Non-communicable diseases have emerged as the biggest threat to life, primarily due to indoor and outdoor air pollution, climate change and exposure to synthetic chemicals. Air pollution is responsible for 25% of strokes and 19% of cancers. The highest proportion of deaths and disease that could be tackled through environmental improvements is in low- and middle-income countries.

The report titled ‘Preventing disease through healthy environments’ showed that 12.6 million or 23% of people died as a result of living or working in an unhealthy environment in 2012. As many as 100 diseases and injuries are related to environmental risk factors such as air, water and soil pollution, chemical exposures, climate change and ultraviolet radiation.

The most vulnerable populations are children under 5 years and adults aged 50-75 years, the report finds. Yearly, the deaths of 1.7 million children under five and 4.9 million adults aged 50 to 75 could be prevented through better environmental management. Children die mainly due to lower respiratory infections and diarrhoeal diseases, while older adults are most impacted by non-communicable diseases.

Regionally, the report finds, low- and middle-income countries in the WHO South-East Asia and Western Pacific Regions had the largest environment-related disease burden in 2012, with a total of 7.3 million deaths, most attributable to indoor and outdoor air pollution.

South-East Asia region, in which the WHO includes India, recorded the highest number of deaths at 3.8 million. Western Pacific Region was second with 3.5 million environment related deaths. The Americas and European Regions had lower burden of deaths due to environmental risks.

Poonam Khetrapal Singh, WHO regional director, said, “Few can be unaware of the growing region-wide burden of non-communicable diseases that are being caused by the environment. Last year, the region was reported to be home to 14 of the world’s 20 most polluted cities, with air pollution leading to increases in cardiovascular diseases such as strokes and ischaemic heart disease, as well as cancer. Household air pollution from the burning of solid fuels such as wood, animal dung and crop waste for cooking purposes, meanwhile, results in 1.69 million premature deaths in the region annually and is responsible for half of the pneumonia deaths in children under 5 years of age.”

Looking across more than 100 disease and injury categories, the report finds that the vast majority of environmentally related deaths are due to cardiovascular diseases, such as stroke (2.5 million deaths annually) and ischaemic heart disease (2.3 million). Unintentional injuries, for example, road traffic deaths, have the third-highest contribution with 1.7 million deaths annually and cancers contribute to 1.7 million deaths.

However, the report noted that with improved sanitation, deaths from infectious diseases have come down.

The report cites proven strategies for improving the environment and preventing diseases. For instance, using clean technologies and fuels for domestic cooking, heating and lighting would reduce acute respiratory infections, chronic respiratory diseases, cardiovascular diseases and burns. Increasing access to safe water and adequate sanitation and promoting hand washing would further reduce diarrhoeal diseases.

Apart from taking action on indoor and outdoor air pollution, it urges the countries to promote waste cycling, bus rapid transit system with pedestrian walkways and safe drinking water.