Fossil fuel air pollution linked to millions of deaths annually

Fossil fuels power cars, heat buildings, and run industries, but they take a steep and often hidden toll on human health. For decades, scientists have documented how pollution and toxic byproducts seep into the air, water, and soil, leaving no stage of life untouched.

From pregnancy complications to chronic disease in old age, the evidence shows that the costs of coal, oil, and gas extend far beyond climate change.

The report’s author is Shweta Narayan, Campaign Lead at the Global Climate and Health Alliance (GCHA), which represents health organizations worldwide.

Pollution’s hidden health toll

“Pollution is the largest environmental cause of disease and premature death in the world today,” wrote Dr. Philip Landrigan, an epidemiologist and pediatrician. That conclusion was based on global disease data and a careful review of exposure and risk.

Outdoor air pollution alone accounts for millions of premature deaths each year. According to a WHO fact sheet, 4.2 million people died in 2019 due to exposure to fine particulate matter in outdoor air.

Scientists also track the sources that push these risks higher. Combustion from coal, oil, and gas releases particles and gases that infiltrate the lungs and bloodstream, and those exposures interact with social and economic stressors in daily life.

Pollution risks for children

One Colorado study of 124,842 births examined how living near intensive natural gas development affected birth outcomes. Mothers in areas with the highest density of wells within 10 miles had higher odds of congenital heart defects, with an odds ratio of 1.3, and possibly neural tube defects, with an odds ratio of 2.0.

Childhood cancer risk also shows worrisome links to traffic pollution. A meta-analysis found that childhood leukemia risk rose with higher exposure to traffic related pollutants, including nitrogen dioxide and benzene.

Children breathe faster than adults and their organs are still developing. That makes early exposure a pivotal window where harm can set the stage for disease later in life.

Older adults hit hardest

In the U.S. Medicare population, a nationwide analysis showed higher mortality with increases in fine particulate matter and ozone, even when levels stayed below national air quality standards. 

“In the entire Medicare population, there was significant evidence of adverse effects related to exposure to PM2.5 and ozone at concentrations below current national standards,” said Professor Qian Di from Tsinghua University.

Older adults often live with heart or lung disease, so an extra burden from polluted air can tip a fragile balance. The research underscores why standards and monitoring need to protect those with the least margin for error.

Fossil fuel subsidies hide true costs

The health burden is not shared equally. Communities near busy roads, refineries, or well pads face higher exposures, and people with lower incomes or limited access to care carry more risk.

Subsidies keep fossil fuels cheaper than their true costs. The IMF estimates that total fossil fuel subsidies reached seven trillion dollars in 2022, about seven percent of global GDP.

This figure includes both explicit and implicit subsidies and reflects the gap between market prices and the full health and environmental costs.

Pollution compounds extreme weather

Extreme weather fueled by fossil fuel-driven warming compounds the health burden. When hurricanes or floods strike, they can damage hospitals, disrupt supply chains, and limit access to care. The consequences go far beyond the immediate injuries.

Smoke from wildfires, which are intensified by hotter, drier conditions, adds another layer of respiratory strain. Research shows spikes in asthma attacks, emergency visits, and premature deaths during smoke events.

Communities already facing chronic pollution from nearby industrial sites can be pushed past their limits when disasters strike.

Workers and neighbors at extraction sites can face contaminated air and water, and the equipment and waste streams bring additional hazards.

Even after combustion, residues and byproducts linger in soil and waterways. Heavy metals and other contaminants can move through food chains and accumulate over time.

Clean energy helps

Cleaner energy reduces the sources of pollution that do the most damage to hearts, lungs, and developing bodies. Cutting emissions from power plants, vehicles, and industrial boilers quickly lowers fine particulate levels in the air people breathe.

“Fossil fuels are not just an environmental crisis, they are a public health emergency,” said Dr. Jemilah Mahmood, Executive Director of the Sunway Centre for Planetary Health (SU). Public health leaders frame this as a direct medical priority, not a distant environmental goal. 

Policies work when they connect health protection with energy and transport planning. That includes strong air quality standards, reliable monitoring, and investments that accelerate clean power and clean mobility in places where exposure is highest.

The urgent case for action

The science points to clear benefits when pollution declines. Hospitalizations drop, lives lengthen, and children grow up with healthier lungs and brains.

The choices are practical. Replace the dirtiest fuels, clean up engines and stacks, and design cities so fewer people live next to heavy traffic and industrial zones.

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