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Urban air pollution is set to become the biggest environmental cause of premature death in the coming decades, overtaking even such mass killers as poor sanitation and a lack of clean drinking water, according to a new report.

Both developed and developing countries will be hit, and by 2050, there could be 3.6 million premature deaths a year from exposure to particulate matter, most of them in China and India. But rich countries will suffer worse effects from exposure to ground-level ozone, because of their ageing populations – older people are more susceptible.

The warning comes in a new report from the Organisation for Economic Cooperation and Development (OECD), which is a study of the global environmental outlook until 2050. The report found four key areas that are of most concern – climate change, loss of biodiversity, water and the health impacts of pollution.

If current policies are allowed to carry on, the world will far exceed the levels of greenhouse gas emissions that scientists say are safe, the report found. "I call it the surrender scenario – where we would be if governments do nothing more than what they have pledged already?" said Simon Upton, environment director at the OECD. "But it could be even worse than that, we've found."

The report said that global greenhouse gas emissions could increase by as much as half, as energy demand rises strongly, if countries fail to use cleaner forms of energy. Water demand is also likely to rise by more than half, and by 2050 as much as 40% of the global population is likely to be living in areas under severe water stress. Groundwater depletion would become the biggest threat to agriculture and to urban water supplies, while pollution from sewage and waste water – including chemicals used in cleaning – will put further strain on supplies.

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