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Air pollution is a major cause of premature death and disease,
and is the largest environmental health threat globally. Besides endangering health and shortening lifespan, air pollution adversely affects economic productivity. The Sustainable Development Goals (SDGs) call for the reduction of the burden of deaths and diseases from air pollution.

Evidence of the adverse effects of air pollution on health has been growing in India. Studies from India have shown that short-term and long-term exposure are associated with disease burden and mortality. The India State- Level Disease Burden Initiative has reported detailed findings on exposure to air pollution and its impacts on deaths, disease burden, and life expectancy in the states of India as part of the Global Burden of Disease Study 2017. Improved methods and new data used in GBD 2019 have led to revised estimates of the impact of air pollution on deaths and disease burden.

This study provides the updated estimates of deaths and morbidity attributable to air pollution in every state of India in 2019
based on the improved GBD 2019 methods, which reveal that this burden is higher than was previously estimated. It estimates the economic loss due to lost output from premature death and morbidity attributable to different components of air pollution at the state level based on the updated estimates of deaths and morbidity attributable to air pollution.

The findings in this paper highlight that the disease burden attributable to air pollution and its economic impact are high in India, with substantial variations across the states. The wide variations in economic loss attributable to ambient particulate matter pollution, household air pollution, and ambient ozone pollution across the states of India, both in absolute terms and as a percentage of gross domestic product, can be useful for the planning and implementation of targeted interventions at the state level.

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