Almost a fifth of all ill health in poor countries and millions of deaths can be attributed to environmental factors, including climate change and pollution, according to a report from the World Bank.
Unsafe water, poor sanitation and hygiene as well as indoor and outdoor air pollution are all said to be killing people and preventing economic development. In addition, says the bank, increasing soil pollution, pesticides, hazardous waste and chemicals in food are significantly affecting health and economies.
More controversially, the report, released on Wednesday in New York, links cancers to environmental conditions and says global warming has a major impact on health.
"For almost all forms of cancer, the risk of contracting this disease can be reduced if physical environments are safe for human habitation and food items are safe for consumption," says the report.
It also cites the spread of malaria and dengue fever as climate change intensifies. Global warming, says the report, is leading to lower yields of some crops and the salination of coastal areas.
"In 2000 more than 150,000 premature deaths were attributed to various climate change impacts, according to the World Health Organization," it says.
While tobacco, alcohol and unsafe sex are still the most likely threats to health in developing countries, rapid urbanization and the spread of slum conditions are now major hazards, says the report.
"Some 1.1 billion people lack access to safe water and 2.6 billion lack access to safe sanitation. [This leads to] about four billion cases of diarrhea a year, which cause 1.8 million deaths a year, mostly among children under five," it says.
Sanitation, says the bank, which is committed to increasing spending on the environment, is very much "a forgotten problem," with spending on improvements estimated at just US$1 billion in 2000 -- less than 10 percent of that spent on water.
Millions of people who have moved to cities to find work have swapped indoor for outdoor air pollution, suggests the report. Urban air pollution is estimated to cause about 800,000 premature deaths, it says, approaching the number of people affected by indoor air pollution in poorly ventilated homes in rural areas.
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