Air pollution

"Bad air quality" and "Air quality" redirect here. For the obsolete medical theory, see Miasma theory. For the measurement of air pollution, see Air quality index. For the qualities of air, see Atmosphere of Earth.

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Air pollution is the presence of substances in the air that are harmful to humans, other living beings or the environment. Pollutants can be gases like ozone or nitrogen oxides, small particles like soot or other chemicals like lead. It affects both outdoor air and indoor air.

Natural sources of air pollution include wildfires, dust storms, and volcanic eruptions. Indoor air pollution is often caused by the use of biomass (e.g. wood) for cooking and heating. Outdoor air pollution comes from some industrial processes, the burning of fossil fuels for electricity and transport, waste management and agriculture. Many of the contributors of local air pollution are also sources of greenhouse emissions i.e., burning of fossil fuels.[1]

Air pollution causes around 7 or 8 million deaths each year.[2][3] It is a significant risk factor for a number of diseases, including stroke, heart disease, chronic obstructive pulmonary disease (COPD), asthma and lung cancer.[3][4] Particulate matter is the most deadly, both for indoor and outdoor air pollution.[2] Ozone affects crops, and forests are impacted by the pollution that causes acid rain. Overall, the World Bank has estimated that welfare losses (premature deaths) and productivity losses (lost labour) caused by air pollution cost the world economy over $8 trillion per year.[5]

Many different technologies and strategies are available for reducing air pollution. National air quality laws have often been highly effective, notably the 1956 Clean Air Act in Britain and the US Clean Air Act, introduced in 1963.[6][7] Some of these efforts have been successful at the international level, such as the Montreal Protocol,[8] which reduced the release of harmful ozone-depleting chemicals, while others, such as international action on climate change, have been less successful.[9]

Sources of air pollution

Schematic drawing, causes and effects of air pollution: (1) greenhouse effect, (2) particulate contamination, (3) increased UV radiation, (4) acid rain, (5) increased ground-level ozone concentration, (6) increased levels of nitrogen oxides

There are many different sources of air pollution.[10] Some air pollutants (such as nitrogen oxides) originate mainly from human activities,[11] while some (notably radon gas) come mostly from natural sources.[12]

Human sources

Most of the world's air pollution is from burning fossil fuels for industry, construction, transportation, and heating, although humans make air pollution in many other ways.[13] For instance, nuclear weapons, toxic gases, germ warfare, and rocketry can cause air pollution.[14]

Industry and construction

Dust and debris rise as large concrete cooling towers collapse during a controlled demolition
Demolition of the cooling towers of a power station, Athlone, Cape Town, South Africa, 2010

The burning of fuels to produce electricity causes air pollution. Lignite and coal produce most air pollution, followed by oil. The burning of fossil gas and biomass causes less air pollution.[15][16] Methane leaks are common in oil and gas production.[17][18][19]

Other industries cause air pollution too.[20] A 2014 study found that in China, manufacturing and construction sectors contributed more than 50% of air pollution. This was due to high emission intensity and high emission factors in its industrial structure.[21] Polluting industries have been pushed out of richer nations, and China has also started to push its most polluting industries out of the country.[22]

Construction, renovation and demolition produces dust, but also other pollutants.[23][24][25] Though banned in many countries, asbestos persists in older buildings, where it poses a risk of lung disease when disturbed.[26] Building materials including carpeting and plywood emit formaldehyde (H-CHO) gas.[27]

Transportation

Road vehicles produce a significant amount of all air pollution (typically, for example, around a third to a half of all nitrogen dioxide emissions)[28][29] and are a major driver of climate change.[30] Vehicles with petrol and diesel engines produce about half of their emissions from their exhaust gas, and the other half from non-exhaust emissions (tyre and brake wear and erosion or disturbance of the road surface); electric vehicles produce no tailpipe emissions, but still produce the other emissions.[31] Diesel trains, ships and planes also cause air pollution.[32]

Agriculture and waste

Smoke rises from a fire, and is dispersed by wind
Controlled burning of a field outside of Statesboro, Georgia, US, in preparation for spring planting
Several people are working on a heap of rubbish, with smoke rising from it.
E-waste processing in Agbogbloshie, Ghana, using open-burning of electronics to access valuable metals like copper

Fertilized farmland may be a major source of nitrogen oxides.[33] Agricultural emissions and emissions from meat production or livestock contribute substantially to air pollution.[34][35] For instance, methane is emitted by the digestion of food by cattle, causing ground-level ozone.[36] Practices like slash-and-burn in forests like the Amazon cause large air pollution alongside deforestation.[37]

Open dumps of waste are a common source of air pollution in low-income countries. They can support the growth of microbes which pollute water and air, and be a source of toxins. Through open burning of waste—whether self-ignited or burned on purpose—soot, methane, and other pollutants are released.[38] The waste in landfills itself also produces methane.[39] Globally, a quarter of solid waste is not collected. Another quarter is not disposed of properly.[40]

Household sources

Main articles: Household air pollution, Indoor air quality, and Energy poverty and cooking
Smoking of fish over an open fire in Ghana, 2018

As of 2023, more than 2.3 billion people in developing countries rely on burning polluting fuels such as firewood, agricultural waste, dry dung, coal or charcoal for cooking, which causes harmful household air pollution.[41] Kerosine, another polluting fuel, is used in many countries for lighting, and but sometimes also for space heating or cooking. Globally, 12% of PM2.5 outdoor air pollution comes from household cooking. Health effects are concentrated among women, who are likely to be responsible for cooking, and young children.[42]

