NEW DELHI – Increasing pollution worldwide is proving deadlier than war, natural disasters, or smoking, according to a report published in The Lancet medical journal. Based largely on 2015 data from the Global Burden of Disease, the report estimates that at least 9 million premature deaths were caused during the year by diseases from toxic exposure.

While the highest number of people who died from pollution occurred in countries mostly in Asia, the highest rates of pollution-related mortality were seen in African nations.

“Industrialization and urbanization have intensified environmental health risks and pollution, especially in developing countries,” the World Bank report “Reducing Pollution” stated. “Air pollution, lead poisoning, inadequate water supply, sanitation and hygiene, and hazardous wastes cause debilitating and fatal illnesses, create harmful living conditions, and destroy ecosystems. Pollution stunts economic growth and exacerbates poverty and inequality in both urban and rural areas. Poor people, who cannot afford to protect themselves from the negative impacts of pollution, end up suffering the most.”

The following, according to the Global Burden of Disease report, are considered the top five most polluted countries in the world.

India

With a 24.5 percent rate of pollution-related mortality, India is considered the most polluted nation in the world. According to statistics, pollution was responsible for a record 2,515,518 deaths. Per 100,000 people, 196.2 deaths are a result of pollution.

One of the most toxic forms of pollution is air pollution. National Public Radio reporter Julie McCarthy explained why India’s air is so degraded.

“The cooler air [during the winter season] creates this inversion in the city. It gets trapped. All this pollution gets trapped. Then you’ve got diesel engine exhaust, which is declared a carcinogen. You’ve got coal-burning plants. You’ve got India’s traditional festival of lights, where people fire off tons of firecrackers. And you’ve got all of this coinciding with smoke coming from farmers in the agricultural areas surrounding Delhi, who are burning the stubble of a crop every year before the winter planting season. And…you’ve got garbage burning 365 days a year.”

Many places across the country also lack clean drinking water and proper sanitation.

“Nearly half the population currently has no choice but to go to the toilet in rivers and fields, beside train tracks or down alleyways,” non-profit WaterAid reported. “Every day, at least 166 children under five die because of diarrhea caused by dirty water and poor sanitation. It is particularly tough to get toilets and water to people living in India’s rapidly expanding slums.”

China

In China, 1,838,251 people die yearly from pollution-related causes—a full 19.5 percent of the nation’s deaths. The nation attributes its environmental problems, including the toxic smog that often blankets it, to coal burning.

“The burning of coal is the biggest factor contributing to northern China’s smoggy conditions, according to Professor Chai Fahe, a researcher with the Chinese Research Academy of Environmental Sciences The South China Morning Post reported.

“Speaking at a press meeting organised by the Ministry of Environmental Protection…Chai said emissions from burning coal in Beijing, Tianjin and Hebei—the most developed regions in northern China—were five times the national average.”

The situation worsens in winter when urban dwellers use coal to heat their homes, the newspaper stated.

Pakistan

Approximately 21.9 percent of Pakistan’s population, or 311,189 people a year, die from pollution-related causes, with the worst being due to a lack of clean air.

“While Delhi’s air quality has generated headlines worldwide in recent days, experts say the air in Lahore rivals the Indian capital’s for toxicity,” The New York Times reported. “The problem is not limited to the city; in 2015, according to a World Health Organization estimate, almost 60,000 Pakistanis died from the high level of fine particles in the air, one of the world’s highest death tolls from air pollution.”

“For years, Pakistani environmentalists have referred to November, when crop burning, higher emissions and cold weather combine to blanket Lahore and the rest of Punjab Province with acrid smog, as a ‘fifth season.’ As in India, which Punjab borders, the problem seems to be growing worse, and this month it has reached what many Pakistanis are calling a crisis point.”

The Guardian further explained why the country’s air is so polluted.

“The causes are complex and range from vehicle and industrial emissions to construction and road dust. But a large part of the problem is crop burning. Because of the short window of time between harvesting rice and planting wheat in the same soil, it’s cheaper and faster for farmers to set the crop residue on fire rather than cart it away. When millions do this, the deadly haze can be seen from NASA satellites.”

Bangladesh

While Bangladesh could be considered the fourth most polluted country in the world, compared to other nations with higher populations, Bangladesh has the highest rate of deaths—26.6 percent—of its 163 million population, or a death toll of 260,836 people yearly who die from pollution-related causes.

“Air pollution is caused due to increasing growth of population, burning fossil fuels and unplanned industrialization,” an editorial in Dhaka’s Daily Sun explained. “The underground water of Bangladesh has been polluted due to presence of arsenic and river water for lack of waste and industrial effluent management. The dwellers of major cities of Bangladesh including the capital are also exposed to high level of noise pollution.

“Environmental degradation of Bangladesh is also caused due to poverty, over-population and lack of awareness among the people. It is manifested by deforestation, destruction of wetlands, soil erosion and natural calamities.”

Nigeria

Considered Africa’s top oil producer and the seventh-most populous country in the world, Nigeria’s 186 million people owe the pollution-related problems it has to the effects of the oil industry. Spills are commonplace and wreak havoc on the health of the nation’s people and its ecosystems. At least 257,093 people die yearly from pollution-related causes, which amounts to 18.7 percent of its population.

A map maintained by the Nigerian Oil Spill Monitor, which keeps track of the status of spills across the nation, are evidence of this, with thousands of little red dots stretching across the country.

“Persistent spills in Nigeria’s oil-producing region have not just contaminated water resources,” Deutsche Welle reported. “Residents are also exposed to harmful chemicals found in crude oil through direct skin contact or the consumption of polluted vegetables. Many also inhale the smoke released by burning oil.

The article cited a report by a Swiss research team that found unborn children can also be adversely affected by the chemicals released during an oil spill.

“Oil spills that occur within 10 kilometers [of the mother] prior to child conception strongly increase the risk of mortality during the first months of life,” Roland Hodler, the study’s author, told the media outlet.

Yet oil spills are not the only problem.

“The road to a cleaner, greener Nigeria is not a short one, and it reflects the broader problem as Africa’s countries grow,” World Bank reported. “Lagos, for example, is the place where old computers and smart phones come to die from across the globe, leaving behind toxic waste and devastating health issues. In the next decade many of the [world’s] largest cities will be located in Africa, and in this way Lagos shows us a glimpse of the future.”

This article contains information from The Associated Press.