PJL reports grants and contracts from the Centre Scientifique de Monaco, UN Environment, and the Barr Foundation, and consulting fees from the Centre Scientifique de Monaco and PJL serves as President of the Collegium Ramazzini, Chair of the Scientific Advisory Board of the Collegium Ramazzini, and Treasurer for the Consortium of Universities for Global Health. HH reports grants from the US National Institutes of Health for neuro-epidemiological research on the developmental neurotoxicity of pollutants HH also reports consultant fees to law firms on cases related to the developmental neurotoxicity of pollutants and HH serves as Chair of the Scientific Advisory Board of the Marilyn Brachman Hoffman Foundation and is a member of the Advisory Board for Physicians for Human Rights. MB reports institutional support from the Bill & Melinda Gates Foundation JH also reports consulting fees from the German Ministry of Environment to develop ideas for advancing the Strategic Approach to Chemicals Management process and JH reports fees from the UK Department for Environment, Food & Rural Affairs for teaching workshops. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health. Global action on all major modern pollutants is needed. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Successful control of these conjoined threats requires a globally supported, formal science–policy interface to inform intervention, influence research, and guide funding. Pollution, climate change, and biodiversity loss are closely linked.
Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty.
We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death.