Gas stoves for cooking contribute to indoor air pollution by emitting NO2, benzene and carbon monoxide.[43] Toasters can produce particulate pollution.[44] Similarly, heating systems such as furnaces and other types of fuel-burning heating devices release polllutants into the air.[45] In some developed countries, including the UK and Sydney, Australia, wood stoves are the major source of particulate pollution in urban areas.[46][47] Wood stoves can also emit carbon monoxide and NOx.[27]

Other sources of indoor air pollution are radon, building materials, biological material and tobacco smoke. Biological material, such as dander, house dust mite, mold and pollen, can come from humans, animals or plants. Some of this material can trigger allergies, such as allergic rhinitis.[27] Fumes from paint, hair spray, varnish, aerosol sprays can be substantial; emissions from these sources was estimated to account for almost half of pollution from volatile organic compounds in the Los Angeles basin in the 2010s.[48]

Natural sources

A dust storm approaches a collection of houses, dwarfing them in height.
Dust storm approaching Stratford, Texas, in 1935

Dust from desert can cause poor air quality far from its source. For instance, dust from the Gobi Desert in China and Mongolia can reach Hawaii, and dust from the Sahara reaches the Mediterennean.[49] Wildfires release smoke and carbon monoxide. During periods of active wildfires, its smoke can make up almost 75% of all air pollution by concentration.[50]

Radon is a radioactive gas that can build up in buildings from the soil. It can cause lung cancer, especially in smokers. Levels are generally low, but can be elevated in buildings with "leaky" foundations or areas with soils rich in uranium.[51]

Vegetation, in some regions, emits environmentally significant amounts of volatile organic compounds (VOCs) on warmer days. These VOCs react with human pollution sources – specifically, NOx, SO2, and organic carbon – to produce a seasonal haze of secondary pollutants.[52] Black gum, poplar, oak and willow are some examples of vegetation that can produce abundant VOCs. The VOC production from these species result in ozone levels up to eight times higher than the low-impact tree species.[53]

Volcanic eruptions produce mostly steam (about 79 percent), but also carbon dioxide (12 per cent), sulfur dioxide (6.5 percent), and small amounts of other pollutants, such as chlorine and ash particulates.[54]

Major pollutants

Main articles: Pollutant and Greenhouse gas emissions

Air pollutants can be solid particles, liquid droplets, or gases, and often take the form of an aerosol (solid particles or liquid droplets dispersed and carried by a gas).[55] A pollutant can be of human or natural origin.

Pollutants are classified as primary or secondary. Primary pollutants are produced directly by a source and remain in the same chemical form after they have been emitted into the atmosphere. Examples include ash from a volcanic eruption, carbon monoxide gas from motor vehicle exhausts, and sulfur dioxide released from factories. Secondary pollutants are not emitted directly. Rather, they form in the air when primary pollutants react or interact. Ground-level ozone is a prominent example of a secondary pollutant. Some pollutants may be both primary and secondary: they are both emitted directly and formed from other primary pollutants.[56]

Ammonia

Ammonia (NH3) is emitted mainly by overuse of synthetic nitrogen fertilisers on farmland, and from manure and urine from livestock.[57] At typical concentrations in the air, it is not harmful to health directly. However, ammonia can react with other pollutants in the air to form ammonium sulfate or nitrate salts, contributing to particulate matter pollution. Furthermore, when ammonia is deposited onto the soil, it can harm ecosystems via eutrophication.[58]

Carbon dioxide

Carbon dioxide (CO2) is mainly emitted by the burning of fossil fuels.[59] It is potentially lethal at very high concentrations (typically 100 times "normal" atmospheric levels).[60][61] Although the World Health Organization recognizes CO2 as a climate pollutant, it does not include the gas in its Air Quality Guidelines or set recommended targets for it.[62] Workplace exposure limits exist in places like UK (5,000 ppm for long-term exposure and 15,000 ppm for short-term exposure).[61] Natural disasters like the limnic eruption at Lake Nyos can result in a large sudden release as well.[63]

CO2 is sometimes called an air pollutant, because it is the main greenhouse gas responsible for climate change.[64][65] This question of terminology has practical consequences, for example, in determining whether the U.S. Clean Air Act (which is designed to improve air quality) is deemed to regulate CO2 emissions. The Inflation Reduction Act of 2022 amended the Clean Air Act to define CO2 from fossil fuel burning explicitly as an air pollutant.[66]

Carbon monoxide

Carbon monoxide (CO) is a colorless, odorless, toxic gas.[67] It is a product of combustion of fuel such as natural gas, coal or wood. In the past, emissions from vehicles were the main source of CO, but modern vehicles do not emit much CO. Now, wildfires and bonfires are the main source of outdoors CO.[68] Indoors, CO is a larger problem and mainly comes from cooking and heating.[69]

Nitrogen oxides

Nitrogen dioxide concentrations as measured from satellite 2002–2004

Nitrogen oxides (NOx), particularly nitrous oxide (NO), are mostly created by the burning of fossil fuels, and in lesser amounts by lightning. Nitrogen dioxide (NO2) is formed from NO in a reaction with other atmospheric gases.[70][71] NO and NO2 can form acid rain, can form into a haze, and can cause nutrient pollution in water.[72] NO2 is a reddish-brown toxic gas with a strong odor, whereas NO is odorless and does not have a color.[73]

Particulate matter

Particulate matter (PM), also known as particle pollution, includes all airborne substances that are not gases.[23][74] It is a mix of microscopic solid particles or droplets suspended in a gas.[75] They consist of a large variety of materials and chemical compounds including toxic substances, and they vary strongly in size.[23] Coarse PM (PM10) is 10 micrometer (μm) or smaller, fine PM (PM2.5) is smaller than 2.5 μm, and ultrafine particles are 0.1 μm or smaller.[76] Smaller articles pose more risk to health, as they can reach the bloodstream.[74][76]

