Explained: India topped air pollution death toll in 2019, says report

Globally, air pollution alone contributes to 66.7 lakh deaths, according to the report, which updates a previous analysis from 2015.

Overall, pollution was responsible for an estimated 90 lakh deaths in 2019 (equivalent to one in six deaths worldwide), a number that has remained unchanged since the 2015 analysis.

Air pollution was responsible for 16.7 lakh deaths in India in 2019, or 17.8% of all deaths in the country that year. This is the largest number of air-pollution-related deaths of any country, according to a recent report on pollution and health published in The Lancet Planetary Health.

Globally, air pollution alone contributes to 66.7 lakh deaths, according to the report, which updates a previous analysis from 2015. Overall, pollution was responsible for an estimated 90 lakh deaths in 2019 (equivalent to one in six deaths worldwide), a number that has remained unchanged since the 2015 analysis. Ambient air pollution was responsible for 45 lakh deaths, and hazardous chemical pollutants for 17 lakh, with 9 lakh deaths attributable to lead pollution.

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Pollution in India

The majority of the 16.7 lakh air pollution-related deaths in India – 9.8 lakh — were caused by PM2.5 pollution, and another 6.1 lakh by household air pollution. Although the number of deaths from pollution sources associated with extreme poverty (such as indoor air pollution and water pollution) has decreased, these reductions are offset by increased deaths attributable to industrial pollution (such as ambient air pollution and chemical pollution), the report noted.

“The World Health Organization (WHO) has substantially tightened its health-based global air quality guidelines, lowering the guideline value for PM2.5 from 10 micrograms per cubic metre to 5. This means that there is hardly any place in India which follows the WHO norms,” Dr Sundeep Salvi, Chair for Chronic Respiratory Diseases of the Global Burden of Diseases study (GBD-19), told The Indian Express. He was not associated with the latest report in The Lancet Planetary Health.

According to the report, air pollution is most severe in the Indo-Gangetic Plain. This area contains New Delhi and many of the most polluted cities. Burning of biomass in households was the single largest cause of air pollution deaths in India, followed by coal combustion and crop burning.

The number of deaths remains high despite India’s considerable efforts against household air pollution, including through the Pradhan Mantri Ujjwala Yojana programme. India has developed a National Clean Air Programme, and in 2019 launched a Commission for Air Quality Management in the National Capital Region. However, India does not have a strong centralised administrative system to drive its air pollution control efforts and consequently improvements in overall air quality have been limited and uneven, the report has said.

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Professor Kalpana Balakrishnan, Dean (Research), Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, and one of the authors of the report, stressed the need for a radical shift in the approach to pollution management efforts.

“In India, we need integrated surveillance platforms for health and exposure surveillance. Population exposure surveillance via biological and environmental monitoring can inform risk attributions within health programmes already in place to reduce the burden of maternal and child health as well as non-communicable diseases. Impacts from lead as shown in the report, that impacts children’s IQ, really drive home the point of irreversible long-term damage for multiple generations. Without surveillance at scale it is impossible to know what worked and what didn’t,” she told The Indian Express.

Lead pollution

Dr Salvi too cited the implications of lead pollution. “An estimated 9 lakh people die every year globally due to lead pollution and this number is likely to be an underestimate. Earlier the source of lead pollution was from leaded petrol which was replaced with unleaded petrol. However the other sources of lead exposure include unsound recycling of lead-acid batteries and e-waste without pollution controls, spices that are contaminated with lead, pottery glazed with lead salts and lead in paint and other consumer products,” he said.

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“Globally more than 80 crore children (India alone contributes to 27.5 crore children) are estimated to have blood lead concentrations that exceed 5 µg/dL — which was, until 2021, the concentration for intervention established by the US Centers for Disease Control and Prevention. This concentration has now been reduced to 3.5 µg/dL,” he said.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. ``Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) "Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. ``At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure "For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. ``Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. X (Twitter): @runaanu ... Read More