Air pollution is the fourth-leading cause of premature deaths worldwide and the problem only continues to worsen, but governments have been reluctant to make the dramatic changes necessary to curb polluting industries in favor of cleaner alternatives.

In an effort to strengthen the case for action, the World Bank along with the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle released a joint study (pdf) Thursday warning about the economic effects of pollution-related fatalities.

In 2013, one in every 10 deaths was caused by diseases associated with outdoor and household air pollution—such as lung cancer, stroke, heart disease, and chronic bronchitis. And, according to the study, these fatalities cost the global economy roughly $225 billion in lost labor income. That number rises to more than $5 trillion when accounting for so-called "welfare costs" —what people are willing to pay for the reduction or prevention of pollution-induced death.

Noting that the losses equal the combined gross domestic product (GDP) of India, Canada, and Mexico, the report authors say the findings are "a sobering wake-up call."

And this problem is only growing worse, particularly in developing nations where rapid urban growth is clogging city air while billions of households are still reliant on cooking with solid fuels—such such as wood, charcoal, coal, and dung—which produce high levels of damaging pollutants.

"In 2013 about 93 percent of deaths and nonfatal illnesses attributed to air pollution worldwide occurred in these countries, where 90 percent of the population was exposed to dangerous levels of air pollution," the report states. "Children under age 5 in lower-income countries are more than 60 times as likely to die from exposure to air pollution as children in high-income countries."

What's more, these fatalities are crippling poor nations economically.

In 2013, which is the most recent data available, China lost nearly 10 percent of its GDP, India lost 7.69 percent, while Sri Lanka and Cambodia each lost roughly 8 percent, as a result of pollution-related deaths.

"Apart from the sheer magnitude of the costs, the disproportionate impacts on the poorest segments of the population make air pollution a threat to shared and inclusive prosperity," the report states. "The poor are more likely to live and work in polluted environments, but they are less able to avoid exposure or self-protect."

Rich nations are not immune, however. Pollution was found to have cost the United States $45bn, Germany $18bn, and the United Kingdom $7.6bn. Iceland, with losses of just $3m, was found to be the least impacted by deaths related to dirty air.

The report does not even include the myriad other economic impacts of pollution, such as health costs as well how it impacts productivity "by stunting plant growth and reducing the productivity of agriculture," for example, or by "making cities less attractive to talented workers, thereby reducing cities' competitiveness."

Therefore, the true costs could be "very much more," as Urvashi Narain, lead author and senior environmental economist for IHME, put it. Adding, "The scale of the problem is truly daunting."

"However impressive and abstract these large numbers are, it is our hope that the cost of premature deaths for countries' economies will leave the pages of this study and inform public debate and policy decisions at the national level," the authors conclude. "In country after country, the cost of pollution in human lives and on the quality of life is too high. We must work together to reduce it."