Sea spray, wildfires, volcanoes and dust storms are the main natural sources of PM, while the burning of biomass and fossil fuels, as well as road emissions and dust resuspension are the main human sources. Human PM is usually finer than natural PM.[77] A definitive link between fine particulate pollution and higher death rates in urban areas was established by the Harvard Six Cities study, published in 1993.[78]

Sulfur dioxide

Sulfur dioxide (SO2), an acidic and corrosive gas, is produced mostly by the burning of crude oil and coal. These fossil fuels often contain sulfur compounds, and their combustion generates sulfur dioxide.[79] In Europe and North America, SO2 is mostly found in areas with significant shipping and industry, as road traffic fuels are regulated.[80] Smaller amounts of SO2 are released from smelting and volcanoes.[81]

High concentrations of SO2 in the air generally also lead to the formation of other sulfur oxides (SOx). SOx can react with other compounds in the atmosphere to form small particles and contribute to particulate matter pollution. At high concentrations, gaseous SOx can harm plants by damaging leafs and decreasing growth.[81] Further oxidation of SO2, mostly taking place in cloud droplets, forms sulfuric acid (H2SO4), which is one of the components of acid rain.[82]

Ground-level ozone

leaves showing patches of white between the veins
Leaves damaged by exposure to ozone

Ground-level ozone (O3) is mostly created when NOx and volatile organic compounds mix in the presence of sunlight. It can also be formed from carbon monoxide or methane.[83] Due to the influence of temperature and sunlight on this reaction, high ozone levels are most common on hot summer afternoons.[84] It can be harmful to human health, but also to some materials, forests, wild plants and crops. It can react with other compounds in the air to form photochemical smog.[85] Smog is a particular problem in big cities where it cannot be easily be transported away by wind, for instance cities built in valleys surrounded by mountains.[86] When ground-level ozone is produced, it can linger in the air for days or weeks, and therefore be transported far from where it was first formed.[87]

Volatile organic compounds

Volatile organic compounds (VOC) are both indoor and outdoor air pollutants.[88] VOCs are a large group of compounds which can cause photochemical smog and aerosols impacting climate. The group includes methane, CO, acetone and toluene. Some can cause cancer, such as butadiene and benzene.[89] Methane is an extremely efficient greenhouse gas which contributes to global warming. Other hydrocarbon VOCs are also significant greenhouse gases because of their role in creating ozone and prolonging the life of methane in the atmosphere.[citation needed]

Other pollutants

  • Chlorofluorocarbons (CFCs): Emitted from goods that are now prohibited from use; harmful to the ozone layer. These are gases emitted by air conditioners, freezers, aerosol sprays, and other similar devices. CFCs reach the stratosphere after being released into the atmosphere.[90] They interact with other gases here, causing harm to the ozone layer. UV rays are able to reach the Earth's surface as a result of this. This can result in skin cancer, eye problems, and even plant damage.[91]
  • Persistent organic pollutants, which can attach to particulates. Persistent organic pollutants (POPs) are organic compounds that are resistant to environmental degradation due to chemical, biological, or photolytic processes. As a result, they've been discovered to survive in the environment, be capable of long-range transmission, bioaccumulate in human and animal tissue, biomagnify in food chains, and pose a major threat to human health and the ecosystem.[92] The Stockholm Convention on Persistent Organic Pollutants identified pesticides and other persistent organic pollutants of concern. These include dioxins and furans which are unintentionally created by combustion of organics, like open burning of plastics, and are endocrine disruptors and mutagens.
  • Persistent free radicals connected to airborne fine particles are linked to cardiopulmonary disease.[93][94]
  • Polycyclic aromatic hydrocarbons (PAHs): a group of aromatic compounds formed from the incomplete combustion of organic compounds including coal and oil and tobacco.[95] Wood burning is another significant source of PAHs.[96]
  • Radioactive pollutants: Produced by nuclear explosions, nuclear events, war explosives, and natural processes such as the radioactive decay of radon.
  • Toxic metals, such as lead and mercury, especially their compounds.
  • Peroxyacetyl nitrate (C2H3NO5): formed from NOx and VOCs, like ozone.
  • Microplastics from construction,[97] cosmetics, clothing, and many other sources.[98]

There are many other chemicals classed as hazardous air pollutants. Some of these are regulated in the USA under the Clean Air Act and in Europe under numerous directives (including the Air "Framework" Directive, 96/62/EC, on ambient air quality assessment and management, Directive 98/24/EC, on risks related to chemical agents at work, and Directive 2004/107/EC covering heavy metals and polycyclic aromatic hydrocarbons in ambient air).[99][100]

  • This video provides an overview of a NASA study on the human fingerprint on global air quality.

