Burden of chronic obstructive pulmonary disease attributable to ambient ozone pollution across China and its provinces, 1990-2021: An analysis for the Global Burden of Disease Study 2021.
10.1097/CM9.0000000000003415
- Author:
Yixuan JIANG
1
;
Fanshu YAN
2
;
Haidong KAN
1
;
Maigeng ZHOU
2
;
Peng YIN
2
;
Renjie CHEN
1
Author Information
1. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China.
2. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
- Publication Type:Journal Article
- MeSH:
Pulmonary Disease, Chronic Obstructive/etiology*;
Ozone/analysis*;
Humans;
China/epidemiology*;
Global Burden of Disease;
Male;
Air Pollution/adverse effects*;
Female;
Middle Aged;
Aged;
Air Pollutants/analysis*;
Disability-Adjusted Life Years;
Quality-Adjusted Life Years
- From:
Chinese Medical Journal
2024;137(24):3126-3135
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Epidemiological studies have demonstrated a causal relationship between ambient ozone (O 3 ) and mortality from chronic obstructive pulmonary disease (COPD), which is the only outcome considered in the Global Burden of Disease Study 2021 for O 3 . This study aims to evaluate the temporal trend and spatial distribution of the COPD burden attributable to O 3 across China from 1990 to 2021.
METHODS:The ambient O 3 concentrations in China were estimated. Based on the methodology framework and standard analytical methods applied in the Global Burden of Disease Study 2021, we estimated the annual number, age-standardized rate, and percentage of deaths and disability-adjusted life-years (DALYs) from COPD attributable to O 3 pollution during 1990-2021 at the national and provincial levels in China.
RESULTS:In 2021, a total of 125.7 (95% uncertainty interval [UI], 26.4-228.3) thousand deaths and 1917.5 (95% UI, 398.7-3504.6) thousand DALYs from COPD were attributable to ambient O 3 pollution in China, accounting for 9.8% (95% UI, 2.1-17.0%) and 8.1% (95% UI, 1.8-14.1%) of the total COPD deaths and DALYs, respectively. Generally, a higher burden was observed among males, the elderly, and the population residing in regions with worse health conditions. The age-standardized rates of COPD deaths and DALYs per 100,000 populations ranged from 0.5 (95% UI, 0-1.4) and 8.1 (95% UI, 0.7-20.9) in Hong Kong to 22.8 (95% UI, 3.9-43.5) and 396.6 (95% UI, 68.9-763.7) in Xizang. From 1990 to 2021, there was a notable decrease in the age-standardized rates of COPD-related deaths (68.2%, 95% UI, 60.1-74.9%) and DALYs (71.5%, 95% UI, 63.7-77.6%), especially in regions with poor health conditions. However, the attributable numbers and percentages changed relatively marginally.
CONCLUSIONS:Ambient O 3 pollution is a major contributor to the COPD burden in China. Our findings highlight the significant spatial heterogeneity across different provinces and underscore the implementation of geographically tailored policies to effectively reduce O 3 pollution and alleviate the associated disease burden.
