Health effects
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Further information: Environmental health
The share of total deaths from indoor air pollution, 2017.
Air pollution is an important risk factor for various diseases, such as COPD (a common lung disease), stroke, heart disease, lung cancer, and pneumonia. Indoor air pollution is also associated with cataract. According to the WHO, 99% of the world's population lives in areas with air pollution that exceeds WHO recommended levels. Even at very low levels (under the World Health Organization recommended levels), fine particulates can continue to cause harm.
Pollutants strongly linked to ill health include particulate matter, carbon monoxide, nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2). Fine particulates are especially damaging, as they can enter the bloodstream via the lungs and reach other organs. Air pollution causes disease by driving inflammation and oxidative stress, suppressing the immune system, and by damaging DNA.
People living in poverty, babies, and older people are disproportionately affected by air pollution; pregnancy is also more risky when exposed to air pollution. Communities with a low socioeconomic status and minority groups are more vulnerable to pollution than more privileged communities. Lower-income groups might for instance have less access to healthcare.
Mortality[edit]
Estimates of yearly deaths from air pollution range from 6.7 million to 8.8 million. In comparison, war caused 50,000 yearly deaths and terrorism 25,000.
Deaths in 2021 from air pollution per 100,000 inhabitants (IHME).Estimates of deaths due to air pollution vary. The 2024 Global Burden of Disease Study estimates that air pollution contributed to 8.1 million deaths in 2021, which is more than 1 in 8 deaths. Outdoor particulate pollution (PM2.5) was the largest cause of death (4.7 million), followed by indoor particulate pollution (3.1 million) and ozone (0.5 million).
The World Health Organization estimates that 6.7 million people die from air pollution each year, 4.2 million due to outdoor air pollution. Roughly 68% of outdoor air pollution-related premature deaths were due to coronary heart disease and stroke, 14% due to COPD, and 14% due to lung infections (lower respiratory tract infections).
A study published in 2019 estimated that, for 2015, the number was about 8.8 million, with 5.5 million of these premature deaths due to air pollution from human sources. The global mean loss of life expectancy from air pollution in 2015 was 2.9 years, substantially more than, for example, 0.3 years from all forms of direct violence.
By region[edit]
Regional deaths due to air pollution depend not only on the regional exposure, but also on how large and how old the population is, and the health of people overall.
In some countries, more than 20% of deaths are attributed to air pollution (e.g. China, Nepal, Bangladesh, Laos, and North Korea). In South America, about 4% of deaths are from air pollution, while in countries such as Australia, Canada, and the US, this number is under 3%.
In absolute number, India and China have the higher number of deaths from air pollution. In India, it contributed to 2.1 million deaths in 2021, whereas China saw 2.4 million deaths. Annual premature European deaths from air pollution are estimated at 416,000 to 800,000. The UK saw some 17,000 deaths in 2021 due to air pollution and the US saw 64,000. Nigeria, Indonesia and Pakistan each saw over 200,000 deaths resulting from air pollution.
By source[edit]
Further information: § Sources
Though the rate of exposure to ground-level ozone ("smog") and small-particulate matter ("soot") has been declining, in 2026, nearly half of people in the US under age 18 live in an area receiving a failing grade for at least one measure of air pollution.
Deaths caused by accidents and air pollution from fossil fuel use in power plants exceed those caused by production of renewable energy.
The burning of fossil fuels is the largest source of air pollution deaths. There are estimated 4.5 million annual premature deaths worldwide due to pollutants released by high-emission power stations and vehicle exhausts. PM2.5 formed from emissions from coal-fired power plants could be more harmful than other types of fine particulate matter.
The World Health Organization (WHO) estimates that cooking-related pollution causes 3.8 million annual deaths. The Global Burden of Disease study estimated the number of deaths in 2021 at 3.1 million.
Cardiovascular disease[edit]
There is strong evidence that air pollution increases the risk of cardiovascular disease, including stroke, high blood pressure, and coronary heart disease. According to the Global Burden of Disease Study, air pollution is responsible for 27% of deaths from strokes worldwide and 28% of coronary heart disease. The risks are highest in regions with higher air pollution (e.g. Asia), for elderly and for people who are overweight.
Air pollution is a leading risk factor for stroke, particularly in developing countries where pollutant levels are highest. A systematic analysis of 17 different risk factors in 188 countries found air pollution is associated with nearly one in three strokes (29%) worldwide (34% of strokes in developing countries versus 10% in developed countries). The mechanisms linking air pollution to increased cardiovascular mortality are not fully understood, but likely include systemic inflammation and oxidative stress.
