Intended for healthcare professionals


One in eight deaths is due to air pollution, says WHO

BMJ 2014; 348 doi: (Published 25 March 2014) Cite this as: BMJ 2014;348:g2379
  1. Anne Gulland
  1. 1London

Seven million people died from exposure to air pollution in 2012—equivalent to one in every eight of all deaths that year.1

New figures from the World Health Organization are more than double the previous estimates of deaths from air pollution. Previous estimates said that in 2004 two million people died from household air pollution2 and that 1.3 million died from outdoor air pollution in 2008.3

The most deaths were in the western Pacific and South East Asia, with a total of 3.3 million deaths linked to indoor air pollution and 2.6 million deaths linked to outdoor air pollution.

Indoor exposure to pollutants claimed more deaths worldwide, as 4.3 million people died in households that cook with coal, wood, and biomass stoves. WHO estimated that 3.7 million deaths were attributable to outdoor air pollution. The agency said that many people were exposed to indoor and outdoor air pollution and that therefore the numbers did not add up to seven million.

Almost 680 000 people died from pollution in Africa in 2012, compared with about 415 000 in the eastern Mediterranean region, nearly 600 000 in Europe, and around 230 000 in the Americas.

The new data are based on WHO’s mortality estimates and on new global data mapping, including satellite mapping, ground level monitoring, and data on pollution from key sites.

Ischaemic heart disease and stroke were responsible for most deaths that were linked to outdoor air pollution (80%), followed by chronic obstructive pulmonary disease (COPD) (11%), lung cancer (6%), and acute lower respiratory infections in children (3%).

Stroke was the most common cause of death that was linked to indoor air pollution (34%), followed by ischaemic heart disease (26%), COPD (22%), acute lower respiratory infections in children (12%), and lung cancer (6%).

Maria Neira, director of WHO’s department for public health, environmental and social determinants of health, said that the risks from air pollution were now far greater than previously thought or understood.

“Few risks have a greater impact on global health today than air pollution; the evidence signals the need for concerted action to clean up the air we all breathe,” she said.

Jon Ayres, professor of environmental and respiratory medicine at the UK University of Birmingham, said the impact that indoor air pollution in developing countries had on lower respiratory tract infections in children and COPD was “very real.” However, he sounded a note of caution on the links between cardiovascular disease and indoor air pollution.

“There are only very limited cardiovascular data for biomass smoke exposure, and the assumption that the toxicity of the particles from (outdoor) vehicles is the same as those from (indoor) biomass is unproven,” he said.


Cite this as: BMJ 2014;348:g2379


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