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Our polluted world: the need for a global pollution strategy Vol 1 September 2017
impose great economic costs on nations around the world.
It has been estimated that the cost of pollution in the US
alone in 2008 was an astonishing US$76�billion.
Yet pollution is preventable. But when compared
with the attention given, for example, to AIDS, malaria,
and tuberculosis, environmental pollution receives far
less attention at the national and international levels,
making it hard to put policy interventions and prevention
strategies into practice. One reason for the relative lack
of action may be the difficulty in establishing causal
associations between pollution and illness, together with
the fact that various components of pollution?such as air
pollution, water pollution, asbestos, and lead?have been
considered separate and mutually exclusive problems. This
fragmentation in the analysis of pollution as a threat to
health means that only fractured interventions are possible,
reducing enormously the total impact. A more holistic
approach to cost-effective control strategies to address
environmental pollution is needed. Successful examples
of control strategies in high-income countries have been
those that reduce exposure at source, such as removal of
lead from gasoline, national bans of asbestos, and policies
to reduce water and air pollution. Such strategies have
proved to be incredibly cost-effective. Removal of lead from
gasoline has returned approximately $200 billion to the US
economy each year since 1980. Policies aiming to prevent
rather than assess the absolute proof of toxicity of certain
types of toxic chemicals should also be implemented if such
a holistic approach is to be taken.
In October, 2017, The Lancet, together with the Global
Alliance on Health and Pollution and the Icahn School
of Medicine at Mount Sinai in New York, will publish a
Commission on Pollution, Health, and Development. The
Commission will aim to catalyse attention to this escalating
planetary danger, increase resources allocated for it, and
initiate coordination of policy action at the global level.
Environmental pollution should be tackled from multiple
perspectives, including social, economic, legislative, and
environmental approaches. Initiatives to change our
lifestyles to protect health and preserve our planet from
the assault of this preventable disease also need to be
encouraged. It is time to take action to control the endemic
pollution of our world. ? The Lancet Planetary Health
Peter Bowater/Science Photo Library
Exposure to environmental pollution remains a major
source of hazard not only for our health but also for our
planet. In 2012, WHO estimated that exposures to polluted
soil, water, and air contributed to an estimated 8�million
deaths worldwide. Of these deaths, 94% (8�million) were
in low-and-middle-income countries. Different pollutants
are linked in children to non-communicable diseases (such
as asthma), cognitive disorders, and perinatal defects, and,
among adults, to heart disease, stroke, and cancer. However,
although environmental pollution is reaching disturbing
pro璸ortions worldwide, it remains a neglected problem in
national policies and on international development agendas.
What drives pollution? What strategies can be taken to
prevent and control pollution?
Since the industrial revolution, urbanisation and
industrialisation, together with economic development,
have led to increases in energy consumption and waste
production. Exposures to air pollution, toxic chemicals,
and pesticides are the main forms of pollution today
causing disease in high-income countries. In low-andmiddle-income countries, household air pollution and
contaminated drinking water are long-established forms
of environmental contamination. WHO estimated that
ambient air pollution caused 3�million deaths, and that
unsafe water, poor sanitation, and inadequate hygiene
caused 842?
000 deaths. Hazardous waste sites and
contamination of soil and abandoned mines have killed
hundreds of thousands people each year.
However, during the past decade, with the spread of
Western lifestyles, and the increasing globalisation of the
chemical manufacturing industry, toxic chemicals, highly
hazardous pesticides, and chemical wastes that previously
were found only in high-income settings have been
rapidly penetrating in low-and-middle-income countries
too. Exposure of millions of people to asbestos in China,
south and southeast Asia, and sub-Saharan Africa, lead
intoxication from lead-acid battery recycling, and exposure
to mercury from gold extraction are only a few dramatic
examples of the growing exposure to toxic chemicals. The
recent European scandal in which eggs were contaminated
with fipronil (an insecticide commonly used to kill lice
in animals) and the discharge of plastic into the sea are
further examples of how exposure to toxic substances can
pose serious risks to our health for the sake of economic
development. Additionally, diseases caused by pollution
Copyright � The Author(s). Published by Elsevier Ltd. This is an Open Access
article under the CC BY 4.0 license.
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