People living in Britain have one and a half years slashed from their life expectancy due to air pollution, warns new research.
Dirty air also causes double the number of deaths than previously thought, according to the study.
The findings suggest that an estimated 8.8 million people died globally from air pollution, rather than the previously estimated 4.5 million.
And in Europe, 790,000 extra deaths took place in 2015 as a result of poor air conditions – caused by diseases linked to pollution.
Up to 80 per cent were due to cardiovascular diseases (CVD), with the condition twice as likely to kill than respiratory diseases.
CVD, which includes heart attacks and stroke, was found to be caused by air pollution more frequently than from smoking alone.
Professor Thomas Münzel, of the University Medical Centre Mainz in Germany, said that smoking is avoidable – but air pollution is not.
He said: “To put this into perspective, this means that air pollution causes more extra deaths a year than tobacco smoking, which the World Health Organisation estimates was responsible for an extra 7.2 million deaths in 2015.
“The number of deaths from cardiovascular disease that can be attributed to air pollution is much higher than expected.
“In Europe alone, the excess number of deaths is nearly 800,000 a year and each of these deaths represents an average reduction in life expectancy of more than two years.”
Researchers used data from a simulation of atmospheric chemical processes and the way it interacts with land, sea and chemicals.
They looked out for gasses emitted from natural and man-made sources such as energy generation, industry, traffic and agriculture.
A new model of global exposure and death rates from the World Health Organisation was then included as a mode of comparison.
This included information on population density, geographical locations, ages, risk factors for several diseases and causes of death.
Researchers focused on levels of polluting fine particles known as ‘particulate matter’ that are less than or equal to 2.5 microns in diameter – known as PM2.5 – and ozone.
Worldwide, they found that air pollution is responsible for 120 extra deaths per year per 100,000 of the population.
In Europe, researchers found that it was even higher, causing 133 and 129 extra deaths a year per 100,000 people, respectively.
When they looked at individual countries, researchers found air pollution caused an excess death rate of 98 per 100,000 in the UK.
This amounts to a reduction of life expectancy of 1.5 years – with Germany experiencing a rate of 154 per 100,000, or 2.4 years less.
Excess death rates were particularly high in eastern European countries, such as Bulgaria, Croatia, Romania and Ukraine, with over 200 each year per 100,000 of the population.
Professor Jos Lelieveld, of the Max-Plank Institute for Chemistry, said dense populations lead to some of the highest exposure.
He said: “The high number of extra deaths caused by air pollution in Europe is explained by the combination of poor air quality and dense population, which leads to exposure that is among the highest in the world.
“Although air pollution in eastern Europe is not much worse than in western Europe, the number of excess deaths it caused was higher.
“We think this may be explained by more advanced health care in western Europe, where life expectancy is generally higher.”
As a result of their findings, researchers claim that governments and international agencies must take urgent action to reduce air pollution.
Professors Münzel and Lelieveld emphasise that, in terms of air pollution, PM2.5 particles are the main cause of respiratory and cardiovascular disease.
Currently, the average annual limit for PM2.5 in the EU is 25 micrograms per cubic metre – 2.5 times higher than the WHO guideline of 10.
Even at this level, several European countries regularly exceed the limit.
Prof Münzel added: “The link between air pollution and cardiovascular disease, as well as respiratory diseases, is well established.
“It causes damage to the blood vessels through increased oxidative stress, which then leads to increases in blood pressure, diabetes, stroke, heart attacks and heart failure.”
Prof Lelieveld added: “Since most of the particulate matter and other air pollutants in Europe come from the burning of fossil fuels, we need to switch to other sources for generating energy urgently.
“When we use clean, renewable energy, we are not just fulfilling the Paris Agreement to mitigate the effects of climate change, we could also reduce air pollution-related death rates in Europe by up to 55 per cent.”
According to Prof Lelieveld, the fine dust content in the air could be reduced further by limiting agricultural emissions, which are responsible for a large amount of particulate matter pollution and for the associated extra number of deaths in Europe.
The findings were published in the European Heart Journal.