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.

Zobrazit více v PubMed

GBD 2019 Diseases and Injuries Collaborators. 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. Lancet. 2020;396(10258):1204–1222. PubMed PMC

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. PubMed PMC

European Respiratory Society . World Health Organization; Brussels: 2013. The economic burden of lung disease. European lung white book: respiratory health and disease in Europe.

UN General Assembly Transforming our world : the 2030 agenda for sustainable development. 2015. https://sdgs.un.org/2030agenda

World Health Organization Thirteenth general programme of work 2019–2023. 2019. https://www.who.int/about/what-we-do/thirteenth-general-programme-of-work-2019-2023

World health statistics 2022: monitoring health for the SDGs, sustainable development goals. World Health Organization; Geneva: 2022. Licence: CC BY-NC-SA 3.0 IGO.

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. https://apps.who.int/iris/bitstream/handle/10665/311667/WHO-DCO-2018.3-eng.pdf

World Health Organization Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. 2007. https://www.who.int/gard/publications/GARD_Manual/en/

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

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. PubMed

GBD 2017 Chronic Respiratory Disease Collaborators Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020;8(6):585–596. PubMed PMC

GBD 2015 Chronic Respiratory Disease Collaborators. 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. Lancet Respir Med. 2017;5(9):691–706. PubMed PMC

Foreman K.J., Lozano R., Lopez A.D., Murray C.J.L. Modeling causes of death: an integrated approach using CODEm. Popul Health Metrics. 2012;10(1):1. PubMed PMC

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. PubMed

GBD 2019 Risk Factors Collaborators Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–1249. PubMed PMC

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. PubMed PMC

Wang H., Abbas K.M., Abbasifard M., et al. 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. Lancet. 2020;396(10258):1160–1203. PubMed PMC

D'Amato G., Cecchi L., D'Amato M., Annesi-Maesano I. Climate change and respiratory diseases. Eur Respir Rev. 2014;23(132):161. PubMed PMC

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. PubMed

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. PubMed PMC

World Health Organization Global health observatory data repository. 2017. https://apps.who.int/gho/data/view.main.BMI30CWBv

World Health Organization . World Health Organization; Geneva: 2009. WHO report on the global tobacco epidemic 2008: the MPOWER package.

Chung-Hall J., Craig L., Gravely S., Sansone N., Fong G.T. Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group. Tobac Control. 2019;28(Suppl 2):s119. PubMed PMC

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

Flor L.S., Reitsma M.B., Gupta V., Ng M., Gakidou E. The effects of tobacco control policies on global smoking prevalence. Nat Med. 2021;27(2):239–243. PubMed PMC

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. PubMed PMC

World Health Organization . 2nd ed. World Health Organization; Geneva: 2018. WHO global report on trends in prevalence of tobacco smoking 2000-2025.

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. PubMed PMC

Energy Sector Management Assistance Program (ESMAP) World Bank; Washington, DC: 2021. What drives the transition to modern energy cooking services? A systematic review of the evidence.

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

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. PubMed PMC

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. PubMed

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.

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

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. PubMed PMC

Hystad P., Larkin A., Rangarajan S., et al. 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. Lancet Planet Health. 2020;4(6):e235–e245. PubMed PMC

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. The European green deal, COM; p. 640. [final]

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. PubMed PMC

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

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. PubMed

Meghji J., Mortimer K., Agusti A., et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021;397(10277):928–940. PubMed

World Health Organization WHO package of essential noncommunicable (PEN) disease interventions for primary health care. 2020. https://www.who.int/publications/i/item/9789240009226

World Health Organization Practical approach to lung health: manual on initiating pal implementation. 2008. https://www.who.int/publications/i/item/WHO-HTM-TB-2008.410 PubMed

Bousquet J., Dahl R., Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J. 2007;29(2):233. PubMed

Beltramo G., Cottenet J., Mariet A.-S., et al. Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. 2021:2004474. PubMed PMC

Aveyard P., Gao M., Lindson N., et al. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. Lancet Respir Med. 2021;9(8):909–923. PubMed PMC

Wu X., Liu X., Zhou Y., et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021;9(7):747–754. PubMed PMC

Han X., Fan Y., Alwalid O., et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177–E186. PubMed PMC

Safiri S., Carson-Chahhoud K., Noori M., et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022:378. e069679. PubMed PMC

Hall R., Hall I.P., Sayers I. Genetic risk factors for the development of pulmonary disease identified by genome-wide association. Respirology. 2019;24(3):204–214. PubMed

Benjafield A.V., Ayas N.T., Eastwood P.R., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687–698. PubMed PMC

Blaiss M.S., Hammerby E., Robinson S., Kennedy-Martin T., Buchs S. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol. 2018;121(1):43–52.e3. PubMed

Park Y., Ahn C., Kim T.-H. Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses. Sci Rep. 2021;11(1):4318. PubMed PMC

The novel virus was first identified in an outbreak in the Chinese city of Wuhan in December 2019. https://www.thelancet.com/journals/lancet/issue/vol396no10258/PIIS0140-6736(20) Accessed October 17, 2020.