Breathing heavy: new evidence on air pollution and health in Bangladesh

Air pollution was the fourth-leading risk factor for premature mortality globally in 2019, causing an estimated 6.67 million deaths (HEI 2020). A large majority of such deaths were caused by ambient, outdoor air pollution due to inhalation of fine particulate matter (PM2.5) (World Bank 2020). While most individuals are susceptible to the health effects of air pollution, those living in low- and middle-income countries are most impacted by ‘unbreathable’ air as they are exposed to very high levels of air pollution, typically exceeding the safe limits set by the World Health Organization (WHO 2022). Bangladesh is particularly vulnerable to the effects of air pollution; the country has been ranked as the most polluted in the world between 2018 and 2021. Dhaka, its capital, has ranked as the second-most polluted city in the world over the same period (IQAir 2021). This report uses data collected from 12,250 individuals, stratified by sources of ambient air pollution chosen from Dhaka and rural Sylhet reflecting varying concentration levels of air pollutants. These include sites in Dhaka city covering locations (in Dhaka city) with major construction and traffic, sites (in Dhaka city) with persistent traffic (no construction), sites (in the outskirts of Dhaka) capturing locations with brick kilns, and sites (in rural Sylhet) as the comparator. The survey collected information on individuals’ physical and mental health conditions, household-level background information, and air pollution data, localized at the community and household levels. Analysis of the primary data was complemented by an analysis of existing literature and historical data on air pollution levels from across the country. This report, one of the first of its kind from Bangladesh, aims to establish the relationship between ambient air pollution and the associated short-term health impacts. With air pollution levels anticipated to increase in the coming years, the negative effects on individuals will continue to amplify, thereby increasing the national burden and cost of care in the medium to long term. The findings and recommendations contained in this report are expected to assist practitioners and subject matter experts in policy dialogue under the overall framework of the government’s Mujib Climate Prosperity Plan Decade 2030.