Lung disease[edit]
Air pollution is associated with increased development, hospitalization, mortality, and COPD (chronic obstructive pulmonary disease). COPD is a common disease which causes restricted airflow and breathing difficulties, and is the fourth-largest cause of death globally. Nearly half of global COPD deaths are due to air pollution. Fine particles (PM2.5) and NO2 are associated with increased risk of developing COPD. In children, air pollution can hinder lung development, which may increase their susceptibility to COPD later in life.
Air pollution is further associated with increased risk of asthma and worsening of symptoms, and this effect seems stronger in children. For adults, fine particles (PM2.5) or NO2 seem linked to asthma onset too. Short-term exposure to ozone makes asthma worse in children. There is limited evidence on (almost) fatal asthma attacks in children: ground-level ozone and PM2.5 seem to increase its risk.
Cancer[edit]
Dark factory-emitted clouds obscuring the Clark Avenue Bridge in Cleveland, Ohio in July 1973.
About 265,000 lung cancer deaths were attributed globally in 2019 to exposure to fine particulate matter (PM2.5) suspended in the air. Exposure to indoor air pollution, including radon, caused another 170,000 lung cancer deaths. Lung cancer was also more common among people exposed to NO2 and black carbon.
Outdoor air pollution may increase risk of other types of cancer too, but the evidence is not as clear as for lung cancer. For example, there may be a relationship between kidney cancer and PM2.5 and NO2 levels. Household air pollution – from cooking with solid fuels, but also from radon in building material – has been associated with cervical, oral, and esophageal cancer.
Pregnancy and children[edit]
Stillbirths, miscarriages, and birth defects are all more likely when the mother is exposed to air pollution during pregnancy. Exposure to air pollution also raises the chance that a baby has a low birth weight. The impacts might be due to pollutants directly impacting the placenta or fetus, or indirectly via the mother's health (as air pollution can cause systemic inflammation and oxidative stress).
Over a third of preterm births were associated with air pollution in 2021 globally. It causes more than half a million newborn deaths, a quarter of overall deaths. The source of PM2.5 differs greatly by region. In South and East Asia, pregnant women are frequently exposed to indoor air pollution because of wood and other biomass fuels being used for cooking, which are responsible for more than 80% of regional pollution. In the Middle East, North Africa, and West sub-Saharan Africa, fine PM comes from natural sources, such as dust storms.
For data including older children, polluted air resulted in the death of over 700,000 children in 2021 (709,000 under 5 years of age and 16,600 aged 5–14 years). Children in low- or middle-income countries are exposed to higher levels of fine particulate matter than those in high income countries. Further health effects of air pollution on children include asthma, pneumonia, and lower respiratory tract infections. There is possibly a link between exposure to air pollution during pregnancy and after birth and autism in children.
Many of these relationships could previously only be described as correlations, as study designs that demonstrate causation are difficult or impossible to conduct in environmental medicine. This would require a randomized controlled trial. Scientists at BIPS in Bremen were able to demonstrate a causal relationship for at least some health problems (e.g. diabetes and high blood pressure) using a special study design.
Brain health[edit]
See also: Brain health and pollution
Air pollution is linked to various diseases of the brain. It increases the risk of dementia.
Indoor air pollution exposure during childhood may negatively affect cognitive function and neurodevelopment. Prenatal exposure may also affect neurodevelopment. Exposure to air pollution may contribute to neurodegenerative diseases such as Parkinson's disease.
Exposure to air pollution may also drive mental health issues, such as depression and anxiety. In particular, air pollution from the use of solid fuels was associated with a higher depression risk. Depression risk and suicide was more strongly linked to finer particulate matter (PM2.5), compared to coarser particles (PM10). The association was strongest for people over the age of 65.
Problems with thinking (cognitive issues) are also associated with air pollution. In people over the age of 40, both NOx and PM2.5 have been linked to general cognitive problems. PM2.5 was also associated with reduced verbal fluency (for instance, number of animals one can list in a minute) and worse executive functions (like attention and working memory). Similarly, children tended to fare worse in tests involving working memory when there was NOx, PM2.5, or PM10 pollution.
Physical activity[edit]
The health benefits of physical exercise may be modulated by air quality. A 2025 cross-national study involving 1.5 million adults demonstrated that high levels of ambient fine particulate matter (PM 2.5 μg/m³) can significantly diminish the protective effects of leisure-time physical activity against all-cause and cause-specific mortality.
The study identified a critical threshold of 25 μg/m³ exposure; below this annual average concentration, regular exercise reduced all-cause mortality by approximately 30%. However, this benefit was halved (to 12–15%) when concentrations exceeded 25 μg/m³ exposure.