Outdoor air pollution from sources as varied as cooking fires in India, traffic in the United States and fertiliser use in Russia, claim some 3.3 million lives globally every year, researchers said. The vast majority of victims - nearly 75 percent - died from strokes and heart attacks triggered mainly by long-term inhalation of dust-like particles floating in the air.
The remainder succumbed due to respiratory diseases and lung cancer, according to a study in the journal Nature.
Smouldering cooking and heating fires in India and China were the single biggest danger - accounting for a third of deaths attributed to outdoor pollution, said study co-author Jos Lelieveld of the Max Planck Institute for Chemistry in Germany.
The new numbers support a 2014 World Health Organisation report that blamed a similar number of deaths on outdoor pollution, and another 4.3 million per year on pollution within the home or other buildings.
Unless stricter regulations are adopted, the number of deaths from outdoor pollution would double to 6.6 million by 2050, the team of international researchers forecast.
"If this growing premature mortality by air pollution is to be avoided, intensive control measures will be needed especially in south and east Asia," Lelieveld told journalists via conference call. He highlighted the "interesting" role of farm fertiliser.
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