To provide a framework for organizing scientific knowledge about pollution and its effects on human health and to help focus pollution-related research, the Commission developed the concept of the pollutome. The pollutome is defined as the totality of all forms of pollution that have the potential to harm human health. The pollutome can be viewed as a fully contained (nested) subset of the exposome. This model includes pollutant exposures during gestation, infancy, childhood, adolescence, adult life (including occupational exposures), and old age. Landrigan et al.Click to enlarge.

The report found that nearly 92% of pollution-related deaths occur in low-income and middle-income countries and, in countries at every income level, disease caused by pollution is most prevalent among minorities and the marginalized.

Children are at high risk of pollution-related disease and even extremely low-dose exposures to pollutants during windows of vulnerability in utero and in early infancy can result in disease, disability, and death in childhood and across their lifespan.

Despite its substantial effects on human health, the economy, and the environment, pollution has been neglected, especially in low-income and middle-income countries, and the health effects of pollution are under-estimated in calculations of the global burden of disease. Pollution in low-income and middle-income countries that is caused by industrial emissions, vehicular exhaust, and toxic chemicals has particularly been overlooked in both the international development and the global health agendas. Although more than 70% of the diseases caused by pollution are non-communicable diseases, interventions against pollution are barely mentioned in the Global Action Plan for the Prevention and Control of Non-Communicable Diseases.

Pollution is costly. Pollution-related diseases cause productivity losses that reduce gross domestic product (GDP) in low-income to middle-income countries by up to 2% per year. Pollution-related disease also results in health-care costs that are responsible for 1.7% of annual health spending in high-income countries and for up to 7% of health spending in middle-income countries that are heavily polluted and rapidly developing. Welfare losses due to pollution are estimated to amount to US$4·6 trillion per year: 6.2% of global economic output. The costs attributed to pollution-related disease will probably increase as additional associations between pollution and disease are identified.

—Landrigan et al.

Other Commission findings include:

• Fuel combustion—fossil fuel combustion in high-income and middle-income countries and burning of biomass in low-income countries—accounts for 85% of airborne particulate pollution and for almost all pollution by oxides of sulfur and nitrogen.

• Key emitters of carbon dioxide, such as electricity-generating plants, chemical manufacturing facilities, mining operations, deforestation, and petroleum-powered vehicles, are also major sources of pollution.

• Household air and water pollution, the forms of pollution associated with profound poverty and traditional lifestyles, are slowly declining. However, ambient air pollution, chemical pollution, and soil pollution—the forms of pollution produced by industry, mining, electricity generation, mechanized agriculture, and petroleum-powered vehicles—are all on the rise, with the most marked increases in rapidly developing and industrializing low-income and middle-income countries.

• Chemical pollution is a great and growing global problem. The effects of chemical pollution on human health are poorly defined and its contribution to the global burden of disease is almost certainly underestimated.

• Cities, especially rapidly growing cities in industrializing countries, are severely affected by pollution.

This is the first global analysis of the impacts of pollution—air, water, soil, occupational—together as well as exploring the economic costs and the social injustice of pollution. Pollution, which is at the root of many diseases and disorders that plague humankind, is entirely preventable.

—Simon Fraser University health sciences professor Bruce Lanphear, who is a Commissioner and report author

Resources

• Landrigan, Philip J et al. (2017) “The Lancet Commission on pollution and health” The Lancet doi: 10.1016/S0140-6736(17)32345-0