So, let's talk green: Death in every breath

A year ago, I wrote about the harmful effects of air pollution. While I knew that this was an issue in India and many parts of the world, I was not prepared for what I read in the Health Effects Institutes' (HEI), State of Global Air 2017 report, released in Boston earlier this week.

Air pollution is the leading environmental cause of death worldwide according to the report. 92% of the world's population lives in areas with long-term exposure to fine particulate matter (PM), the most significant element of air pollution. It contributed to 4.2 million premature deaths and to a loss of 103 million healthy years of life in 2015, making air pollution the 5th highest cause of death among all health risks, including smoking, diet, and high blood pressure. Evidence is clear on the impacts of air pollution on the rates of cardiovascular disease and stroke, in addition to effects on respiratory disease.

More than 2,000 researchers contributed to this report which factored in the role of an exhaustive set of behavioural, dietary and environmental risk factors for more than 300 diseases in 195 countries from 1990 onwards. "The Global Burden of Disease (GBD) leads a growing worldwide consensus among the WHO, World Bank, International Energy Agency and others, that air pollution poses a major global public health challenges," said Bob O'Keefe, Vice President of HEI and Chair of Clean Air Asia. "Nowhere is that risk more evident than in the rapidly growing economies of Asia," he added. The WHO estimated 3 million deaths from PM exposure for the year 2012, and it has gone up to 4.2 million in 2015, according to the GBD report.

The industrial sector, comprising both coal, which was responsible for 155,000 deaths, and non-coal, responsible for 95,000 deaths, was the largest contributor to mortality attributable to ambient PM. Household burning of both coal and biomass like wood and agricultural waste, is also an important contributor to the burden of disease attributable to ambient PM. Household combustion of these solid fuels had a combined impact resulting in 177,000 deaths in 2015 that was larger than that of the 137, 000 deaths from transportation and power plant emissions. Bangladesh and India, have experienced the steepest increases in air pollution levels since 2010 and now have the highest PM concentrations among the countries shown in the report.

In 2015, long-term exposures to ambient PM contributed to 4.2 million deaths and to a loss of 103 million years of healthy life, making PM exposure responsible for 7.6% of all global deaths and 4.2% of all global years of healthy life. China and India each had the highest absolute numbers of deaths attributable to PM.  Together, these two countries accounted for 52% of the total global PM attributable deaths and 50% of the years of healthy life. On a global basis, long-term exposure to ambient PM was responsible for 17.1% of mortality from ischemic heart disease, 14.2% from stroke, 16.5% from lung cancer, 24.7% from Lower Respiratory Infections, and 27.1% from COPD in 2015.

Is there hope now for countries like India and China? Is it possible to ever clean our air and make it safe? The answer is yes, and there are success stories. The US, with its Clean Air Act, has made substantial progress in reducing people exposed to PM pollution since 1990. While some 88,000 Americans still face increased risks of dying early due to PM levels today, the US has experienced a reduction of about 27% in average annual population exposures to fine particulate matter, proving that this is still possible. So there is hope.

While human beings gasp for breath and look for clean air, planet Earth is also gasping for breath to escape the effects of greenhouse gases which are emitted when we burn fossil fuels like coal. Let us clean up our act and the air we breathe, to honour the planet and ourselves and to avoid death in every breath.