1990—2019年全球环境危险因素疾病负担—GBD2019数据再分析

刘静怡; 孟聪申; 韩京秀

doi:10.13421/j.cnki.hjwsxzz.2023.03.004

1990—2019年全球环境危险因素疾病负担—GBD2019数据再分析

Global disease burden due to environmental risk factors in 1990—2019: a reanalysis of GBD2019 data

摘要

摘要:
目的了解1990—2019年全球归因于环境危险因素的疾病负担及其变化趋势。
方法从2019年全球疾病负担研究(GBD2019)报告及全球疾病负担协作网络公布的GBD数据库, 获得自1990—2019年全球环境危险因素的暴露情况、归因死亡数和伤残调整寿命年(DALY), 并通过绘制时间变化趋势图和计算年度变化率, 分析近30年全球环境危险因素暴露及归因疾病负担的变化趋势。
结果 2019年, 环境危险因素中大气臭氧(O₃)和环境铅的人群暴露风险最高, 人群暴露风险比例分别为54.34%和51.26%;归因于环境危险因素的过早死亡数和DALY分别占全球疾病负担的19.9%和14.3%, 其中导致疾病负担最重的环境危险因素是空气污染, 其次是不安全的水、卫生设施和洗手, 非适宜温度以及其他环境危险因素, 其归因死亡数分别为667、166、196和99万人(分别占全球死亡数的11.8%、2.9%、3.5%和1.7%), 其归因DALY分别为21 328、8 754、3 760和2 356万人年(分别占全球DALY的8.4%、3.5%、1.5%和0.9%)。1990—2019年, 全球大气颗粒物污染和O₃污染的暴露风险和疾病负担均呈增加趋势。此外, 住宅氡污染的疾病负担也呈现上升趋势, 而室内空气污染, 不安全的水、卫生设施和洗手导致的疾病负担呈下降趋势。
结论环境危险因素仍是人类所面临的主要健康危险因素, 尤其是大气颗粒物和O₃污染、住宅氡污染和环境铅暴露, 需控制其污染水平, 降低健康危害。

Abstract:
Objective To investigate the global disease burden attributable to environmental risk factors and its changing trend from 1990 to 2019.
Methods The data on global exposure to environmental risk factors, attributable deaths, and disability-adjusted life years (DALYs) from 1990 to 2019 were obtained from the report of the Global Burden of Disease Study 2019 (GBD2019) and the GBD database published by the Global Burden of Disease Collaborative Network. The time changing trend charts were plotted and the annual rate of change were calculated to analyze the changing trends of global exposure to environmental risk factors and attributable burden of disease in the past 30 years.
Results In 2019, the environmental risk factors with the highest proportion of population exposure risk were ambient ozone (O₃) and environmental lead, which were 54.34% and 51.26%, respectively. The number of premature deaths and DALYs attributable to environmental risk factors of global burden of disease (GBD) accounted for 19.9% and 14.3%, respectively, of which air pollution was the highest environmental risk factor for GBD, followed by unsafe water/sanitation/hand-washing, non-optimal temperature and other environmental risk factors. The attributable deaths were 6.67, 1.66, 1.96 and 0.99 million, accounting for 11.8%, 2.9%, 1.7%, and 3.5% of global deaths, respectively. While attributable DALYs were 213.28, 87.54, 37.60 and 23.56 million, accounting for 8.4%, 3.5%, 1.5%, and 0.9% of global DALYs, respectively. In 1990—2019, the exposure risk and GBD of atmospheric particulate matter pollution and O₃ pollution showed an increasing trend. In addition, the GBD attributable to residential radon pollution also tended to increase, while the GBD attributable to indoor air pollution, unsafe water, sanitation and hand washing tended to decrease.
Conclusion Environmental risk factors remain the main risk factors for public health, especially atmospheric particulate matter pollution, O₃ pollution, residential radon pollution, and environmental lead exposure, which are necessary to control or reduce the exposure levels and health hazards of these factors.

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