Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Abstract

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6-4.3) with a prevalence of 454.6 million cases (417.4-499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4-225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9-3.6) deaths. With 262.4 million (224.1-309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries.

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References 54

1. 1.
   Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 · 2020

   Corrected
2. 2.

   Syamlal G.B.A., Dodd K.E. Medical expenditures attributed to asthma and chronic obstructive pulmonary disease among workers — United States, 2011–2015. MMWR Morb Mortal Wkly Rep. 2020;69:809-814.

   Not in our library10.15585/mmwr.mm6926a1

3. 3.

   European Respiratory Society. 2013.

   Not in our library

4. 4.

   UN General Assembly. Transforming our world: the 2030 agenda for sustainable development. 2015.

   Not in our library

5. 5.

   World Health Organization. Thirteenth general programme of work 2019–2023. 2019.

   Not in our library

6. 6.

   World health statistics 2022: monitoring health for the SDGs, sustainable development goals. 2022.

   Not in our library

7. 7.

   World Health Organization. Towards a global action plan for healthy lives and well-being for all. Uniting to accelerate progress towards the health-related SDGs. 2018.

   Not in our library

8. 8.

   World Health Organization. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. 2007.

   Not in our library

9. 9.

   Pauwels R. Global initiative for chronic obstructive lung diseases (GOLD): time to act. Eur Respir J. 2001;18(6):901.

   Not in our library

10. 10.

    Reddel H.K., FitzGerald J.M., Bateman E.D., et al. GINA 2019: a fundamental change in asthma management. Eur Respir J. 2019;53(6):1901046.

    Not in our library10.1183/13993003.01046-2019

11. 11.
    Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 · 2020

    No notice
12. 12.
    Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 · 2017

    Corrected
13. 13.
    Modeling causes of death: an integrated approach using CODEm · 2012

    No notice
14. 14.

    Murray C.J.L., Lopez A.D. Global mortality, disability, and the contribution of risk factors: global Burden of Disease Study. Lancet. 1997;349(9063):1436-1442.

    Not in our library10.1016/s0140-6736(96)07495-8

15. 15.
    Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 · 2020

    No notice
16. 16.

    Global Burden of Disease Cancer Collaboration. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524-548.

    Not in our library10.1001/jamaoncol.2016.5688

17. 17.
    Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019 · 2020

    No notice
18. 18.
    Climate change and respiratory diseases · 2014

    Not checked
19. 19.

    D'Amato G., Chong-Neto H.J., Monge Ortega O.P., et al. The effects of climate change on respiratory allergy and asthma induced by pollen and mold allergens. Allergy. 2020;75(9):2219-2228.

    Not in our library10.1111/all.14476

20. 20.

    Stenius-Aarniala B., Poussa T., Kvarnström J., Grönlund E.-L., Ylikahri M., Mustajoki P. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ. 2000;320(7238):827.

    Not in our library10.1136/bmj.320.7238.827

21. 21.

    World Health Organization. Global health observatory data repository. 2017.

    Not in our library

22. 22.

    World Health Organization. 2009.

    Not in our library

23. 23.
    Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group · 2018

    No notice
24. 24.

    Goodchild M., Zheng R. Tobacco control and healthy China 2030. Tobac Control. 2019;28(4):409.

    Not in our library10.1136/tobaccocontrol-2018-054372

25. 25.
    The effects of tobacco control policies on global smoking prevalence · 2021

    No notice
26. 26.

    Thomson B., Rojas N.A., Lacey B., et al. Association of childhood smoking and adult mortality: prospective study of 120 000 Cuban adults. Lancet Global Health. 2020;8(6):e850-e857.

    Not in our library10.1016/s2214-109x(20)30221-7

27. 27.

    World Health Organization. 2018.

    Not in our library

28. 28.

    Wills T.A., Soneji S.S., Choi K., Jaspers I., Tam E.K. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J. 2021;57(1):1901815.

    Not in our library10.1183/13993003.01815-2019

29. 29.

    Energy Sector Management Assistance Program (ESMAP). 2021.

    Not in our library

30. 30.

    Batchelor S., Brown E., Scott N., Leary J. Two birds, one stone—reframing cooking energy policies in Africa and Asia. Energies. 2019;12(9).

    Not in our library

31. 31.

    Rosenthal J., Quinn A., Grieshop A.P., Pillarisetti A., Glass R.I. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain Dev. 2018;42:152-159.

    Not in our library10.1016/j.esd.2017.11.003

32. 32.

    Wong G.W., Brunekreef B., Ellwood P., et al. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Lancet Respir Med. 2013;1(5):386-394.

    Not in our library10.1016/s2213-2600(13)70073-0

33. 33.

    Shaddick G., Thomas M.L., Mudu P., Ruggeri G., Gumy S. Half the world's population are exposed to increasing air pollution. NPJ Climate Atmos Sci. 2020;3(1):23.

    Not in our library

34. 34.

    Fayiga A.O., Ipinmoroti M.O., Chirenje T. Environmental pollution in Africa. Environ Dev Sustain. 2018;20(1):41-73.

    Not in our library

35. 35.

    Wu Y., Song P., Lin S., et al. Global burden of respiratory diseases attributable to ambient particulate matter pollution: findings from the global burden of disease study 2019. Front Public Health. 2021;9:740800.

    Not in our library10.3389/fpubh.2021.740800

36. 36.
    Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study · 2020

    Not checked
37. 37.

    Communication from the Commission to the European Parliament, the European Council, the Council, the European Economic and Social Committee and the Committee of the Regions. 2019;640.

    Not in our library

38. 38.

    GBD, 2016 Occupational Chronic Respiratory Risk Factors Collaborators. Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med. 2020;77(3):142.

    Not in our library10.1136/oemed-2019-106013

39. 39.

    The Lancet. Improving occupational health in China. Lancet. 2019;394(10197):443.

    Not in our library10.1016/s0140-6736(19)31799-4

40. 40.

    Wang D., Liang R., Yang M., et al. Incidence and disease burden of coal workers' pneumoconiosis worldwide, 1990–2019: evidence from the Global Burden of Disease Study 2019. Eur Respir J. 2021;58(5):2101669.

    Not in our library10.1183/13993003.01669-2021

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  Not checked

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