Exposure

Air pollution levels for urban, rural areas and cities and town. India and Pakistan have concentrations of around 50 microgram PM2.5 per cubic meter. China has levels around 35, Indonesia around 15, and the US around 8. Rural areas typically have somewhat cleaner air than urban areas.
PM2.5 Levels Across the World's 5 Most Populated Nations in 2019

Exposure to air pollution varies by location, but also by age, by profession and by activity.[citation needed] For instance, somebody doing strenuous exercise will breathe in more pollution than somebody who is sitting typically.[101] For some pollutant, low exposure can be seen as safe, whereas other pollutants have negative health effects even at low levels.[102] Exposure to air pollution is worst in lower-middle income countries in line with the environmental Kuznets curve.[103]

Share of the population exposed to air pollution levels above WHO guidelines, 2017

As evidence has grown that even very low levels of air pollution hurt human health, the WHO halved its recommended safe limit for particulate matter from 10 μg/m3 to 5 μg/m3 in 2021. Under the new guideline, nearly the entire global population—97.3 percent—is classified as exposed to unsafe levels of air pollution.[104] The new limit for nitrogen dioxide (NO2) is 75% lower.[105] For all pollutants together, the WHO concluded that 99% of the world population is exposed to harmful air pollution.[106]

For some pollutants such as black carbon, traffic related exposures may dominate total exposure despite short exposure times since high concentrations coincide with proximity to major roads or participation in (motorized) traffic.[107] A large portion of total daily exposure occurs as short peaks of high concentrations.[108]

Hotspots

Main article: Toxic hotspot

Air pollution hotspots are areas where air pollution emissions expose individuals to increased negative health effects.[109] They are particularly common in highly populated, urban areas, where there may be a combination of stationary sources (e.g. industrial facilities) and mobile sources (e.g. cars and trucks) of pollution. Fine particulate matter such as diesel soot, which contributes to more than 3.2 million premature deaths around the world each year, is a significant problem. It is very small and can lodge itself within the lungs and enter the bloodstream. Diesel soot is concentrated in densely populated areas, and one in six people in the U.S. live near a diesel pollution hot spot, such as Cancer Alley along the Mississippi River.[110]

External videos
video icon AirVisual Earth – realtime map of global wind and air pollution[111]

While air pollution hotspots affect a variety of populations, some groups are more likely to be located in hotspots. Previous studies have shown disparities in exposure to pollution by race and/or income. Hazardous land uses (toxic storage and disposal facilities, manufacturing facilities, major roadways) tend to be located where property values and income levels are low. Low socioeconomic status can be a proxy for other kinds of social vulnerability, including race, a lack of ability to influence regulation and a lack of ability to move to neighborhoods with less environmental pollution. These communities bear a disproportionate burden of environmental pollution and are more likely to face health risks such as cancer or asthma.[112]

Studies show that patterns in race and income disparities not only indicate a higher exposure to pollution but also higher risk of adverse health outcomes.[113] Communities characterized by low socioeconomic status and racial minorities can be more vulnerable to cumulative adverse health impacts resulting from elevated exposure to pollutants than more privileged communities.[113] Blacks and Latinos generally face more pollution than Whites and Asians, and low-income communities bear a higher burden of risk than affluent ones.[112] Racial discrepancies are particularly distinct in suburban areas of the Southern United States and metropolitan areas of the Midwestern and Western United States.[114] Residents in public housing, who are generally low-income and cannot move to healthier neighborhoods, are highly affected by nearby refineries and chemical plants.[115]

Cities

Beijing air in 2005 after rain (left) and a smoggy day (right)
Further information: List of most polluted cities in the world by particulate matter concentration and List of least polluted cities by particulate matter concentration

Air pollution is usually concentrated in densely populated metropolitan areas, especially in developing countries where cities are experiencing rapid growth and environmental regulations are relatively lax or nonexistent. Urbanization leads to a rapid rise in premature mortality due to air pollution in fast-growing tropical cities.[116] However, even populated areas in developed countries have unhealthy levels of pollution, with Los Angeles and Rome being two examples.[117] Between 2002 and 2011 the incidence of lung cancer in Beijing near doubled. While smoking remains the leading cause of lung cancer in China, the number of smokers is falling while lung cancer rates are rising .[118]

Top 5 most polluted cities in 2024[119]
City PM2.5 concentration
Byrnihat, India 128
Delhi, India 108
Karaganda, Khazagstan 105
Mullanpur, India 102
Lahore, Pakistan 102

Health effects

The share of total deaths from indoor air pollution, 2017

Air pollution is an important risk factor for various diseases, such as COPD (a common lung disease), stroke, heart disease, lung cancer and pneumonia. Indoor air pollution is also associated with cataract.[120] Air pollution has further been linked to brain disorders, such as dementia, depression, anxiety and psychosis.[121] Diseases that develop from persistent exposure to air pollution are environmental health diseases, which develop when a health environment is not maintained.[122]

Pollutants strongly linked to negative health effects include particulate matter,[123] carbon monoxide,[124] nitrogen dioxide (NO2), ozone (O3),[125] and sulphur dioxide (SO2). Fine particulates are especially damaging, as they can enter the bloodstream via the lungs and reach other organs.[126][127] Air pollution causes disease by driving inflammation and oxidative stress, suppressing the immune system and by damaging DNA.[120]

Even at very low levels (under the World Health Organization recommended levels), fine particulates can continue to cause harm.[128] However, according to the WHO, 99% of the world's population lives in areas with air pollution that exceeds WHO recommended levels.[129] Children are highly vulnerable to air pollution as they breathe at a higher rate than adults. Because they are shorter, they breathe in air closer to the ground, which usually has higher pollution levels (for instance, from vehicle exhaust or dust).[130] People living in poverty, babies and older people are also disproportionately affected by air pollution; pregnancy is also more risky when exposed to air pollution.[131]

Mortality

Estimates of the death toll from air pollution vary across publications.
Deaths in 2021 from air pollution per 100,000 inhabitants (IHME)

Estimates of deaths due to air pollution vary.[132] The 2024 Global Burden of Disease Study estimates that air pollution contributed to 8.1 million deaths in 2021, which is more than 1 in 8 deaths. Outdoor particulate pollution (PM2.5) was the largest cause of death (4.7 million), followed by indoor air pollution (3.1 million) and ozone (0.5 million).[2]

