Abstract
SummaryBackgroundThe association of air pollution with multiple adverse health outcomes is becoming well established, but its negative economic impact is less well appreciated. It is important to elucidate this impact for the states of India.MethodsWe estimated exposure to ambient particulate matter pollution, household air pollution, and ambient ozone pollution, and their attributable deaths and disability-adjusted life-years in every state of India as part of the Global Burden of Disease Study (GBD) 2019. We estimated the economic impact of air pollution as the cost of lost output due to premature deaths and morbidity attributable to air pollution for every state of India, using the cost-of-illness method.Findings1·67 million (95% uncertainty interval 1·42–1·92) deaths were attributable to air pollution in India in 2019, accounting for 17·8% (15·8–19·5) of the total deaths in the country. The majority of these deaths were from ambient particulate matter pollution (0·98 million [0·77–1·19]) and household air pollution (0·61 million [0·39–0·86]). The death rate due to household air pollution decreased by 64·2% (52·2–74·2) from 1990 to 2019, while that due to ambient particulate matter pollution increased by 115·3% (28·3–344·4) and that due to ambient ozone pollution increased by 139·2% (96·5–195·8). Lost output from premature deaths and morbidity attributable to air pollution accounted for economic losses of US$28·8 billion (21·4–37·4) and $8·0 billion (5·9–10·3), respectively, in India in 2019. This total loss of $36·8 billion (27·4–47·7) was 1·36% of India's gross domestic product (GDP). The economic loss as a proportion of the state GDP varied 3·2 times between the states, ranging from 0·67% (0·47–0·91) to 2·15% (1·60–2·77), and was highest in the low per-capita GDP states of Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, and Chhattisgarh. Delhi had the highest per-capita economic loss due to air pollution, followed by Haryana in 2019, with 5·4 times variation across all states.InterpretationThe high burden of death and disease due to air pollution and its associated substantial adverse economic impact from loss of output could impede India's aspiration to be a $5 trillion economy by 2024. Successful reduction of air pollution in India through state-specific strategies would lead to substantial benefits for both the health of the population and the economy.FundingUN Environment Programme; Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Highlights
Air pollution is a major cause of premature death and disease, and is the largest environmental health threat globally.[1,2,3,4,5] Besides endangering health and shortening lifespan, air pollution adversely affects economic produc tivity.[6,7] The Sustainable Development Goals (SDGs) call for reduction of the burden of deaths and diseases from air pollution.[8]Air pollution risks are typically quantified for ambient particulate matter pollution, household air pollution, and, to a smaller extent, tropospheric ozone
The death rate due to household air pollution decreased by 64·2% (52·2–74·2) from 1990 to 2019, while that due to ambient particulate matter pollution increased by 115·3% (28·3–344·4) and that due to ambient ozone pollution increased by 139·2% (96·5–195·8)
disability-adjusted life-years (DALYs) is a composite metric that combines the years of life lost due to premature death (YLLs) and the years lived with disability (YLDs)
Summary
Air pollution is a major cause of premature death and disease, and is the largest environmental health threat globally.[1,2,3,4,5] Besides endangering health and shortening lifespan, air pollution adversely affects economic produc tivity.[6,7] The Sustainable Development Goals (SDGs) call for reduction of the burden of deaths and diseases from air pollution.[8]Air pollution risks are typically quantified for ambient particulate matter pollution, household air pollution, and, to a smaller extent, tropospheric ozone. The main sources of ambient particulate matter pollution in India are residential and commercial biomass burning, windblown mineral dust, coal burning for energy generation, industrial emissions, agricultural stubble burning, waste burning, construction activities, brick kilns, transport vehicles, and diesel generators.[9,10,11,12,13,14,15,16] Household air pollution is caused mainly by the use of solid fuels for cooking, such as wood, dung, agricultural residues, coal, and charcoal.[17,18,19] Ground-level ambient ozone is produced when pollutants emitted from transport vehicles, power plants, factories, and other sources react in the presence of sunlight with hydrocarbons emitted from diverse sources.[20]
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