2017 Global Burden of Disease (GBD) report says India has the second highest number of early deaths due to PM2.5 in the world -- nearly equals China

Early deaths due to ozone pollution are the highest in India

More than a quarter of global deaths due to air pollution occur in India alone 

With a large and ageing population in the grip of rising and toxic pollution, India stands at serious health risk: CSE

New Delhi, February 14, 2017: New estimates of the global burden of disease (GBD) released today by the US-based Health Effect Institute (HEI) paint a grim picture for India. Globally, air pollution is estimated to cause more than 4.2 million early deaths -- of these, 1.1 million deaths occur in India alone. This is more than a quarter of the global deaths. India now nearly equals China which scores the highest number of early deaths due to PM2.5. Worse, India now tops the dubious list of highest number of early deaths due to ozone pollution. 

The rate of increase in early deaths in India is quite scary. While early deaths related to PM2.5 in China have increased by 17.22 per cent since 1990, in India these have increased by 48 per cent. Similarly, while early deaths due to ozone in China have stabilised since 1990, in India these have jumped by 148 per cent. This demands urgent intervention.

Air pollution is the leading environmental cause of death worldwide; as many as 92 per cent of the world’s population lives in areas with unhealthy air. The 2017 report presents a deeper analysis than the earlier GBD report (2015) and examines the long term trends from 1990 through 2015. 

The HEI has built on the GBD project of the Institute for Health Metrics and Evaluation (IHME), involving more than 2,000 researchers. These researchers enumerate and track death and disability and the influence of behavioral, dietary, and environmental risk factors for more than 300 diseases and injuries, by age and sex, from 1990 to the present, in 195 different countries and territories. 

“India cannot afford to remain complacent or on denial any more. With so many people dying early and falling ill and losing productive years due to particulate and ozone pollution, it is a state of health emergency. This demands nation-wide intervention to ensure stringent mitigation and a roadmap to meet clean air standards,” says Anumita Roychowdhury, executive director-research and advocacy, CSE.  

Key highlights of the new GBD analysis 
India ranks second highest in the world in the number of early deaths due to PM2.5
The number of premature deaths due to PM2.5 in India is the second highest in the world -- it has nearly equaled China’s dubious record. While China has recorded 1,108,100 premature deaths, India records 1,090,400 deaths. Even though India had started off with a much lower number of people dying early deaths in 1990, it has quickly caught up with China. 

Not only the absolute numbers of early deaths are high in India, the rate of increase is higher than China’s. While early deaths related to PM2.5 in China has increased by 17.22 per cent since 1990, in India it has increased by 48 per cent. 

Early deaths in India are also the highest among the South Asian countries – it is 9 times higher than neighbouring Bangladesh and 8 times higher than Pakistan. This is an extremely serious issue – in the past, the GBD estimates had indicated that air pollution was the fifth largest killer in India. 

India in grip of deadly health risk from ozone pollution 
Without anyone noticing it ozone, a very reactive gas, has become a serious health problem in India. Even though the absolute number of early deaths due to ozone is far less than those caused by PM2.5 – 107,800 compared to 1,090,400 due to PM2.5 -- India records the highest number of ozone-related deaths in the world. Ozone aggravates respiratory problems, especially chronic obstructive pulmonary disease (COPD). It may be noted that India has now included COPD in its non-communicable disease programme.  

Deaths due to ozone are showing a much higher rate of increase than deaths related to particulate matter. It is this rate of increase in India that is scary: ozone-related early deaths in India have recorded an increase by as much as 148 per cent since 1990. During the same period, health risk from particulate pollution has increased by 48 per cent. 

Ozone-related early deaths in India are 33 per cent higher than those recorded for China. India has also recorded a much faster increase in ozone-related deaths since 1990 than China – on an average, the increase ranges at 20 per cent in India as opposed to 0.50 per cent in China. In 1990, ozone deaths in India were far less than in China. But now India has surpassed China, where ozone-related deaths have remained more or less stable.

In South Asia, ozone deaths in India are 13 times higher than in Bangladesh and 21 higher than in Pakistan.

CSE has followed up to understand the reason for the high number of ozone-related deaths. The HEI scientists explain that ozone in GBD estimates is from the chemical transport model, but the evidence of increasing ozone levels in India, especially in north India, is seen from the available measurements. For ozone, the increase in exposure is so large that it overwhelms the improvements in underlying chronic obstructive pulmonary disease mortality – in other words, exposure matters and combines with aging and population growth to lead to increasing deaths. For particulate matter, there is an increase in exposure but the overall improvement in mortality rates is large enough to lead to a decrease in the death rates.  

Ozone is not directly emitted but is formed by reaction of a variety of gases like nitrogen oxide, carbon monoxide and volatile organic compounds under the influence of sunlight and temperature. According to scientists, formation of ozone is expected to be higher in countries in tropics and sub-tropics and near the equator. To some extent, rising temperature is also aggravating this trend. India will be well advised to take early and stringent steps to control ozone precursors which are very difficult to control. This means stringent control of gaseous emissions from combustion sources including vehicles. The air pollution problem cannot be dismissed as dust. Ozone precursors like nitrogen oxides, carbon monoxides and volatile organic compounds also have serious local public health impacts. 

The global trend 
This new analysis shows that long-term exposure to fine particulate matter has contributed to 4.2 million premature deaths and to a loss of 103 million healthy years of life globally in 2015.  This is the fifth highest risk factor for deaths from heart disease and stroke, lung cancer, chronic lung disease, and respiratory infections. This report has looked at 79 health risk factors. An additional 254,000 deaths occur due to exposure to ozone and its impact on chronic lung disease. PM2.5 was responsible for a substantially larger number of deaths than other well-known risk factors. 

The European Union is the third highest in terms of health risks from particulate and ozone. The US stands sixth in health risk from particulate pollution and fourth in ozone pollution. 

It is important to note that the developed world that has witnessed early action on air pollution, has seen some improvement but the risk remains. In the US, there has been about 27 per cent reduction in average annual population exposures to fine particulate matter. The reduction in Europe is comparatively smaller. Yet some 88,000 Americans and 258,000 Europeans still face increased risks of dying early due to particulate levels today. 

Act now
The new scary results leave no room for diffidence and denial of the problem anymore. As the GBD analysis now becomes an annual tracker of change, it is possible for the world and India to know the trend in emerging health risk from air pollution.  This has to inform policies and action to protect public health.

The Union Ministry of Environment, Forest and Climate Change needs to implement nation-wide strategy to control both particulate and gaseous pollutants to meet clean air standards, says Roychowdhury.


For more analysis and interviews, please contact Souparno Banerjee, 9910864339 / souparno@cseindia.org.