The WHO estimates that 6.7 million people die from air pollution each year, 4.2 million due to outdoor air pollution.[133] Roughly 68% of outdoor air pollution-related premature deaths were due to ischaemic heart disease and stroke, 14% due to COPD and 14% due to lung infections (lower respiratory tract infections).[133]

A study published in 2019 estimated that, for 2015, the number was around 8.8 million, with 5.5 million of these premature deaths due to air pollution from human sources.[134][135] The global mean loss of life expectancy from air pollution in 2015 was 2.9 years, substantially more than, for example, 0.3 years from all forms of direct violence.[136]

By region

Air pollution deaths by nation due to fossil fuels

India and China have the higher number of deaths from air pollution. In India, it contributed to 2.1 million deaths in 2021, whereas China saw 2.4 million deaths.[137] In some countries, more than 20% of deaths were attributed to air pollution, for instance in Nepal, Bangladesh, Laos and North Korea. Air pollution deaths are high in middle-income countries due to industry and in low-income countries due to the use of solid fuels for cooking.[138]

Annual premature European deaths from air pollution are estimated at 416,000[139] to 800,000.[135] The UK saw some 17,000 deaths in 2021 due to air pollution. Nigeria, Indonesia and Pakistan each saw over 200,000 deaths resulting from air pollution.[140]

Eliminating energy-related emissions in the United States would prevent 46,900–59,400 premature deaths each year and provide $537–$678 billion in benefits from avoided PM2.5-related illness and death.[141] A 2023 study on sulfur dioxide emissions by coal power plants (coal PM2.5) concluded that "exposure to coal PM2.5 was associated with 2.1 times greater mortality risk than exposure to PM2.5 from all sources."[142] From 1999 to 2020, a total of 460,000 deaths in the US were attributed to coal PM2.5.[142]

By source

Further information: § Sources
Deaths caused by accidents and air pollution from fossil fuel use in power plants exceed those caused by production of renewable energy.[143]

The largest cause of air pollution is fossil fuel combustion[144] – mostly the production and use of cars, electricity production, and heating.[145] There are estimated 4.5 million annual premature deaths worldwide due to pollutants released by high-emission power stations and vehicle exhausts.[146]

A study concluded that PM2.5 air pollution induced by the contemporary free trade and consumption by the 19 G20 nations causes two million premature deaths annually, suggesting that the average lifetime consumption of about ~28 people in these countries causes at least one premature death (average age ~67) while developing countries "cannot be expected" to implement or be able to implement countermeasures without external support or internationally coordinated efforts.[147][148]

The World Health Organization (WHO) estimates that cooking-related pollution causes 3.8 million annual deaths.[149] The Global Burden of Disease study estimated the number of deaths in 2021 at 3.1 million.[150]

Cardiovascular disease

There is strong evidence that air pollution increases the risk of cardiovascular disease, including stroke, high blood pressure, and ischemic heart disease.[151] According to the Global Burden of Disease Study, air pollution is responsible for 27% of deaths from strokes worldwide and 28% of ischemic heart disease.[152] The risks are highest in regions with higher air pollution (i.e. Asia), for elderly and for people who are overweight.[151]

Air pollution is a leading risk factor for stroke, particularly in developing countries where pollutant levels are highest.[152] A systematic analysis of 17 different risk factors in 188 countries found air pollution is associated with nearly one in three strokes (29%) worldwide (34% of strokes in developing countries versus 10% in developed countries).[153][154] The mechanisms linking air pollution to increased cardiovascular mortality are not fully understood, but likely systemic inflammation and oxidative stress.[155]

Lung disease

Air pollution has been associated with increased hospitalization and mortality and COPD (chronic obstructive pulmonary disease).[156] COPD is a common disease which causes breathing difficulties and is the fourth-largest cause of death globally.[157] Almost half of COPD deaths are due to air pollution.[152] Fine particles (PM2.5) or NO2 were associated with increased risk of developing COPD.[158]

Air pollution is further associated with increased risk of asthma and worsening of symptoms, and this effect seems stronger in children.[159] For adults, fine particles (PM2.5) or NO2 seem linked to asthma onset too.[160] Short-term exposure to ozone makes asthma worse in children.[161] There is limited evidence on (almost) fatal asthma attacks in children: ground-level ozone and PM2.5 seem to increase its risk.[162]

The risk of lung disease from air pollution is greatest for infants and young children, whose normal breathing is faster than that of older children and adults; the elderly; those who work outside or spend a lot of time outside; and those who have heart or lung disease comorbidities.[163]

Cancer

Dark factory clouds obscure the Clark Avenue Bridge in Cleveland, Ohio, July 1973.
Dark factory-emitted clouds obscuring the Clark Avenue Bridge in Cleveland, Ohio in July 1973

Around 265,000 lung cancer deaths were attributed globally in 2019 to exposure to fine particulate matter, PM2.5, suspended in the air.[164] Exposure to indoor air pollution, including radon, caused another 170,000 lung cancer deaths.[164] Lung cancer was also more common among people exposed to NO2 and black carbon.[165]

Outdoor air pollution may increase risk of other types of cancer too, but the evidence is not as clear as for lung cancer.[166] For instance, there may be a relationship between kidney cancer and PM2.5 and NO2 levels.[167] Household air pollution, for instance from cooking with solid fuels, but also from radon in building material, has been associated with cervical, oral, and esophageal cancer.[166]

