According to a comprehensive new medical study published by The Lancet Commission on Pollution and Health, environmental pollution kills more people globally than AIDS, malaria, war, natural disasters, and famine.

In 2015, 16 percent of deaths — an estimate of 9 million people — were caused by environmental pollution. Unfortunately, this estimate is conservative as thousands of new chemicals infiltrate the air each day, their toxicity unknown and ignored.

“Pollution endangers planetary health, destroys eco-systems, and is intimately linked to global climate change,” summarizes the report.

Those who suffer the most are the poor; 92% of those affected were low-middle income countries where air pollution isn’t regulated or monitored heavily.

India and China had the highest pollution-related deaths, followed by Pakistan and Bangladesh. The United States was also in the top ten. But when deaths per 100,000 people were counted, sub-Saharan Africa — Somalia, Central African Republic, and Chad — had the highest tally. Sadly, it’s post neonatal babies, children ages 1-4, and adults over age 50 who have the highest rate of pollution-related death.

Industrial, chemical, and soil pollution are increasing with manufacturing, petroleum based, and farming industries. Burning fuel accounts for 85% of airborne pollution with coal being the worst offender. Cities where the population is concentrated are especially vulnerable to chemical pollution, including pesticides, toxic and pharmaceutical waste, and unknown chemicals. As witnessed with lead and chlorofluorocarbons, we wait far too long to address these hazards.

And chemical production largely takes place in the poorest cities where businesses pay cheap labor costs, putting the health of the workers increasingly at risk.

Breathing polluted air has been linked to lower respiratory infection, cardiovascular diseases including heart attacks and strokes, pneumonia, and lung cancer. Household air pollution is also high for households where burning fuel inside is a daily practice for people to cook and heat their homes.

Not only does pollution increase health care expenses, costing about $4.6 trillion or 6.2 percent of the global economy, it simultaneously decreases economic output. It cost the world $225 billion in 2013. The idea that productivity stems from deregulation has long been debunked. At the cost of people’s lives, policy has long favored business, industry, and the select few who benefit financially from these decisions. But controlling pollution advances society in a sustainable way, contributing to the health of the planet.

Hopefully this study encourages an examination of airborne pollution and addressing it on a global level. Continued research on the link between pollution and death is needed in hope that awareness will eventually influence both international and local community policy. We need only to look at the history of the Clean Water Act, to acknowledge this battle and remember this.