Air pollution is made up of fine particulate matter from power generation, transportation and open burning. Household pollution is created by stoves that burn coal, wood and animal dung for cooking and heat, primarily in India and Africa. Both can lead to heart attacks and strokes, and the researchers found that nearly 1 million people die annually from these causes in China, more than a half-million die in India, and nearly 300,000 die in the United States and European Union countries.

Although the report used 2013 data, co-author Dan Greenbaum, president of the nonprofit Health Effects Institute in Boston, noted that “these things don’t change overnight.” Last year’s death toll likely was similar, he said.

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The Chinese government is moving aggressively to improve air quality by forcing automobiles there to be equipped with cleaner technology, and power plants to lower the amount of particulates they spew. But gains are offset by the country’s drive to become a world economic power — through the very industries it seeks to better regulate.

The United States, where yearly deaths from air pollution fell from 119,000 to 79,000 between 1990 and 2013, and the European Union, where they fell from 350,000 to 218,000 over the same period, stand as models for China, Greenbaum said. The United States continues to push for lower emissions from automobile traffic and has imposed stronger rules on industry, such as cement plants and those that generate electricity from coal.

China’s worsening air pollution is a problem far beyond its borders, with previous studies showing that it marginally increases air pollution on the U.S. West Coast. At the AAAS meeting, Greenbaum said, a Chinese scientist is set to present an analysis showing that “coal is by far the largest health burden, about 50 percent of the problem.”

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Report co-author Qiao Ma, a doctoral student at the School of Environment at Tsinghua University in Beijing, found that outdoor air pollution from coal contributed to about 366,000 Chinese deaths in 2013. According to her projection, between 990,000 and 1.3 million people there will lose their lives prematurely by 2030 unless ambitious pollution-reduction targets are introduced.

“Our study highlights the urgent need for even more aggressive strategies to reduce emissions from coal and from other sectors,” Ma said in a statement.

Air pollution is “by far the leading environmental risk factor for disease,” Michael Brauer, another co-author and professor at the University of British Columbia’s School of Population and Public Health in Vancouver, said in the statement. “Reducing air pollution is an incredibly efficient way to improve the health of a population.”

India has moved to reduce household pollution, but not with the same urgency as China. “It’s harder to solve the household problems because these are poor families that can’t convert to electric stoves,” Greenbaum said. “People who are in the kitchen, women primarily, are exposed to extremely high levels of pollution.”

But Indian officials are intent on regulating what they can, said Chandra Venkataraman, a professor of chemical engineering at the Indian Institute of Technology Bombay, who analyzed pollution there as part of the report. Emission standards legislation has been introduced in the wake of the international climate agreement reached last December in Paris. And policies are in place to move the country from coal-burning heavy industry. Venkataraman said officials also want to end a standard Indian practice of widespread burning to clear agricultural fields.