Pregnancy and children

Stillbirths, miscarriages and birth defects are all more likely when the mother is exposed to air pollution during pregnancy. Exposure to air pollution also raises the chance a baby has a low birth weight. The impacts might be due to pollutants directly impacting the placenta or fetus, or indirectly as via the mother's health (as air pollution can cause systemic inflammation and oxidative stress).[130]

Over a third of preterm births were associated with air pollution in 2021 globally. It causes more than half a million newborn deaths, a quarter of overall deaths.[130] The source of PM2.5 differs greatly by region. In South and East Asia, pregnant women are frequently exposed to indoor air pollution because of wood and other biomass fuels being used for cooking, which are responsible for more than 80% of regional pollution. In the Middle East, North Africa and West sub-Saharan Africa, fine PM comes from natural sources, such as dust storms.[168]

Including older children, polluted air leads resulted in the death of over 700,000 children in 2021 (709,000 under 5 years of age and 16,600 aged 5–14 years).[130] Children in low or middle income countries are exposed to higher levels of fine particulate matter than those in high income countries.[169] Further health effects of air pollution on children include asthma, pneumonia and lower respiratory tract infections.[170] There is possibly a link between exposure to air pollution during pregnancy and after birth and autism in children.[171][172]

Brain health

See also: Brain health and pollution

Air pollution is linked to various diseases of the brain.[121] Indoor air pollution exposure during childhood may negatively affect cognitive function and neurodevelopment.[173][174] Prenatal exposure may also affect neurodevelopment.[175][176] It may also contribute to neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease.[174] There are various routes by which air pollution could cause brain damage: it can cause neuroinflammation, or secondary effects from lung inflammation. At the same time, it can cause cardiovascular disease which in itself raises the risk of brain diseases.[121]

Exposure to air pollution may also drive mental health issues, such as depression and anxiety.[177] In particular, air pollution from the use of solid fuels was associated with a higher depression risk.[178] Depression risk and suicide was more strongly linked to finer particulate matter (PM2.5), compared to coarser particles (PM10). The association was strongest for people over the age of 65.[179]

Problems with thinking (cognitive issues) are also associated with air pollution. In people over the age of 40, both NOx and PM2.5 have been linked to general cognitive problems. PM2.5 was also associated with reduced verbal fluency (for instance, number of animals one can list in a minute) and worse executive functions (like attention and working memory). Similarly, children tended to fare worse in tests involving working memory when there was NOx, PM2.5, or PM10 pollution.[180]

Agricultural effects

Various studies have estimated the impacts of air pollution on agriculture, especially ozone. A 2020 study showed that ozone pollution in California may reduce yields of certain perennial crops such as table grapes by as much as 22% per year, translating into economic damages of more than $1 billion per year.[181] After air pollutants enter the agricultural environment, they not only directly affect agricultural production and quality, but also enter agricultural waters and soil.[182]

The COVID-19 induced lockdown served as a natural experiment to expose the close links between air quality and surface greenness. In India, the lockdown induced improvement in air quality, enhanced surface greenness and photosynthetic activity, with the positive response of vegetation to reduce air pollution was dominant in croplands.[183] On the other hand, agriculture in its traditional form is one of the primary contributors to the emission of trace gases like atmospheric ammonia.[184]

Economic effects

Air pollution has a strong impact on the economy via its health effects (such as reduced productivity at work and the costs of healthcare) and its effects on crop yield. It also affects tourism, biodiversity, forestry and water quality. For instance, tourism may be negatively affected due to decreased visibility and damage to cultural heritage.[185] People may be more prone to making accidents due to air pollution. For instance, increased NO2 levels are linked to construction site accidents.[186]

In terms the welfare cost on human health (non-market costs), a World Bank study found that PM2.5 pollution in 2019 cost the world economy over $8 trillion, over 6% of global GDP. In India and China, the loss of GDP was over 10%. Around 85% of this loss globally came from the loss of life, the rest from increased ill health.[5]: 23–24  The costs of lives lost are calculated using the Value of Statistical Life, a number that tries to estimate how much people would be willing to pay to reduce their risk of dying.[5]: xiii  This number differs by country and is difficult to estimate for low- and middle-income countries.[187]

The direct market impacts on productivity loss, healthcare use and crop losses were estimated to rise to 1% of GDP by 2060, according to the OECD. The Caspian region and China would see the largest impact.[188] Air pollution also has an impact on energy production, as it reduces the amount of sunlight that reaches solar panels. It also causes the panels to become dirty, further reducing their energy output.[189]

History of air pollution

Mummified remains of people in Peru, Egypt and Britain show that ancient people in these regions suffered from blackening of the lungs caused by open fires in poorly ventilated homes. Recorded complaints of air pollution go back to the Greek and Roman period. Outdoor air pollution became a problem with the rise of cities, caused by household smoke and by early industrial activities (such as smelting and mining). In particular, lead levels, found in Arctic ice cores, were about ten times higher in the Roman period than in the period before.[190]

During the Industrial Revolution, outdoor air pollution started to rise strongly, mostly due to the large-scale burning of coal. This occurred first in Britain, then in the rest of Northern Europe and the United States. By the 19th century, buildings around industrial plants started to blacken, while plants and trees in public parks started to wither. Smoke-induced fogs reduced the amount of sunlight city-dwellers got, contributing to cases of rickets, a childhood disease caused by lack of sunlight and poor diet.[191]

See caption
Poster in the Soviet Union saying "The smoke of chimneys in the breath of Soviet Russia"

