A 'pandemic' of air pollution shortens lives worldwide by nearly three years on average, and causes 8.8 million premature deaths annually, scientists said Tuesday.
Eliminating the toxic cocktail of molecules and lung-clogging particles cast off by burning oil, gas and coal would restore a full year of life expectancy, they reported in the journal Cardiovascular Research.
"Air pollution is a larger public health risk than tobacco smoking," lead author Jos Lelieveld of the Max Planck Institute in Mainz, Germany told AFP.
"Much of it can be avoided by replacing fossil fuels with clean renewable energy."
Compared to other causes of premature death, air pollution kills 19 times more people each year than malaria, nine times more than HIV/AIDS, and three times more than alcohol, the study found.
Coronary heart disease and stroke account for almost half of those deaths, with lung diseases and other non-communicable diseases such as diabetes and high blood pressure accounting for most of the rest.
Only six percent of mortality stemming from polluted air is due to lung cancer.
"Our results show there is an 'air pollution pandemic'," said senior author Thomas Munzel of the Max Planck Institute's departments of chemistry and cardiology.
"Both air pollution and smoking are preventable, but over the past decades much less attention has been paid to air pollution than to smoking, especially among cardiologists."
The worst-hit region is Asia, where average lifespan is cut 4.1 years in China, 3.9 years in India, and 3.8 years in Pakistan.
In some parts of these countries, toxic air takes an even steeper toll, other research has shown.
In India's Uttar Pradesh -- home to 200 million -- small particle pollution by itself slashes life expectancy by 8.5 years, while in China's Hebei Province (population 74 million) the shortfall is nearly six years, according to the Air Quality Life Index, developed by researchers at the Energy Policy Institute of Chicago.
African lives are also foreshortened by 3.1 years on average, with people in some nations -- Chad, Sierra Leone, Central African Republic, Nigeria and Cote d'Ivoire -- losing 4.5 to 7.3 years.
Among wealthier nations, the Soviet Union's former satellite states have the deadliest pollution, especially in Bulgaria, Hungary and Romania.
"We show that about two-thirds of premature deaths are attributable to human-made pollution, mainly from fossil fuel use," Munzel said.
"This goes up to 80 percent in high-income countries," he added.
"5.5 million deaths worldwide a year are potentially avoidable."
- Impact 'significantly underestimated' -
Unavoidable excess mortality stems from natural dust storms, such as in central Asia and northern Africa, along with forest fires, though both phenomena are being amplified by manmade climate change, according to climate scientists.
The least-impacted regions of the world are the Americas, western and northern Europe, and small island states.
The figure of 8.8 million premature deaths from outdoor air pollution each year is double estimates from World Health Organization (WHO).
"The impact of air pollution on cardiovascular and other non-communicable diseases was significantly underestimated," Lelieveld explained, echoing a conclusion from other recent research.
Air pollution causes damage to the blood vessels through greater oxidative stress, leading to increases in blood pressure, diabetes, stroke, heart attacks and heart failure.
The revised number for China is 2.8 million premature deaths each year, two-and-a-half times the WHO estimates.
The researchers said there are signs in India, China and other emerging economies that people are growing intolerant of life-shortening toxic air.
"The realisation that air pollution is a major health risk can contribute to the willingness to phase-out fossil fuels -- with the co-benefit of reducing climate warming," Lelieveld said.
To assess the impact of air pollution on life expectancy, the researchers applied data on exposure to micro-particles (PM2.5) and ozone for the year 2015 to models that simulate how chemical processes in the atmosphere interact with natural and manmade pollutants, and data from the Global Burden of Disease.
Indoor pollution -- mainly from cookstoves fuelled by biomass or coal -- is also a major killer, but was not considered here.
TENSIONS with Pakistan, fluctuating ties with Bangladesh, and growing Chinese influence in Nepal and Sri Lanka have complicated India’s neighbourhood policy, a top foreign policy and security expert has said.
C Raja Mohan, distinguished professor at the Motwani Jodeja Institute for American Studies at OP Jindal Global University, has a new book out, called India and the Rebalancing of Asia.
