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

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.