11 Nov Air Pollution and Lung Health Scorecard
Air pollution is the leading risk factor for death from lung conditions including chronic obstructive pulmonary disease (COPD), pneumonia, and lung cancer. Together these conditions caused a massive 7.9 million deaths in 2o21, with 35% or 2.8 million attributable to air pollution. Air pollution is a factor in almost half (48%) of all COPD deaths, 30% of pneumonia deaths and 19% of lung cancer deaths, according to the Global Burden of Disease.
Of all causes of air pollution, it is particulate matter measuring less than 2.5 micrometers in diameter – less than a 30th of the diameter of a human hair – that causes the largest burden of deaths from lung disease. This “PM2.5” is emitted both outdoors and indoors, from vehicles, coal-burning power plants, industrial activities, waste burning, farming practices, and household cooking and heating using coal, charcoal, wood, agricultural residue, animal dung, and kerosene.
Both outdoor and household sources of PM2.5 contribute to respiratory deaths, but not equally. The majority (60%) of these deaths are from outdoor sources, while 40% are from indoor sources. While household air pollution-related respiratory deaths have been falling since 2010 (COPD -25%, pneumonia -38%, and lung cancer -36%), outdoor air pollution-related deaths have risen sharply (COPD 36%, lung cancer 34%, pneumonia 6%).
Not all populations are equally vulnerable to air pollution-related respiratory deaths. Sixty-four percent of all of these deaths are among adults over 70 years, 28% are among adults 15-49 years, and 7% among children under 14 years. Air pollution-related COPD deaths are heavily concentrated (75%) among the over 70’s, while one in three pneumonia deaths among children under 15 years is attributable to air pollution. Household air pollution is a factor in 70% of these child pneumonia deaths.
To focus attention on the toxic relationship between air pollution and lung health, Every Breath Counts released an Air Pollution and Lung Health Scorecard ranking the 20 countries with the most air pollution-related deaths from COPD, pneumonia, and lung cancer. These 20 countries are home to 85% of all air pollution-related respiratory deaths with 12 in Asia, 4 in Africa, 2 in the Middle East, and 2 in the Americas. Of great concern is the subset of countries where more than half of all air pollution-related respiratory deaths are among the under 70s, including Pakistan, Nigeria, Democratic Republic of Congo, Ethiopia, Egypt, and Tanzania.
It is important to note that the leading causes of air pollution-related respiratory deaths and the most affected populations differ markedly across the countries on the list. For example, in India the greatest burden of death is caused by outdoor air pollution among older adults with COPD, while in Nigeria household air pollution among children under five contributes to a massive pneumonia burden. Despite efforts to increase household access to clean cooking fuels and technologies, there has been limited progress. Since 2010, only half of the 20 countries on the scorecard have achieved more than 50% population access to clean cooking.
It is vital that governments in all 20 countries introduce policies that target both the leading causes of air pollution-related respiratory deaths and their most vulnerable populations. Specifically, the Every Breath Counts Coalition is calling on national governments to embrace a national target to reduce air pollution-related respiratory deaths by 50% by 2030, to establish a Clean Air Taskforce with representation from the health, energy, agriculture, industry, and urban development ministries to report annually on national progress, and to accelerate measures to achieve the target including:
- Reducing average PM2.5 exposure by 50% or until achievement of the updated WHO targets of not more than 5μg/m3 per year and 15 µg/m3 for more than three days per year
- Increasing the proportion of households with access to clean cooking fuels and technologies to above 70
- Prioritizing action in the sub-national populations who face the greatest risks of air pollution-related respiratory death
Investments to reduce air pollution and the risk of death from COPD, pneumonia, or lung cancer will help countries accelerate progress to several of the Sustainable Development Goals for health, including:
- 3.2.1 Reduce child (0-4 years) deaths to at least 25 per 1,000 births
- 3.4.1 Reduce by one third premature mortality from non-communicable diseases
- 3.9.1 Reduce % of adult (15+ years) deaths attributable to PM2.5 air pollution
- 7.1.2 Increase % population with access to clean fuels and technologies for cooking to 100%
- 11.6.2 Reduce annual mean levels of fine particulate matter (PM2.5 and PM10) in cities
In this critical year for climate action with COP30, it is vital that the health sector works together with the climate change and clean air movements to put air pollution reduction center-stage of global and national respiratory health agendas. Evidence of effective strategies, especially in the world’s cities, is emerging constantly. No more excuses.
Read the Air Pollution and Lung Health Scorecard
Published for the Second Global Conference on Air Pollution and Health, 21 March, 2025