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More than 1.67 million deaths were linked to air pollution in India last year, including 116,000 babies who died in their first month of life, according to a report based on a study published in The Lancet.

The report, called State of Global Air 2020, was released by the Health Effects Institute (HEI) in cooperation with the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and the University of British Columbia.

The findings of the report are based on the most recent Global Burden of Disease (GBD) Study published in the international medical journal, The Lancet last week.

The report, a comprehensive analysis of air pollution’s global impact on the newborn, found that outdoor and household particulate matter killed more than 116,000 Indian infants in their first month of life in 2019.

More than half of these deaths were associated with outdoor PM2.5, and others were linked to use of solid fuels such as charcoal, wood and animal dung for cooking, the report said.

Calling air pollution the biggest health risk, the report highlighted that long-term exposure to outdoor and household air pollution contributed to over 1.67 million annual deaths from stroke, heart attack, diabetes, lung cancer, chronic lung diseases, and neonatal diseases, in India in 2019.

According to the report, for the youngest infants, most deaths were related to complications from low birth weight and preterm birth.

The report comes amid the covid-19 pandemic and warnings that people with heart and lung disease are particularly vulnerable to the coronavirus that has killed more than 110,000 in India.

Although the full links between air pollution and covid-19 are not yet known, there is clear evidence linking air pollution with increased heart and lung disease. This has led to concerns that exposure to high levels of air pollution during the winter months in India and elsewhere in Asia could worsen the effects of covid-19.

Infants in the first month of life are already at a vulnerable stage. And a growing body of scientific evidence from multiple countries, including recent Indian Council of Medical Research (ICMR)-supported studies in India, indicates that particulate air pollution exposure during pregnancy is linked to low birth weight and preterm birth.

These conditions, both of which are associated with serious complications, already account for the vast majority of deaths in the neonatal period (455,000 in 2019). The State of Global Air report, for instance, estimates that nearly 21% of neonatal deaths from all causes are attributable to ambient and household air pollution.

“This newest evidence suggests an especially high risk for infants born in South Asia and sub-Saharan Africa. Although there has been a slow and steady reduction in household reliance on poor-quality fuels, the air pollution from these fuels continues to be a key factor in the deaths of these youngest infants," said Dan Greenbaum, president of HEI.

“Overall, air pollution is now the largest risk factor for death among all health risks," the report said. India, Bangladesh, Pakistan and Nepal are among the top ten countries with the highest PM2.5 exposures in 2019; all of these countries experienced increases in outdoor PM2.5 levels between 2010 and 2019.

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