@article{526b17deabc9410388d6359051d17342,
title = "Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017: The Lancet Respiratory Medicine",
abstract = "Background: Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings: In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), age-standardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation: Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis. Funding: Bill & Melinda Gates Foundation. {\textcopyright} 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license",
keywords = "fuel, ozone, Africa, Africa south of the Sahara, age, aging, Article, asthma, cancer mortality, cardiovascular mortality, cause of death, chronic obstructive lung disease, chronic respiratory tract disease, disability-adjusted life year, epidemiological data, geographic distribution, global disease burden, high income country, human, indoor air pollution, interstitial lung disease, lung sarcoidosis, Middle East, morbidity, mortality rate, occupational hazard, Oceanian, particulate matter, passive smoking, pneumoconiosis, population growth, prevalence, priority journal, risk factor, sex, smoking, South Asia, Southeast Asia, standardization, systematic review, trend study, adolescent, adult, aged, child, chronic disease, cost of illness, female, infant, life expectancy, male, middle aged, mortality, newborn, preschool child, quality adjusted life year, respiratory tract disease, sex factor, very elderly, young adult, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Asthma, Child, Child, Preschool, Chronic Disease, Cost of Illness, Female, Global Burden of Disease, Humans, Infant, Infant, Newborn, Life Expectancy, Lung Diseases, Interstitial, Male, Middle Aged, Pneumoconiosis, Prevalence, Pulmonary Disease, Chronic Obstructive, Quality-Adjusted Life Years, Respiratory Tract Diseases, Risk Factors, Sarcoidosis, Pulmonary, Sex Factors, Young Adult",
author = "{GBD Chronic Respiratory Disease} and J.B. Soriano and P.J. Kendrick and K.R. Paulson and V. Gupta and E.M. Abrams and R.A. Adedoyin and T.B. Adhikari and S.M. Advani and A. Agrawal and E. Ahmadian and F. Alahdab and S.M. Aljunid and K.A. Altirkawi and N. Alvis-Guzman and N.H. Anber and C.L. Andrei and M. Anjomshoa and F. Ansari and J.M. Ant{\'o} and J. Arabloo and S.M. Athari and S.S. Athari and N. Awoke and A. Badawi and J.A.M. Banoub and D.A. Bennett and I.M. Bensenor and K.S.S. Berfield and R.S. Bernstein and K. Bhattacharyya and A. Bijani and M. Brauer and G. Bukhman and Z.A. Butt and L.A. C{\'a}mera and J. Car and J.J. Carrero and F. Carvalho and C.A. Casta{\~n}eda-Orjuela and J.-Y.J. Choi and A. Faro and M. Levi and A.D. Lopez and F. Madotto and L.G. Mantovani and L. Monasta and T.H. Nguyen and L. Ronfani and A.T. Toma and F.S. Violante",
note = "Cited By :43 Export Date: 5 March 2021 Chemicals/CAS: ozone, 10028-15-6 Funding details: Bill and Melinda Gates Foundation, BMGF Funding text 1: This study was funded by the Bill & Melinda Gates Foundation. See appendix 1 (p 14) for full acknowledgments. References: Chronic respiratory diseases https://www.who.int/health-topics/chronic-respiratory-diseases#tab=tab_1, (Accessed 22 May 2020); GBD 2017: a fragile world (2018) Lancet, 392; Global Alliance against Chronic Respiratory Disease—About GARD https://www.who.int/gard/en/, (Accessed 22 May 2020); Global surveillance, prevention and control of chronic respiratory diseases. A comprehensive approach http://www.who.int/gard/publications/GARD_Manual/en/, (Accessed 22 May 2020); The global impact of respiratory disease (2017), https://www.who.int/gard/publications/The_Global_Impact_of_Respiratory_Disease.pdf, 2nd edn. 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year = "2020",
doi = "10.1016/S2213-2600(20)30105-3",
language = "English",
volume = "8",
pages = "585--596",
journal = "Lancet Respir. Med.",
issn = "2213-2600",
publisher = "Lancet Publishing Group",
number = "6",
}