He also described how India’s engagement with the US, Japan, Australia and Europe has moved from symbolism to one of substance. Raja Mohan said, “After independence, India withdrew from regional security politics, focusing on global issues and non-alignment. But the past decade has seen a reversal. India is now back in the Asian balance of power. The very concept of the ‘Indo-Pacific’ reflects that, putting the ‘Indo’ into the ‘Pacific.’”
The idea, he explained, has deep historical roots: “The British once viewed the Indian and Pacific Oceans as interconnected realms. Now, after decades of separation, those spaces are merging again.”
Narendra Modi with Xi Jinping and (right)Vladimir Putin at last month’s SCO summit in China
While India once aspired to build a “post-Western order” alongside China, those dreams have long since faded, according to the expert.
“Contradictions between India and China have sharpened,” he said, citing territorial disputes, a $100 billion (£75bn) trade deficit, and China’s growing influence among India’s neighbours.
By contrast, India’s ties with the US and Europe have strengthened.
“Where once India shunned security cooperation with Washington, it is now deeply engaged,” he said. Yet he emphasised that India remains an independent actor, “not a traditional ally like Japan or Australia.”
His comments were made during the Adelphi series, hosted by the International Institute for Strategic Studies (IISS) last month. According to the expert, who is also a visiting research professor at the National University of Singapore, the return of India to regional security politics marks a significant change in its foreign policy since independence. Popular discussions about the “rise of Asia” tend to oversimplify what Raja Mohan explained was a deeply uneven transformation. “It’s more accurate to say Asia as a whole is rising,” he said, adding, “but not evenly. China has risen much faster than the rest.”
This imbalance has created internal contradictions within Asia, according to the academic. “China’s sense of entitlement to regional dominance and its territorial claims have provoked reactions from other Asian countries,” he said.
While China’s economic ascent, once “a marriage of Western capital and Chinese labour”, that relationship has strained over the past 15 years as the Asian country grew into a global military and economic powerhouse, according to Raja Mohan.
And the US, which previously nurtured China’s growth, now seeks to restore balance in Asia, shifting from a policy of engagement to one of cautious competition, he said.
Dwelling on India’s rise, he said, “The question is not whether India can match China alone, but whether it can help build coalitions that limit unilateralism. History shows weaker states can play crucial balancing roles, as China once did against the Soviet Union.”
He explored how the US-China and India-China dynamics might evolve, particularly under US president Donald Trump.
“Some believe the US is retrenching to focus on Asia, others think Trump might seek a grand bargain with China,” Raja Mohan said. “Much depends on how Washington manages its ties with Russia and its global posture.”
He also described how India’s engagement with the US, Japan, Australia and Europe has moved from symbolism to one of substance. Raja Mohan said, “After independence, India withdrew from regional security politics, focusing on global issues and non-alignment. But the past decade has seen a reversal. India is now back in the Asian balance of power. The very concept of the ‘Indo-Pacific’ reflects that, putting the ‘Indo’ into the ‘Pacific.’”
The idea, he explained, has deep historical roots: “The British once viewed the Indian and Pacific Oceans as interconnected realms. Now, after decades of separation, those spaces are merging again.”
While India once aspired to build a “post-Western order” alongside China, those dreams have long since faded, according to the expert.
“Contradictions between India and China have sharpened,” he said, citing territorial disputes, a $100 billion (£75bn) trade deficit, and China’s growing influence among India’s neighbours.
By contrast, India’s ties with the US and Europe have strengthened.
“Where once India shunned security cooperation with Washington, it is now deeply engaged,” he said. Yet he emphasised that India remains an independent actor, “not a traditional ally like Japan or Australia.”
His comments were made during the Adelphi series, hosted by the International Institute for Strategic Studies (IISS) last month. According to the expert, who is also a visiting research professor at the National University of Singapore, the return of India to regional security politics marks a significant change in its foreign policy since independence. Popular discussions about the “rise of Asia” tend to oversimplify what Raja Mohan explained was a deeply uneven transformation. “It’s more accurate to say Asia as a whole is rising,” he said, adding, “but not evenly. China has risen much faster than the rest.”
