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


Sara Momtazmanesh, Non-Communicable Diseases Research Center
Sahar Saeedi Moghaddam, Non-Communicable Diseases Research Center
Seyyed Hadi Ghamari, Non-Communicable Diseases Research Center
Elaheh Malakan Rad, Tehran University of Medical Sciences
Negar Rezaei, Non-Communicable Diseases Research Center
Parnian Shobeiri, Non-Communicable Diseases Research Center
Amirali Aali, Mashhad University of Medical Sciences, School of Medicine
Mohsen Abbasi-Kangevari, Non-Communicable Diseases Research Center
Zeinab Abbasi-Kangevari, Non-Communicable Diseases Research Center
Michael Abdelmasseh, Marshall University
Meriem Abdoun, Université Ferhat Abbas Sétif 1
Deldar Morad Abdulah, University of Duhok
Abu Yousuf Md Abdullah, University of Waterloo
Aidin Abedi, University of Southern California
Hassan Abolhassani, Research Center for Immunodeficiencies
Zahra Abrehdari-Tafreshi, University of Tehran
Basavaprabhu Achappa, Manipal Academy of Higher Education
Denberu Eshetie Adane Adane, Debre Tabor University
Tigist Demssew Adane, Rijksuniversiteit Groningen
Isaac Yeboah Addo, UNSW Sydney
Mohammad Adnan, Ball Memorial Hospital
Qorinah Estiningtyas Sakilah Adnani, Faculty of Medicine
Sajjad Ahmad, Abasyn University
Ali Ahmadi, Shahid Beheshti University of Medical Sciences
Keivan Ahmadi, Imperial College Faculty of Medicine
Ali Ahmed, Monash University Malaysia
Ayman Ahmed, Institute of Endemic Diseases Sudan
Tarik Ahmed Rashid, University of Kurdistan Hewlêr
Hanadi Al Hamad, Hamad Medical Corporation

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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. Funding: Bill & Melinda Gates Foundation.

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National Institutes of Health



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