Israel emerges favorably in the World Health Organization's first international comparison on the impact of environmental hazards on people's health, released Wednesday. Estimates of years of life lost (disability-adjusted life years or DALY) in Israel due to respiratory infections and diseases, lung cancer and cardiovascular diseases caused by outdoor pollution are among the lowest in the world, with 6,000 estimated deaths per year from these causes. The best-rated countries in the world, including Israel, received a DALY of 14, compared to 316 in countries with the worst statistics. Although Israel is intensely urbanized (92 percent of the population live in urban areas), the DALY per capita per year was rated at a low 1.2, with 1,500 deaths per year due to poor outdoor air. Israel's water, sanitation and hygiene were ranked very high, while its rates of asthma, intentional injuries, cardiovascular diseases, diarrhea, and musculoskeletal diseases were much lower than the world average. It also was listed as having no overcrowding, malnutrition or use of leaded gasoline. The US, by comparison, had a DALY of 19 and a 3% malnutrition rate. Israel's lung cancer rating was 0.5, compared to 2.5 in the worst-ranked countries. Other cancers occurred in Israel at a rate of 2.1 compared to 4.1 in the worst-rated nations. The WHO data demonstrated that in every country, people's health could be improved by reducing environmental risks including pollution, workplace hazards, ultraviolet radiation, noise, agricultural risks, and climate and ecosystem change. According to the report, 13 million deaths worldwide could be prevented every year by making environments healthier. In some countries, more than a third of the disease burden could be prevented through environmental improvements. The worst-affected countries include Angola, Burkina Faso, Mali and Afghanistan. In 23 countries worldwide, more than 10% of all deaths are due to two environmental risk factors: unsafe water, including poor sanitation and hygiene and indoor air pollution due to solid fuel used for cooking. Worldwide, children under five are the main victims of environmental hazards and make up 74% of deaths resulting from diarrheal disease and lower respiratory infections. Low-income countries suffer the most from environmental health hazards, losing about 20 times more healthy years of life per person per year than high income countries. However, the data show that no country is immune from an environmental impact on the health of its population. Even in countries with better environmental conditions, almost one sixth of the disease burden is preventable, and efficient environmental interventions could significantly reduce both cardiovascular disease and road traffic injuries. "These country estimates are a first step towards assisting national decision-makers in the sectors of health and environment to set priorities for preventive action," said Susanne Weber-Mosdorf, WHO assistant director-general for sustainable development and healthy environments. "It is important to quantify the burden of disease from unhealthy environments. This information is key to help countries select the appropriate interventions." For the purposes of the WHO assessment, the category "environmental factors" includes pollution, occupational factors, UV radiation, noise, agricultural methods, climate and ecosystem change, the built environment and people's behavior. The data also show that household interventions could dramatically reduce the death rate. Using cleaner fuel such as gas or electricity, better cooking devices, improving ventilation and/or modifying behavior (such as keeping children away from smoke) could have a major impact on respiratory infections and diseases among women and children. Interventions at the community or national level would involve promoting household water treatment and safe storage and introducing energy policies which favour development and health. Reducing levels of air pollution as set out in WHO's air quality guidelines would save an estimated 865,000 lives per year.