Pollution caused 25 lakh premature deaths in India in 2015, the most in any country, The Lancet Commission on Pollution and Health said in a report published on Thursday. Globally, 90 lakh people died because of pollution.

China recorded 18 lakh pollution-related deaths. Bangladesh, Pakistan, North Korea, South Sudan and Haiti also saw at least a fifth of their premature deaths caused by pollution. The Lancet study is the first attempt to pull together data on disease and death caused by all forms of pollution.

The deaths from environmental pollution was three times more than those from AIDS, tuberculosis and malaria combined, the scientists said. “People in poorer countries, like construction workers in New Delhi, are more exposed to air pollution and less able to protect themselves from exposure, as they walk, bike or ride the bus to workplaces that may also be polluted,” Reuters quoted Karti Sandilya, one of the authors of the study and an adviser to environmental group Pure Earth, as saying.

Around 92% of pollution-related deaths have been in low-or-middle-income developing countries. The study attributed this to policy-makers being more focused on developing economies and lifting people out of poverty. The study also pointed out how environmental regulations in these countries were weaker.