The 2017 State of Global Air report, released Tuesday by the institute and others, finds that since 1990 the absolute number of ozone-related deaths has risen at an alarming rate in India — by about 150 percent — while in China, some European nations and Russia, the number has remained stable. Measured per head of population, India substantially outpaces China, with 14.7 ozone-related deaths for every 100,000 people, compared with China's 5.9.

In addition, the absolute number of deaths in India attributed to fine particulate matter in the air were approaching China’s toll in 2015 and probably exceed that figure by now, according to Dan Greenbaum, president of the Health Effects Institute. An increase in vehicle traffic, emissions from coal-fired power plants and other industrial facilities, and fires fueled by wood and dung contribute to the problem. When calculated per 100,000 of population, the number in both countries has decreased, although India's remains far above China's.

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“India has substantially higher air-pollution levels than China today and is caught up and surpassing China in terms of the risk to the population’s health,” Greenbaum said.

The study shows that in 2015, long-term exposure to fine particulate matter — the dangerous tiny particles that can penetrate the lungs and cause cancer, heart disease and other ailments — contributed to 4.2 million deaths globally. China and India together accounted for 52 percent of those.

According to Greenbaum, the health effects are worsening in India as air pollution increases, while the Chinese data is stabilizing after an aggressive campaign to diminish emissions from coal-fired power plants and other pollution-control efforts. India is taking longer to address coal emissions and vehicle standards, he said, meaning its death toll will continue to rise. The country has tightened its emissions standards for cars and will align them with strict European standards by 2020.

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In India’s capital, New Delhi — the world’s 11th-most-polluted city, according to the World Health Organization — the courts forced the authorities to come up with an emergency plan to address an air-pollution emergency after a toxic cloud of smoke from fireworks and crop-burning descended on the city in November, sending pollution levels skyrocketing to more than six times the acceptable levels. India’s Supreme Court banned the sale of fireworks, popular during the Hindu festival Diwali, in the capital after the emergency.

India also has a wide band of heavily polluted cities across its north, Greenbaum said. In December, the data portal IndiaSpend found that the pilgrimage city of Varanasi had the country’s worst air, followed by heavily industrial cities such as Kanpur.