2019 pollution and health metrics: global, regional and country analysis

Pollution is an enormous and poorly addressed health
problem. In October 2017, The Lancet Commission
on pollution and health quantified the human toll of
worldwide pollution—9 million premature deaths a
year.1 The data for that analysis was from 2015. This
report updates those results with the most recent
dataset—2017—and also breaks down the results
by country, enabling us to rank the best and worst
performers in each region.
The new data shows pollution still to be the largest
environmental cause of premature death on the planet,
killing 8.3 million people in 2017,2 or nearly one death in
seven. These deaths are caused by exposure to toxic air,
water, soil, and chemical pollution globally. The results are
still conservative, as many known toxins are not included
in the analysis.1 This report draws its data from the
Institute for Health Metric’s (IHME’s) 2017 Global Burden
of Disease Study.2
The reductions in death from 2015 to 2017 mostly
reflect changes in calculations of methodology related
to air pollution. New analyses, conducted by IHME’s air
pollution experts, Health Effects Institute,3 reviewed the
overlap between indoor air and outdoor air with new
data and methodologies. Changes were also made in
methodologies for various occupational pollutants and for
lead. Each of these updated the IHME calculations.
Overall, the results show an improvement in the number
of premature deaths from traditional types of pollution—
sanitation and household air contaminated by smoke from
cook stoves—from 2015 to 2017. But premature deaths
from modern pollution, those types of pollution caused by
industrialization and urbanization, are on the rise. Modern
pollution, now responsible for 5.3 million deaths a year, is
poorly addressed in development agendas and still lacks
substantive focus within international agencies, though
attention to the problem is growing.
The Lancet Commission Report was principally organized
around global-level data; national level results were not
published. In order to respond to the interest of national
governments, local researchers, and the broad public, this
report presents a deeper analysis of the data available to
the Commission and sets out regional and country-level
overviews of pollution’s heavy toll on health.
The analysis finds that those 8.3 million premature deaths
are spread unevenly amongst the countries of the world.
In fact, the top 10 countries most affected are responsible
for two thirds of those deaths.
It should be noted that these numbers are rough
estimates, with a large degree of uncertainty. The IHME
data provides a range from 7 million to 10 million total
premature deaths, attributing 5 million of those to air
pollution. Other analyses attribute more deaths to air
pollution alone—7 million according to WHO4 and 9
million deaths according to a recent European study.5 We
use the IHME data in this report as it gives a stable basis
for country comparisons and changes over time. We have
not taken into account overlaps in pollution risk factors in
this analysis.