It is difficult to conceptualize the impact of pollution. As a collective, we know pollution exists. We know it's bad for the planet, we know it's harmful to our species in a vague, futuristic sense. Yet today, experts acknowledge that the link between air pollution and public health is much more direct, immediate, and impactful than what was ever previously understood.
According to the World Bank, "In 2012, an estimated 9 million people died from air, water and land pollution representing 13 percent of all premature deaths that year, according to the Global Alliance on Health and Pollution." Of these deaths, the World Health Organization (WHO) attributes roughly 4 million to outdoor air pollution and 3 million to indoor air pollution. This now makes air pollution the world's largest single environmental health risk, and the cause of more deaths than smoking and road accidents combined.
According to the WHO, stroke and heart disease caused 80% of outdoor pollution deaths, followed by 11% from lung diseases, and 6% from cancers. Indoor pollution resulted in similar disease-related deaths, but were skewed towards a greater percentage of deaths from women and children. Respiratory disease in children represented 13% of deaths from household ambient pollution.
The two most common pollutants, found in both indoor and outdoor environments, are ozone (better known as smog) and particle pollution. Smog is created when gases like nitrogen oxides and carbon monoxide, released by tailpipes and smokestacks, come in contact with sunlight. The transport, energy, waste management, and manufacturing industries are the most significant contributors to atmospheric ozone.
Particle pollution represents a mix of tiny solid and liquid particles that are suspended in the air, some of which are so small that they are able to pass through the lung tissue and into the blood stream, narrowing arteries and causing systemic inflammation. According to the EPA, these small particles are mainly the by-product of burning fossil fuels in factories and motor vehicles. In the instance of indoor pollution, the domestic burning of dirty fuels (wood, coal, dung) for cooking and heating is the greatest producer of ambient particles.
Pollution is often felt first and hardest by people in developing countries. Southeast Asia is currently the most severely affected, as it faces elevated levels of both outdoor and indoor sources of pollution. The explosion of manufacturing and urbanization in the last century has led to unprecedented levels of outdoor ambient pollution. In parts of China, smog levels are so high that agricultural experts liken the effect to a "nuclear winter," due to the impact on crop photosynthesis. The Chinese government now posts streaming, twitter-like updates on air quality for regions throughout the country. Indoor pollution is an equal threat, as poor and rural populations, those that still use solid fuels for heating and cooking, represent a considerable demographic in South-East Asia.
While all people in developing countries face an elevated risk of premature death from air pollution, women and children are disproportionately affected, as they spend more time within the home breathing in smoke and toxins produced from coal, wood, and dung stoves. Ignoring the issue of pollution means ignoring the well-being of these most vulnerable populations.
Perhaps one of the most disconcerting aspects of this data is the fact that until very recently, experts have significantly underestimated the risks that air pollution poses on health, particularly for the extreme poor. Of the 7 million deaths in 2012, only 180,000 came from the Americas and Europe combined. This previously unmeasured impact on human health has allowed recommended air quality standards to remain loose or even ignored in many countries.
While climate change remains a vexed issue, the impact of pollution on our own mortality is something that has received less attention. The World Bank Spring meetings in D.C. present an opportunity for the leaders of developing and developed countries to bring to light how pollution increasingly threatens people's lives on a daily basis. In particular, it represents a moment where leaders can commit to significantly reduce air, land and water pollution levels through a dedicated Pollution Management and Environmental Health Trust Fund. This Fund will focus initially on large cities in Asia and Africa, where urbanization is proceeding the fastest. Such an initiative will prove to be crucial if we are to mitigate the impacts of pollution, particularly for those who feel its impacts most acutely.
The increasing awareness that pollution is impacting on our health shows that it's no longer an opaque and unimaginable issue. Fundamentally, it underlines pollution as a human development issue, as much as one about the use of global commons. If we are to eradicate extreme poverty by 2030, surely the management of pollution and improvement of air quality in the most densely populated places on earth are part of this story.