetes, obesity, osteoporosis, decreased fertility, miscarriage, mood di

Climate change and air pollution have the same cause and the same solution, but they play out on different time scales. One of the most striking things about air pollution is how quickly health improves when it clears. The economic shutdowns triggered by COVID-19 last year temporarily slowed the world’s carbon emissions, but the total amount of carbon in the atmosphere continued to rise, and the long-term threat from climate change got that much worse. In contrast, every incremental and local decline in pollutants such as PM2.5 or nitrogen dioxide translates immediately into fewer asthma attacks, heart attacks, and deaths.sorders, sleep apnea—the list goes on.

While the pandemic’s deadly impact has been impossible to ignore, pollution gets far less attention, though it kills far more people. One reason is that it’s so hard to link pollution to individual deaths—to attach names and faces to the victims.

Dirty air is a plague on our health, causing 7 million deaths and many more preventable illnesses worldwide each year. But the solutions are clear.

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