This imbalance has created internal contradictions within Asia, according to the academic. “China’s sense of entitlement to regional dominance and its territorial claims have provoked reactions from other Asian countries,” he said.
While China’s economic ascent, once “a marriage of Western capital and Chinese labour”, that relationship has strained over the past 15 years as the Asian country grew into a global military and economic powerhouse, according to Raja Mohan.
And the US, which previously nurtured China’s growth, now seeks to restore balance in Asia, shifting from a policy of engagement to one of cautious competition, he said.
Dwelling on India’s rise, he said, “The question is not whether India can match China alone, but whether it can help build coalitions that limit unilateralism. History shows weaker states can play crucial balancing roles, as China once did against the Soviet Union.”
He explored how the US-China and India-China dynamics might evolve, particularly under US president Donald Trump.
“Some believe the US is retrenching to focus on Asia, others think Trump might seek a grand bargain with China,” Raja Mohan said. “Much depends on how Washington manages its ties with Russia and its global posture.”
China, he noted, has already toned down its aggressive “wolf warrior” diplomacy, realising that assertiveness has backfired. Yet the underlying structural contradictions between China and both the US and India “are unlikely to disappear.”
Asked about India’s balancing act between the US and Russia, especially after Moscow’s invasion of Ukraine, the expert was pragmatic.
“India has steadily moved closer to the US and the West, but Trump’s trade-first approach has caused turbulence,” Raja Mohan said.
He cited the threats of high tariffs on Indian imports and resentment over trade imbalances with Washington DC.
On Russia, Raja Mohan’s view was that the relationship has been “in slow decline since the 1990s.”
While India’s GDP now outpaces Russia’s, it continues to engage Moscow for practical reasons. “India’s oil purchases from Russia rose from two per cent to forty per cent after 2022. That’s pragmatism, not alignment,” Raja Mohan said.
He added that prime minister Narendra Modi’s recent handshakes with China’s president Xi Jinping and Russia’s president Vladimir Putin at the Shanghai Co-operation Organization (SCO) summit in China were “signals, reminders to the West that India has options.”
Raja Mohan said India was at the cusp of a historic transformation. “India once provided security across Asia - in both world wars, millions of Indian soldiers fought overseas. That history was forgotten when India withdrew from global security,” he said.
“Now we are reclaiming that role. Ideally, the partnership with the US is the best. But if not, India and other Asian powers will have to shoulder the burden themselves.”
“Japan, Korea, India, Australia - all will have to do more on their own,” he said. “We’ll need to pull up our own bootstraps.”
Dr Benjamin Rhode, senior fellow at IISS, chaired the session.
aggressive “wolf warrior” diplomacy, realising that assertiveness has backfired. Yet the underlying structural contradictions between China and both the US and India “are unlikely to disappear.”
Asked about India’s balancing act between the US and Russia, especially after Moscow’s invasion of Ukraine, the expert was pragmatic.
“India has steadily moved closer to the US and the West, but Trump’s trade-first approach has caused turbulence,” Raja Mohan said.
He cited the threats of high tariffs on Indian imports and resentment over trade imbalances with Washington DC.
On Russia, Raja Mohan’s view was that the relationship has been “in slow decline since the 1990s.”
While India’s GDP now outpaces Russia’s, it continues to engage Moscow for practical reasons. “India’s oil purchases from Russia rose from two per cent to forty per cent after 2022. That’s pragmatism, not alignment,” Raja Mohan said.
He added that prime minister Narendra Modi’s recent handshakes with China’s president Xi Jinping and Russia’s president Vladimir Putin at the Shanghai Co-operation Organization (SCO) summit in China were “signals, reminders to the West that India has options.”
Raja Mohan said India was at the cusp of a historic transformation. “India once provided security across Asia - in both world wars, millions of Indian soldiers fought overseas. That history was forgotten when India withdrew from global security,” he said.
“Now we are reclaiming that role. Ideally, the partnership with the US is the best. But if not, India and other Asian powers will have to shoulder the burden themselves.”
“Japan, Korea, India, Australia - all will have to do more on their own,” he said. “We’ll need to pull up our own bootstraps.”
Dr Benjamin Rhode, senior fellow at IISS, chaired the session.
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