Seven of the world’s 10 worst polluted cities are in India, a new study has revealed, with wider South Asia home to scores more blighted by dirty air. The first-ever comprehensive analysis of air pollution’s global impact on newborns finds that outdoor and household particulate matter pollution contributed to the deaths of more than 1,16,000 Indian infants in their first month of life in 2019, a new global study State of Global Air 2020 revealed.

India recorded the world’s highest annual average concentration of PM 2.5 exposure in its air in 2019, according to the State of Global Air 2020 (Soga 2020) report released on Wednesday, extending to a decade the rising streak of the common air pollutant that has emerged as a respiratory health risk in the Capital and other cities.

Household air pollution (from burning solid fuels for cooking) accounted for about 64 per cent of all neonatal deaths attributable to air pollution; the rest were attributable to ambient particulate matter 2.5 (PM2.5). Infant deaths in India were followed by those in Nigeria (67,900), Pakistan (56,500) and Ethiopia (22,900). The report, published by the United States-based Health Effects Institute, analysed for the first time the impacts of particulate matter pollution (ambient PM2.5 and household air pollution) exposure on infants’ health and survival in their first month of life.

However, the study found progress in reducing household air pollution exposures but levels stagnant for outdoor PM2.5. The report, State of Global Air 2020, said more than half of these deaths were associated with outdoor PM2.5 and others were linked to use of solid fuels such as charcoal, wood, and animal dung for cooking. Long-term exposure to outdoor and household air pollution contributed to over 1.67 million annual deaths from stroke, heart attack, diabetes, lung cancer, chronic lung diseases, and neonatal diseases in India in 2019. For the youngest infants, most deaths were related to complications from low birth weight and preterm birth. Overall, air pollution is now the largest risk factor for death among all health risks, according to the annual State of Global Air 2020 report published by the Health Effects Institute (HEI). The HEI is an independent, nonprofit research institute funded jointly by the US Environmental Protection Agency, industry, foundations, and development banks.

India, Bangladesh, Pakistan and Nepal feature among the top 10 countries with the highest PM2.5 exposures in 2019; all of these countries experienced increases in outdoor PM2.5 levels between 2010 and 2019. Gurugram, a city about 30km southwest of India’s capital New Delhi, had the worst pollution levels globally in 2018, the study published on Tuesday by AirVisual and Greenpeace showed. Three other Indian cities, and Faisalabad, in Pakistan, made up the top five. Out of the 20 most polluted cities worldwide, 18 were in India, Pakistan and Bangladesh. New Delhi, home to more than 20 million people, was ranked at 11, making it the world’s most polluted capital, ahead of Dhaka, in Bangladesh, and Kabul, in Afghanistan.

The World Health Organization estimates seven million people are killed every year due to air pollution, while non-fatal effects of over-exposure to PM2.5 include irregular heartbeats, aggravated asthma and decreased lung function, according to the United States Environmental Protection Agency.

The report also highlighted one positive development: In the past decade, India managed to reduce the number of people exposed to household air pollution to 61 per cent from 73 per cent.