Three years ago I had a heart operation that will have cost the NHS tens of thousands of pounds, and which made me rethink how we lived and how I had got into this mess. I had always kept pretty fit, I thought: I ate well, loved exercise and had long stopped smoking. I thought I was active and healthy. So what else was there that could have contributed to my heart disease, Britain’s costliest and most prevalent killer, and the world’s greatest epidemic?

Last week came solid evidence that living in toxic Britain can seriously harm your health. Cardiologists at Queen Mary University of London found that even “safe” levels of air pollution are linked to heart abnormalities similar to those seen during the early stages of heart failure. Their study of almost 4,000 people was backed up by a major US study which showed that higher exposure to fine particles and nitrogen oxides is linked to an acceleration in the hardening of the arteries.

We have long known that air pollution leads to coughing, shortness of breath and irritation in the eyes, nose and throat. It is also clearly linked to respiratory diseases such as asthma and bronchitis, as well as diabetes and some cancers. But the more researchers look at people’s long-term exposure to air pollution, the worse the picture gets, and the more dangerous the minute particles and chemicals emitted by sources including fossil fuels are found to be. It is now beyond doubt that children’s health is greatly affected, and links have been made between it and Parkinson’s, Alzheimer’s, dementia and congenital birth defects.

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But although high air pollution – the sort that we breathe during occasional smogs or beside busy roads – has long been known to exacerbate pre-existing heart conditions and to trigger heart attacks, until now cardiologists have never confirmed that there is a link between the two, even at very low levels. If this is the case, as the study suggests, then we are all victims, and pollution is not just the world’s worst environmental blight but is ultimately linked to one in six of all deaths in the world every year.

We need more studies, but we must get used to the idea that nowhere is now safe, and that the epidemic of heart disease that first rich countries and now poorer ones have been experiencing is not just aggravated by air pollution but is partly caused by it.

The statistics are stark. In the UK, more than 2 million people suffer from cardiovascular diseases, and nearly one in seven men and one in 12 women will go on to die from them. Heart disease costs the UK economy nearly £30bn a year to treat, as much as the state spends on secondary education. It is one of the greatest single drains on the public purse.

You would think then that any responsible government would try to eliminate something that takes more lives in a year than all the wars Britain has fought since 1950. Britain, however, defies common sense, and despite a recent flurry of action shows little sign that it wants to seriously address pollution any time soon. Backed by the libertarian right, at best misled by carmakers and barely challenged by their own scientists, governments for many years have incentivised the most polluting fuels and knowingly increased pollution. To nominally reduce climate change pollutants, the British car fleet was, from 2000 onwards, transformed by sweeteners offered to consumers and manufacturers. Nine million extra highly polluting diesel cars were put on the roads with results that are only now being seen.

It may be a coincidence, and the statistics are clouded by increases in population and more people living longer, but in the years after diesel was first incentivised, the NHS estimates that the total number of people living with heart failure in the UK increased by 23%, from 750,127 in 2002 to 920,616 in 2014. The number of operations to insert stents to improve blood flow in arteries doubled in the decade to 2012, although the part played by air pollution in this rise is not clear.

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Despite the mounting evidence of air pollution’s costs and health impact, Britain has had to be dragged screaming through the courts to make it comply with minimal clean air guidelines and laws. Successive governments have continually tried to evade their legal responsibilities, spending millions of pounds fighting in the courts and lobbying the EU to be allowed to continue to pollute. Even though Britain largely outsourced its traditional pollution by switching manufacturing to places like China in the 1990s, it still has some of the foulest air in the industrial world.

The government now has a new draft clean air strategy out for consultation until 14 August and claims to be acting faster to tackle air pollution than almost every other major developed economy. It pledges to halve the number of people living in places that do not meet World Health Organization pollution guidelines, and it proposes to end the sale of new diesel and petrol cars and vans by 2040. It claims that its actions will cut the costs of air pollution to society by £1bn every year by 2020, rising to £2.5bn every year from 2030.

But intending to cut the air pollution bill by around 12.5% in 12 years and waiting 20 years to be rid of the worst vehicles seems criminally weak. Meanwhile, government is knowingly forging ahead with infrastructure plans that will inevitably increase air pollution; it shows no inclination to stop ships from polluting the air, and wants to massively increase air travel and to allow fracking.

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Public Health England expects the number of people to be seriously affected by air pollution to grow substantially, from around 2 million today in Britain to about 2.5 million by 2035. If current levels of pollution continue, the direct costs of treating them could be more than £5bn a year by then. The situation is worse in the US. In the past few weeks the Trump administration has begun its greatest assault yet on public health and the environment by moving to freeze or reduce fuel efficiency standards and weaken the clean air laws. The effect will inevitably be to massively increase air pollution and health costs for millions of Americans.

The number of Americans with cardiovascular disease was already expected to rise to 131.2 million – or 45% of the total US population – with costs expected to reach $1.1tn by 2035. With weaker laws, the numbers could be much higher.

So could the car-clogged streets of Sunderland, Birmingham and London, where I lived for many years, have contributed to my disease and those of millions of others? Probably. Could the oil companies be responsible for far more than climate change? Certainly. Could Britain’s monstrous and mounting bill for heart disease be partly due to the highly polluting diesel cars that governments so scandalously encouraged us to drive? Quite possibly.

What is certain is that air pollution is now an international scandal, and the cause of a health emergency that governments and industry have failed to address. It undoubtedly threatens life more than any war or disaster. When there are clear alternatives to burning fossil fuels then politicians who do not act to prevent it must stand accused not just of failing to act, but of condoning the mass poisoning of their people.

• John Vidal is a former Guardian environment editor