In the 1830s, anti-smoke groups emerged in Britain, followed by groups in the United States in the 1880s. Legislation against pollution was weak however, as it was seen to conflict with industrial interests. During the Interwar period, a move towards gas and oil meant there was less air pollution, but this trend reversed when World War II broke out.[191] The United Kingdom suffered its worst air pollution during the 1952 Great Smog of London, with some 12,000 deaths, which led to the Clean Air Act 1956.[192] The 1948 Donora Smog in the US, killing 20 people, prompted the US to start regulating air pollution.[191][193] Japan followed in the 1960, but other heavily-polluted regions, such as the Soviet Union and China, did not implement effective regulation.[191]

Technological disasters have caused severe problems with air pollution. The world's worst pollution disaster was the 1984 Bhopal Disaster in India. Leaked industrial vapours from the Union Carbide factory (later bought by Dow Chemical Company), killed at least 20,000 people and affected around 600,000.[194] An accidental leak of anthrax spores from a biological warfare laboratory in the former USSR in 1979 is believed to have caused at least 64 deaths.[195]

From the 1950s, smog in developed countries was regulated, but other pollutants were not. Acid rain, caused by sulphur dioxide, became a major issue as it spread across borders. In the 1990s, for instance, Japan experienced acid rain from Chinese and Korean industry. International cooperation was needed to curb acid rain, and various coalitions were started. In 1975, it was discovered that certain chemicals caused a hole in the ozone layer; thanks to succesfull international negotiations, these chemicals were banned worldwide in the 1987 Montreal Protocol. There has been far less success in curbing greenhouse gas emissions, mostly from the production and burning of fossil fuels. The 1997 Kyoto Protocol introduced modest reduction targets but lacked strong enforcement,[196] while the 2015 Paris Agreement set no binding limits, instead encouraging countries to raise their ambition over time.[197]

Measurement and monitoring

Monitoring

Further information: Air pollution measurement and Environmental monitoring
Display showing poor air quality for PM2.5 and PM10
Air quality monitoring, New Delhi, India

Air pollution can be monitored using different techniques. For instance, satellites and remote sensing is used to track PM, NO2 and ozone.[198] Many regions have a network of monitoring stations, with good coverage in India, China, Europe and the US. Poor coverage exist however for a number of highly-polluted countries, such as Chad and Iran. The density of measurements is improving as there are more low-cost techniques to measure air pollution.[199] Low-cost monitors can also be used for indoor air quality monitoring.[200] Finally, air quality sensors can be incorporated into drones to measure air pollution higher up in the air.[201] Some websites attempt to map air pollution levels using available data.[202][203]

Air quality indexes (AQIs) offer a simple way for governments to communicate changes in air quality and associated health risks, especially during short-term pollution episodes, such as wildfires.[204] An AQI is essentially a health protection tool people can use to help reduce their short-term exposure to air pollution by adjusting activity levels during increased levels of air pollution. Examples include Canada's Air Quality Health Index (AQHI),[205] Malaysia's Air Pollution Index, and Singapore's Pollutant Standards Index.

Modelling and inventories

Main article: Air quality modeling

When direct data is unavailable or when projecting future air pollutant levels, estimates can be derived using models or emission factors.[206] Air pollutant emission factors are typical values that link the amount of a pollutant released into the air to a related activity. This could for instance be the typical amount of particulate matter released from a coal-power station.[207] The United States Environmental Protection Agency has published a compilation of air pollutant emission factors for a wide range of industrial sources,[208] as well as the European Environment Agency.[209]

Air quality models use meteorological and emissions data to simulate how pollutants disperse and react in the atmosphere. Regulatory agencies use them to assess whether a new source of air pollution would exceed acceptable pollution levels, for permitting purposes. They can also be used to predict future pollution levels under different policy scenarios.[210] There are models for local pollution, but also for cross-boundary pollution.[211]

Pollution reduction by sector

Pollution prevention seeks to prevent pollution such as air pollution and could include adjustments to industrial and business activities such as designing sustainable manufacturing processes (and the products' designs)[212] and related legal regulations as well as efforts towards renewable energy transitions.[213][214]

Industry

Before flue-gas desulfurization was installed, the emissions from this power plant in New Mexico contained excessive amounts of sulfur dioxide.
Thermal oxidisers are air pollution abatement options for hazardous air pollutants (HAPs), volatile organic compounds (VOCs), and odorous emissions.

Various pollution control technologies and strategies are available to reduce air pollution. For instance, industrial plants can install scrubbers, such as flue gas desulfurization or catalysts to remove NOx.[215] Stringent environmental regulations, effective control technologies and shift towards the renewable source of energy also helping countries like China and India to reduce their sulfur dioxide pollution.[216]

In the power sector, a very effective means to reduce air pollution is the transition to renewable energy or nuclear power.[215] According to 2015 study 2015 the switch to 100% renewable energy in the United States would eliminate about 62,000 premature deaths per year and about 42,000 in 2050, if no biomass were used. This would save about $600 billion in health costs a year due to reduced air pollution in 2050, or about 3.6% of the 2014 U.S. gross domestic product.[217]

Transport

Support for a ban on high-emission vehicles in city centres in Europe, China and the US from respondents to the European Investment Bank Climate Survey
a row of electric rickshaws with a couple of people inside
Electric rickshaws in Nepal
Tram in Alicante, Spain

The avoid-shift-improve framework groups efforts to cut pollution from vehicles into reducing travel, shifting to sustainable transport, and improving vehicle technology.[218] Reducing motor vehicle travel can curb pollution. One strategy is to build compact cities, so that amenities are close by and cars are not needed.[219] Motor traffic can be reduced by creating more walkable cities and by investing in cycling infrastructure.[220] Working from home is another way of avoiding motorised traffic.[218] After Stockholm reduced motor vehicle traffic in the central city with a congestion tax, nitrogen dioxide and PM10 pollution declined, as did acute asthma attacks in children.[221]

