Pollution accounted for one in six deaths worldwide in 2019, a study has found.
A report by the Lancet Commission on Pollution and Health found that air, chemical and water pollution were responsible for nine million deaths worldwide.
More than 90 per cent of pollution-related fatalities occurred in low-income and middle-income countries such as India and Nigeria, the study said.
Deaths from toxic air and chemicals had risen by 7 per cent since the previous review and 66 per cent since 2000.
Toxic air and contaminated water are an “an existential threat to human health and planetary health, and jeopardise the sustainability of modern societies”, it added.
“We're sitting in the stew pot and slowly burning,” said Richard Fuller, a study co-author and head of the global nonprofit Pure Earth. But unlike climate change, malaria, or HIV, “we haven't given (environmental pollution) much focus”.
The figures put pollution roughly on par with smoking - which kills some 8 million people a year - in terms of global deaths. Covid has killed 6.7 million people since the pandemic began in 2020.
The new analysis looks more specifically at the causes of pollution – separating traditional contaminants such as indoor smoke or sewage from more modern pollutants, such as industrial air pollution and toxic chemicals.
Tainted water and soil, as well as dirty air, put Chad, the Central African Republic and Niger as the three countries with the most pollution-related deaths, according to the data.
Ethiopia and Nigeria saw a drop in pollution-related deaths of two-thirds between 2000 and 2019 as a result of state programmes to cut indoor air pollution and improve sanitation.
The researchers wrote that pollution and the climate crisis are “the key global environmental issues of our time”.
“These issues are intricately linked and solutions to each will benefit the others… but we cannot continue to ignore pollution. We are going backwards.”
Mr Fuller said: “Pollution prevention is largely overlooked in the international development agenda.
“Attention and funding has only minimally increased since 2015, despite well-documented increases in public concern about pollution and its health effects.”