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Dirty air is biggest external threat to human health, worse than tobacco or alcohol, major study finds

Canadian wildfire smoke polluting air across U.S.

Air pollution is more dangerous to the health of the average person on planet Earth than smoking or alcohol, with the threat worsening in its global epicenter South Asia even as China quickly improves, a benchmark study showed Tuesday.

Yet the level of funding set aside to confront the challenge is a fraction of the amount earmarked for fighting infectious diseases, said the research from the Energy Policy Institute at the University of Chicago, known as EPIC.

Its annual Air Quality Life Index (AQLI) report showed that fine particulate air pollution — which comes from vehicle and industrial emissions, wildfires and more — remains the "greatest external threat to public health."

If the world were to permanently reduce these pollutants to meet the World Health Organization's guideline limit, the average person would add 2.3 years onto his or her life expectancy, according to the data, which has a 2021 cutoff. That adds up to 17.8 billion life years saved, the researchers point out.

Fine particulate matter is linked to lung disease, heart disease, strokes and cancer.

Tobacco use, by comparison, reduces global life expectancy by 2.2 years while child and maternal malnutrition is responsible for a reduction of 1.6 years.

Buildings are seen in the haze caused by the air pollution in Jakarta, Indonesia, on August 16, 2023. YASUYOSHI CHIBA/AFP via Getty Images

"The impact of (fine particulate air pollution) on global life expectancy is comparable to that of smoking, more than 3 times that of alcohol use and unsafe water, more than 5 times that of transport injuries like car crashes, and more than 7 times that of HIV/AIDS," the report says.  

Asia and Africa bear the greatest burden yet have some of the weakest infrastructure to deliver citizens timely, accurate data. They also receive tiny slices of an already small global philanthropic pie.

For example, the entire continent of Africa receives less than $300,000 to tackle air pollution.

"There is a profound disconnect with where air pollution is the worst and where we, collectively and globally, are deploying resources to fix the problem," Christa Hasenkopf, director of air quality programs at EPIC, told Agence France-Presse.

While there is an international financing partnership called the Global Fund that disburses $4 billion annually on HIV/AIDS, malaria and tuberculosis, there is no equivalent for air pollution.

"Yet, air pollution shaves off more years from the average person's life in the DRC (Democratic Republic of Congo) and Cameroon than HIV/AIDS, malaria, and other health threats," the report said.

Globally, South Asia is the region impacted most. Bangladesh, India, Nepal and Pakistan are, in order, the top four most polluted countries in terms of annualized, population-weighted averages of fine particulate matter, which are detected by satellites and defined as particles with a diameter of 2.5 microns or less (PM2.5).

Air pollution concentrations are then fed into the AQLI metric, which calculates their impact on life expectancy based on peer-reviewed methods.

Residents of Bangladesh, where average PM2.5 levels were 74 micrograms per cubic meter, would gain 6.8 years of life if this were brought to WHO guidelines of 5 micrograms per cubic meter.

India's capital Delhi, meanwhile, is the "most polluted megacity in the world" with annual average particulate pollution of 126.5 micrograms per cubic meter.

China, on the other hand, "has had remarkable progress in terms of its war on air pollution" thst began in 2014, said Hasenkopf.

Its air pollution dropped 42.3 percent between 2013 and 2021. If the improvements are sustained, the average Chinese citizen will be able to live 2.2 years longer.

In the United States, legislative actions like the Clean Air Act helped reduce pollution by 64.9 percent since 1970, helping Americans gain 1.4 years of life expectancy.

But the growing threat of wildfires — linked to hotter temperatures and drier conditions due to climate change — are causing pollution spikes from the western United States to Latin America and Southeast Asia. 

For example, California's historic wildfire season of 2021 saw Plumas County receive an average concentration of fine particulate matter more than five times over the WHO guideline.

Record wildfires in Canada this summer spurred widespread concerns about air quality and the potential impact on health

North America's story of air pollution improvements in recent decades is similar to Europe, but there remain stark differences between western and eastern Europe, with Bosnia the continent's most polluted country.

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