Environmental pollution — from filthy air to contaminated water — is killing more people every year than all war and violence in the world. More than smoking, hunger or natural disasters. More than AIDS, tuberculosis and malaria combined.

One out of every six premature deaths in the world in 2015 — about 9 million — could be attributed to disease from toxic exposure, according to a major study released Thursday in The Lancet medical journal. The financial cost from pollution-related death, sickness and welfare is equally massive, the report says, costing some $4.6 trillion in annual losses — or about 6.2 percent of the global economy.

“There’s been a lot of study of pollution, but it’s never received the resources or level of attention as, say, AIDS or climate change,” said epidemiologist Philip Landrigan, dean of global health at the Icahn School of Medicine at Mount Sinai, New York, and the lead author on the report.

The report marks the first attempt to pull together data on disease and death caused by all forms of pollution combined.

“Pollution is a massive problem that people aren’t seeing because they’re looking at scattered bits of it,” Landrigan said.

Experts say the 9 million premature deaths the study found was just a partial estimate, and the number of people killed by pollution is undoubtedly higher and will be quantified once more research is done and new methods of assessing harmful impacts are developed.

Areas like Sub-Saharan Africa have yet to even set up air pollution monitoring systems. Soil pollution has received scant attention. And there are still plenty of potential toxins still being ignored, with less than half of the 5,000 new chemicals widely dispersed throughout the environment since 1950 having been tested for safety or toxicity.

Asia and Africa are the regions putting the most people at risk, the study found, while India tops the list of individual countries.

One out of every four premature deaths in India in 2015, or some 2.5 million, was attributed to pollution, the study found. China’s environment was the second deadliest, with more than 1.8 million premature deaths, or one in five, blamed on pollution-related illness.

Several other countries such Bangladesh, Pakistan, North Korea, South Sudan and Haiti also see nearly a fifth of their premature deaths caused by pollution.