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We estimated that long-term exposure to ambient PM2·5 caused 4·2 million deaths and 103·1 million lost years of healthy life in 2015, and exposure to ozone caused an additional 254 000 deaths. PM2·5 caused an estimated 7·6% of total global mortality in 2015 and was the fifth-ranking global mortality risk factor. Although global rates of mortality due to PM2·5 exposure decreased from 1990 to 2015 as a result of improved air quality in high-income countries and declining mortality rates for cardiovascular diseases, the absolute numbers of attributable deaths and DALYs increased as a result of increases in pollution and the absolute numbers of deaths from non-communicable diseases,