Traffic can be shifted to cleaner modes of transport, for instance by increased use of public transport.[222][223] The 9-Euro-Ticket scheme in Germany which allowed people to buy a monthly pass allowing use on all local and regional transport (trains, trams and busses) for 9 euro (€) for one month of unlimited travel saved 1.8 million tons of CO2 emissions during its three-month implementation from June to August 2022.[224] Finally, road vehicles can be improved from increased fuel efficiency, conversion to cleaner fuels, and conversion to electric vehicles. For example, buses in New Delhi, India, have run on compressed natural gas since 2000, to help eliminate the city's "pea-soup" smog.[170][225] Phase-out of fossil fuel vehicles is a critical component of a shift to sustainable transport. However, even in electric vehicles, rubber tires produce significant amounts of air pollution, ranking as 13th worst pollutant in Los Angeles.[226]

Areas downwind (over 20 miles) of major airports have more than double total particulate emissions in air than other areas, even when factoring in areas with frequent ship calls, and heavy freeway and city traffic like Los Angeles.[227] Aviation biofuel mixed in with jetfuel at a 50/50 ratio can reduce jet derived cruise altitude particulate emissions by 50–70%, according to a NASA led 2017 study (however, this should imply ground level benefits to urban air pollution as well).[228]

Cooking and heating

Various technologies are available for clean cooking, to replace traditional biomass stoves or three-stone fires. For instance, a switch to cooking with biogas, bioethanol, electricity, natural gas or LPG (liquified petroleum gas), significantly reduced air pollution. Improved cookstoves, which use biomass more efficiently, improve air quality less, but can be an intermediate solution if clean cookstoves or their fuels are not available. These clean cooking devices, including those run on fossil fuels, usually have a smaller climate impact than traditional biomass stoves.[229]

Combustion of fossil fuels for space heating can be replaced by using heat pumps and seasonal thermal energy storage.[230][231]

Waste and agriculture

A growing number of countries regulates waste, which include national or city-wide waste management systems, opening managed landfills, landfill gas capture (for electricity production), and waste separation.[38]

Policy and regulation

Campaigning, public awareness and litigation

In 2022, the UN General Assembly passed a resolution recognizing the right to a clean, healthy, and sustainable environment as a human right.[232]

In the United Kingdom, air pollution campaigning currently involves a mixture of grassroots activism (by groups such as Mums for Lungs and individual campaigners such as Rosamund Kissi-Debrah[233]), public health awareness (through events such as Clean Air Day), legal work (advanced by activist lawyers such as ClientEarth), and more traditional campaigning (by environmental groups such as Greenpeace and Friends of the Earth, public health advocacy groups such as British Lung Foundation and Asthma UK, and organizations that raise health and safety issues, such as the British Safety Council).[234] Citizen science projects combine scientific research with public health awareness raising and grassroots environmental campaigning.[235]

In 2019, the Court of Justice of the EU, found that France did not comply with the limit values of the EU air quality standards applicable to the concentrations of nitrogen dioxide (NO2) in 12 air quality zones.[236]

Laws and regulations

Main articles: Air quality law and Emission standard
Smog in Cairo

Although a majority of countries have air pollution laws, 43% of countries lack a legal definition of air pollution, 34% lack outdoor air quality standards, and just 31% have laws for tackling pollution originating from outside their borders. Few countries have limits that are as strict as the World Health Organization's recommendations.[237]

Some air pollution laws include specific air quality standards, such as the U.S. National Ambient Air Quality Standards and E.U. Air Quality Directive,[238] which specify maximum atmospheric concentrations for specific pollutants. Other examples of air quality laws around the world include the Clean Air Act in Britain, the US Clean Air Act, and TA Luft in Germany.[239] Some air pollution laws put limits on emissions (e.g. from vehicles), as well as air standards.[240]

The World Health Organization's Global Air Quality Guidelines encourage improvements in a similar way to national standards, but are "recommendations" and "good practice" rather than mandatory targets that countries must achieve.[241]

Best practices

Tarps and netting are often used to reduce the amount of dust released from construction sites.

Cities and towns often work together, both nationally and internationally, to share best practices for improving air quality. Initiatives of this kind include the BreatheLife Network of 79 cities (a campaign launched in 2016 by the Climate and Clean Air Coalition, World Health Organization, United Nations Environment Programme, and World Bank),[242] World Cities Day and the International Day of Clean Air for Blue Skies (two UN initiatives), and the Partnership for Healthy Cities (sponsored by the World Health Organization and health organization Vital Strategies).[243]

Other networks include the C40 Cities Climate Leadership Group, a public 'non-state' network of the world's leading cities that aims to curb their greenhouse emissions.[244] The C40 has been identified as 'governance from the middle' and is an alternative to intergovernmental policy.[245] It has the potential to improve urban air quality as participating cities "exchange information, learn from best practices and consequently mitigate carbon dioxide emissions independently from national government decisions".[244] A criticism of the C40 network is that its exclusive nature limits influence to participating cities and risks drawing resources away from less powerful city and regional actors.

Indigenous people

Because Indigenous people[246] frequently experience a disproportionate share of the effects of environmental degradation and climate change, even while they have made very little contribution to the processes causing these changes, environmental justice is especially important to them. Indigenous peoples have been marginalized and their lands and resources have been exploited as a result of historical and continuing colonization, institutional injustices, and inequality.

See also

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