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AReport onAirPollution andItsRolein theWorld’sLeadingCauses ofDeath in partnership with The State of Global Air is a collaboration between the Health EffectsInstitute and the Institute for Health Metrics and Evaluation’s Global Burdenof Disease project. ISSN 2578-6873© 2025 Health Effects Institute ABOUT STATE OF GLOBAL AIR ABOUT THIS REPORT HOW CAN I EXPLORE THE DATA? The State of Global Air is a researchand outreach initiative to providereliable, comprehensive, and up-to-date information about air qualitystatus and trends around the world.A collaboration of the Health EffectsInstitute and the Institute for HealthMetrics and Evaluation’s GlobalBurden of Disease project, theprogram gives citizens, journalists,policymakers, and scientists accessto high-quality, objective informationabout air pollution exposure and itshealth impacts. All data and reportsare free and available to the public. Now in its sixth iteration, theState of Global Air report presentsinformation on exposures to outdoorand household air pollution andassociated adverse health impactsfrom a variety of pollutants,including fine particles or PM2.5(ambient and household particulatematter), nitrogen dioxide (NO2), andozone. For the first time, the reportquantifies air pollution’s impact ondementia. This report is produced inpartnership with the NCD Allianceand focuses on noncommunicablediseases. This report has a companioninteractive website with tools toexplore, compare, and download dataand graphics. Anyone can use thewebsite to access data for cities andcountries around the world and tracklong-term trends for air pollutantsand associated health impacts. Visitwww.stateofglobalair.org. Citation:Health Effects Institute.2025. State of Global Air 2025: AReport on Air Pollution and Its Rolein the World’s Leading Causes ofDeath. Boston, MA: Health EffectsInstitute. Disclaimer: The presentation of the material in this publication does not imply the expression of any opinion whatsoever on the part of HEIconcerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Data and figures from this publication may be used for noncommercial purposes. Contents of this report may not be used for any commercialpurposes without prior permission from the Health Effects Institute. Please write to us atcontactsoga@healtheffects.org. Table of Contents Executive Summary of the global population lives in areaswhere there are no national air qualitystandards.11% of the world’s population is exposed tolevels of PM2.5above the least stringentinterim target of 35 μg/m3(IT-1).36% Air pollution continues to be the secondleading risk factor for early death,surpassed only by high blood pressure. Low- and middle-income countries face thelargest burden. 90% of all air pollutiondeaths were in these countries: deaths attributed to air pollution in 2023,7.9 million about1 in 8deaths worldwide. Of this total,4.9 million deathswereattributable to ambient PM2.5exposure, 2.8 millionwere from household airpollution, and470,000were from ozone. India and Chinaeach had more than2 million deathsattributable to air pollution in 2023. In 2023, dementia attributable to airpollution resulted in 626,000 deaths and11.6 million healthy years of life lost. Bangladesh, Pakistan, and Nigeriaeach saw more than200,000 deaths. Indonesia, Myanmar, and Egypteach saw more than100,000 deaths. of deaths in adults over the age of 60are due to noncommunicable diseases.95% Noncommunicable diseases accounted for6.8 million deaths. 86% 1 in 2chronic obstructivepulmonary disease (COPD) deaths 1 in 4heart disease deaths of global deaths were attributableto air pollution in 2023. More than1 in 4dementiadeaths Nearly1 in 6diabetesdeaths Introduction Air pollution is a public health burdenwithout boundaries.Drifting acrossborders, seasons, and societies, itmakes people across all walks of lifesick, with impacts that ripple throughcommunities, countries, economies, andfuture generations. Severe air pollutionepisodes bring these threats into starkfocus for millions in cities around theworld. During the past year in SouthAsia, Central Asia, and Europe, air qualityepisodes—largely from agricultural burnsand the burning of fossil fuels—blanketedcities in thick smog. In West Africa, theannual Harmattan dust storms shroudedcommunities in clouds of dust from theSahara Desert, making navigating roadsand waterways a treacherous undertaking.Across North America and Latin Americancountries, including Brazil, Bolivia, and Venezuela, wildfires have brought thedual hazard of devastating fire anddamaging smoke. 7.9million The impacts of these pollution spikeslinger long after the air has cleared.So, too, do the impacts from the day-to-day air pollution that has remainedpersistently high in som