Pollution caused one in six deaths worldwide in 2019, a new study has revealed – more than the annual global tolls for war, malaria, HIV, tuberculosis, drugs or alcohol.

The study, published Tuesday by the Lancet Commission on pollution and health, found pollution kills 9 million people every year – nearly three quarters of them due to harmful air.

According to the study, deaths caused by air pollution and toxic chemical pollution increased by 66% over the past two decades, fueled by uncontrolled urbanization, population growth and a dependence on fossil fuels.

“The health impacts of pollution remain enormous, and low- and middle-income countries bear the brunt of this burden,” said Richard Fuller, the study’s lead author. “Despite its enormous health, social and economic impacts, pollution prevention is largely overlooked in the international development agenda.”

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India recorded the largest number of air pollution-related deaths in 2019, with more than 1.6 million people killed in the nation of 1.3 billion, according to the study.

Pollution levels in nearly all of India are far above World Health Organization guidelines, it added, forcing millions to breathe toxic air every day.

Last year, six of the world’s 10 most polluted cities were in India, according to monitoring network IQAir. Bad air could be reducing the life expectancy of hundreds of millions of Indians by as much as nine years, according to a recent study by the Energy Policy Institute at the University of Chicago.

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