This paper is the first to assess the global economic burden caused by air pollution from fossil fuels. It incorporates many recent first-of-a-kind findings, including the first study to assess the contribution of fossil fuels to global air pollution levels and health impacts, as well as novel research on the burden of asthma and diabetes linked to air pollution.

The economic costs of air pollution from fossil fuels are estimated at US$2.9 trillion in 2018, or 3.3% of global GDP, far exceeding the likely costs of rapid reductions in fossil fuel use.

An estimated 4.5 million people died in 2018 due to exposure to air pollution from fossil fuels. On average, each death was associated with a loss of 19 years of life.

Fossil fuel PM2.5 pollution was responsible for 1.8 billion days of work absence, 4 million new cases of child asthma and 2 million preterm births, among other health impacts that affect healthcare costs, economic productivity and welfare.