Pollution kills at least 9 million people every year and “threatens the continuing survival of human societies,” according to research from a new landmark study.

In 2015, almost one in six deaths – an estimated 9 million globally – were found to relate to pollution in some form.

The research, published Thursday in The Lancet medical journal, found that the overwhelming majority of pollution-related casualties – around 92 percent – were found in poor or middle-income nations. And in countries looking to industrialize rapidly, such as China, India, Pakistan, Madagascar and Bangladesh, pollution was connected to as many as a quarter of all deaths, the report said.

The study is the first attempt to collate data on disease and death caused by all forms of pollution combined.

Philip Landrigan, a professor at the Icahn School of Medicine in New York City, who jointly led the international research, said: “Pollution is much more than an environmental challenge — it is a profound and pervasive threat that affects many aspects of human health and wellbeing.”

“It deserves the full attention of international leaders, civil society, health professionals, and people around the world. Despite its far-reaching effects on health, the economy and the environment, pollution has been neglected in the international assistance and the global health agendas, and some control strategies have been deeply underfunded.”

Air pollution was found to have had the biggest impact on people across the world, with dirty air accounting for around 6.5 million premature deaths in 2015. Meantime, water pollution was responsible for 1.8 million fatalities, while work-related pollution — which caused 800,000 deaths two years ago — posed the next largest risk, the report said.

While Brunei and Sweden had the lowest numbers of pollution-related fatalities, the report found Somalia and Bangladesh were the worst affected.

“Pollution endangers the stability of the Earth’s support systems and threatens the continuing survival of human societies,” the authors of the Commission on Pollution and Health research said in the report.

They also concluded that pollution represented one of the “great existential challenges” of the human-dominated era.

The research was carried out by around 40 international scientists, using data from the Global Burden of Disease Study from the Institute for Health Metrics and Evaluation at the University of Washington.