The scientists examined the connection between exposure to pollutants and the occurrence of diseases. In order to calculate the worldwide exposure to pollutants, which primarily include fine particles and ozone, the researchers used an atmospheric chemical mode. They then combined the exposure data with the Global Exposure -- Mortality Model that derives from many epidemiological cohort studies. Using these tools and data, scientists investigated the effects of different pollution sources, distinguishing between natural (wildfires, aeolian dust) and anthropogenic emissions, including fossil fuel use. Based on their results they could estimate the disease-specific excess mortality and loss of life expectancy in all countries world-wide. The study results show that the mortality caused by ambient air pollution is highest in East Asia (35 percent) and South Asia (32 percent), followed by Africa (11 percent), Europe (9 percent) and North- and South America (6 percent). Lowest mortality rates are found in Australia (1,5 percent) associated with the strictest air quality standards of all countries. "We understand more and more that fine particles primarily favor vascular damage and thus diseases such as heart attack, stroke, cardiac arrhythmia and heart failure. It is of outmost importance that air pollution is adopted as a cardiovascular risk factor and that it is distinctly mentioned in the ESC/AHA guidelines of prevention, acute and coronary syndromes and heart failure," continued Münzel.