Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
Sara Momtazmanesh, Sahar Saeedi Moghaddam, Seyyed‐Hadi Ghamari, Elaheh Malakan Rad, Negar Rezaei, Parnian Shobeiri, Amirali Aali, Mohsen Abbasi‐Kangevari, Zeinab Abbasi-Kangevari, Michael Abdelmasseh, Meriem Abdoun, Deldar Morad Abdulah, Abu Yousuf Md Abdullah, Aidin Abedi, Hassan Abolhassani, Zahra Abrehdari-Tafreshi, Basavaprabhu Achappa, Denberu Eshetie Adane Adane, Tigist Demssew Adane, Isaac Yeboah Addo, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Sajjad Ahmad, Ali Ahmadi, Keivan Ahmadi, Ali Ahmed, Ayman Ahmed, Tarik A. Rashid, Hanadi Al Hamad, Fares Alahdab, Astawus Alemayehu, Sheikh Mohammad Alif, Syed Mohamed Aljunid, Sami Almustanyir, Khalid A Altirkawi, Nelson Alvis‐Guzmán, Javad Aminian Dehkordi, Mehrdad Amir‐Behghadami, Robert Ancuceanu, Cătălina Liliana Andrei, Tudorel Andrei, Catherine M Antony, Anayochukwu Edward Anyasodor, Jalal Arabloo, Judie Arulappan, Tahira Ashraf, Seyyed Shamsadin Athari, Engi F. Attia, Meshesha Tsegazeab Ayele, Sina Azadnajafabad, Abraham Samuel Babu, Sara Bagherieh, Ovidiu Constantin Baltatu, Maciej Banach, Mainak Bardhan, Francesco Barone‐Adesi, Amadou Barrow, Saurav Basu, Nebiyou Simegnew Bayileyegn, Isabela M. Benseñor, Nikha Bhardwaj, Pankaj Bhardwaj, Ajay Nagesh Bhat, Krittika Bhattacharyya, Souad Bouaoud, Dejana Braithwaite, Michael Bräuer, Muhammad Hammad Butt, Zahid A Butt, Daniela Călina, Luis Alberto Cámera, Gashaw Sisay Chanie, Periklis Charalampous, Vijay Kumar Chattu, Odgerel Chimed‐Ochir, Dinh‐Toi Chu, Aaron J. Cohen, Natália Martins, Omid Dadras, Aso Mohammad Darwesh, Saswati Das, Sisay Abebe Debela, Laura Delgado‐Ortiz, Diriba Dereje, Mostafa Dianatinasab, Nancy Diao, Daniel Díaz, Lankamo Ena Digesa, Gebisa Dirirsa, Paul Narh Doku, Deepa Dongarwar, Abdel Douiri, Haneil Larson Dsouza, Ebrahim Eini, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Ahmed Elabbas Mustafa Elagali, Muhammed Elhadi, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar
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.