Environmental pollution is the largest cause of disease and death, killing more people each year than war and violence, according to a new study published by the Lancet medical journal. The study found that at least 9 million premature deaths in 2015 were caused in part by toxic exposure, though experts say this is just a partial estimate and the number of people killed by pollution is higher. The majority of pollution-related deaths happen in low- or middle-income countries where more resources are put towards growing the economy than establishing environmental regulations. “What people don’t realize is that pollution does damage to economies. People who are sick or dead cannot contribute to the economy. They need to be looked after,” said Richard Fuller, head of the global toxic watchdog Pure Earth and one of the 47 scientists who contributed to the 51-page report.