Air pollution, largely driven by the continued use of fossil fuels, poses a significant threat to global health and wellbeing. Transitioning to clean, renewable energy sources can not only combat climate change but also deliver major health benefits by reducing pollution, improving energy access, and enhancing energy security.
The persistent use of fossil fuels is not only the main driver of climate change that threatens people’s health and wellbeing, but also a main driver of ill-health from associated air pollution, and lack of access to energy.
A global transition to clean and renewable sources of fuels not only holds the key to tackle climate change, but also offers the potential for major health benefits by avoiding the burning of dirty fuels, and ensuring people have access to cleaner, healthier and more reliable sources of energy, safer employment opportunities, and reduce vulnerability of energy supply to uncertain geopolitics.
What causes air pollution?
Air pollution mostly arises from human-made sources
- The primary contributors to air pollution include vehicle emissions, industrial activities, burning of fossil fuels, agricultural practices, and deforestation. Toxic contaminants, released into the air by activities like fuel burning, industrial processes, and the ware of tires and breaks from our vehicles, can penetrate into the bloodstream and put our health at risk.
- Natural sources such as wildfires and volcanic eruptions also release pollutants into the atmosphere, but though these are responsible for a small fraction of human exposure to air pollution.
All of these sources emit harmful substances like particulate matter (PM), nitrogen oxides (NOx), sulfur dioxide (SO2), carbon monoxide (CO), and volatile organic compounds (VOCs), which contaminate the air we breathe both inside and outside our homes and workplaces, and pose significant health risks.
The latest data of the Lancet Countdown shows that failure to transition to clean energy sources has led to an estimated 2.52 million deaths from fossil fuel derived outdoor air pollution, and an estimated 2.3 million deaths from dirty fuel-derived household air pollution in 2022.
With 67% of global greenhouse gas emissions coming from fossil fuel combustion, preventing the most dangerous climate change scenarios requires structural changes in the energy sector. In addition to emissions, the extraction and use of fossil fuels pose myriad health impacts throughout the fuels’ lifecycle (see Panel 6 of the 2024 Lancet Countdown report).
However, far from declining, global energy-related CO2 emissions are at an all-time high.
How does air pollution affect health?
Exposure to polluted air has both immediate and long-term health consequences. Short-term effects include respiratory irritation (e.g. coughing and a burning feeling in the throat), headaches, dizziness, and exacerbation of conditions like asthma.
Long-term exposure increases the risk of chronic diseases such as lung cancer, cardiovascular diseases, stroke, and chronic obstructive pulmonary disease (COPD). This is because fine particulate matter (PM2.5) is dangerous as it can penetrate deep into the lungs and even enter the bloodstream, leading to systemic inflammation and organ damage.
Susceptibility to air pollution harms and exposure
Children, the elderly and pregnant women are more susceptible to air pollution-related diseases. Genetics, co-morbidities, nutrition and sociodemographic factors also impact a person’s susceptibility to air pollution. For example, people in low-income communities often experience higher exposure levels due to industrial proximity, inadequate housing, and reliance on polluting fuels for cooking and heating.
Energy poverty and air pollution
Almost 2·3 billion people, particularly in low- and middle-income countries still rely on solid fuels like wood, charcoal, and coal for cooking and heating. Burning these fuels releases toxic pollutants that drive health harms. They are also unreliable sources of energy that restrict access to the heating, cooling, and refrigeration services needed in many places for healthy living. In many low-resource settings, it is also often women and children that are in charge of collecting the fuel needed to meet domestic energy needs. This keeps them away from education and employment opportunities, reinforcing and exacerbating gender disparities, and undermining development opportunities.
The burning of such polluting biomass accounts for 92% of the energy used in the home by people in low HDI countries, and only 2·3% of electricity in these countries comes from clean renewables, compared with 11·6% in very high HDI countries.
What would a clean energy transition mean for health?
Many of the drivers of air pollution (i.e. combustion of fossil fuels) are also sources of greenhouse gas emissions. Policies to reduce air pollution, therefore, offer a win-win strategy for both climate and health, lowering the burden of disease attributable to air pollution, as well as contributing to the near- and long-term mitigation of climate change.
This life-saving action is already well evidenced: between 2010 and 2022, deaths from fossil fuel-derived air pollution fell almost 6%, largely due to efforts to reduce pollution from coal burning, avoiding 160,000 deaths annually.
Clean energy for healthcare settings
Access to clean energy sources can also support health by providing more reliable energy to healthcare facilities. Almost one billion people globally are still served by healthcare facilities that don’t have access to reliable energy and this lack of access means life-saving interventions can often not be performed, incubators cannot run, and women must deliver babies in the dark. Sustainable and localized energy supply solutions are not only cost-effective and clean, but also rapidly deployable and resilient to geopolitics and fluctuating energy prices.
Policies supporting green energy access, particularly for disadvantaged communities, must complement fossil fuel phase out to ensure that the benefits of cleaner air and improved health are shared equitably across all populations.
The health harms of an unequal energy transition
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- Use of renewables has grown, but disproportionately more in high-income countries, leaving low- and middle-income countries behind in the adoption of clean energy.
- Low – and middle-income countries are grossly dependent on external energy sources, which are expensive, and not available off grid.
- This is leaving low- and middle-income countries at greater risk of the health impacts of air pollution and dirty fuel reliance
Want to find out more? Explore the latest Lancet Countdown findings on our data platform
Thanks to the Lancet Countdown’s Professor Ian Hamilton, Working Group 3 Co-Chair on Mitigation Actions and Health Co-benefits, and Professor Stella Hartinger, Lancet Countdown Latin America Director and Working Group 3 Author, for their contributions to this page.