Yin P, Cai Y, Liu J M, Liu Y N, Qi J L, Wang L J, You J L, Zhou M G
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jan 6;51(1):53-57. doi: 10.3760/cma.j.issn.0253-9624.2017.01.011.
To assess the disease burden attributable to household air pollution in 1990 and 2013 in China. Based on data from the Global Burden of Disease Study 2013 in China (GBD 2013), we used population attributable fractions (PAF) to analyze the burden of different diseases attributable to solid-fuel household pollution in 2013 in China(not inclnding HongKang, Macao, Taiwan). We compared PAF, mortality, and disability-adjusted life years (DALY) for diseases attributable to solid-fuel household pollution in 31 provinces in mainland China in 1990 and 2013, and stratified the burden by age group. The estimated world average population during 2000- 2025 was used to calculate age-standardized mortality and DALY rates. In 2013, 14.9% of lower respiratory infections in children <5, 32.5% of chronic obstructive pulmonary disease (COPD), 12.0% of ischemic stroke, 14.2% of hemorrhagic stroke, 10.9% of ischemic heart disease, and 13.7% of lung cancer were attributable to solid-fuel household pollution. In addition, 807 000 deaths were attributable to solid-fuel household pollution, including 296 000 from COPD, 169 000 from hemorrhagic stroke, 152 000 from ischemic heart disease, 88 000 from ischemic stroke, 75 000 from lung cancer, and 28 000 from lower respiratory infections in children <5. The age-standardized mortality rate from solid-fuel household pollution decreased by 59.3% from 158.8/100 000 in 1990 to 64.6/100 000 in 2013. The age-standardized mortality rate from solid-fuel household pollution decreased in all 31 provinces, with the highest decline observed in Shanghai (96.3%), and lowest in Xinjiang (39.9%). In 2013, the age-standardized DALY rate from solid-fuel household pollution was highest in Guizhou (2 233.0/100 000) and lowest in Shanghai (27.0/100 000). The DALY rate was the highest for the >70 age group (7 006.0/100 000). Compared with 1990, the 2013 mortality rate and DALY rate from solid-fuel household pollution decreased in all age groups, with the highest decline observed in the <5 age group (91.9% and 91.8% , respectively). Although the disease burden attributable to household air pollution decreased notably between 1990 and 2013, household pollution caused a high number of deaths and DALY loss in certain western provinces.
评估1990年和2013年中国家庭空气污染所致的疾病负担。基于《2013年中国全球疾病负担研究》（GBD 2013）的数据，我们使用人群归因分数（PAF）分析2013年中国（不包括香港、澳门、台湾）固体燃料家庭污染所致的不同疾病负担。我们比较了1990年和2013年中国大陆31个省份固体燃料家庭污染所致疾病的PAF、死亡率和伤残调整生命年（DALY），并按年龄组对负担进行分层。使用2000 - 2025年期间的世界平均估计人口来计算年龄标准化死亡率和DALY率。2013年，5岁以下儿童下呼吸道感染的14.9%、慢性阻塞性肺疾病（COPD）的32.5%、缺血性中风的12.0%、出血性中风的14.2%、缺血性心脏病的10.9%以及肺癌的13.7%归因于固体燃料家庭污染。此外，80.7万例死亡归因于固体燃料家庭污染，其中包括29.6万例来自COPD、16.9万例来自出血性中风、15.2万例来自缺血性心脏病、8.8万例来自缺血性中风、7.5万例来自肺癌以及2.8万例来自5岁以下儿童下呼吸道感染。固体燃料家庭污染的年龄标准化死亡率从1990年的158.8/10万降至2013年的64.6/10万，下降了59.3%。31个省份固体燃料家庭污染的年龄标准化死亡率均有所下降，其中上海下降幅度最大（96.3%），新疆最小（39.9%）。2013年，固体燃料家庭污染的年龄标准化DALY率在贵州最高（2233.0/10万），在上海最低（27.0/10万）。DALY率在70岁以上年龄组最高（7006.0/10万）。与1990年相比，2013年固体燃料家庭污染的死亡率和DALY率在所有年龄组均有所下降，其中5岁以下年龄组下降幅度最大（分别为91.9%和91.8%）。尽管1990年至2013年间家庭空气污染所致的疾病负担显著下降，但家庭污染在某些西部省份仍导致了大量死亡和DALY损失。
