Most attention on Iran today is understandably focused on the war and the possibility of another round of major attacks. But one consequence has received far less attention: Iran is heading toward winter with a damaged energy system and the prospect of burning more fuel, much of it dirtier, in a country where polluted air was already killing tens of thousands every year.

The war did not create Iran’s air pollution crisis. Long before the first gas facility was struck, polluted air was already killing Iranians on a mass scale. The country’s deputy health minister estimated that air pollution caused nearly 60,000 deaths in a single year, while the World Health Organization attributes roughly one-quarter of deaths from stroke and ischemic heart disease in Iran to air pollution.