Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
Environ Pollut. 2022 Jan 1;292(Pt B):118411. doi: 10.1016/j.envpol.2021.118411. Epub 2021 Oct 27.
Estimating the burden of diseases induced by overexposure to solar ultraviolet radiation (SUVR) can help to prioritize environmental health interventions. The age-sex specific and cause-specific mortality and disability-adjusted life years (DALYs) attributable to overexposure to SUVR at the national and subnational levels in Iran, 2005-2019 were estimated. The burden of disease induced by overexposure to SUVR was quantified in four steps as follows: (1) estimating exposure to SUVR, (2) estimating total incidences and deaths of target causes, (3) assessing population attributable fractions of the target causes for the SUVR, and (4) calculating the attributable burden of disease. The attributable DALYs, deaths, age-standardized DALY rate, and age-standardized death rate at the national level were determined to be respectively 21896, 252, 42.59, and 0.56 in 2005 and were respectively changed to 28665, 377, 38.76, and 0.53 in 2019. The contributions of causes in the attributable DALYs at the national level were different by year and sex and for both sexes in 2019 were as follows: 46.15% for cataract, 20.36% for malignant skin melanoma, 16.07% for sunburn, 12.41% for squamous-cell carcinoma, and 5.01% for the other five causes. The contributions of population growth, population ageing, risk exposure, and risk-deleted DALY rate in the temporal variations of the attributable burden of disease in the country were +20.73%, +20.68%, +2.01%, and -12.51%. The highest and lowest provincial attributable age-standardized DALY rates in 2019 were observed in Fars (46.8) and Ardebil (32.7), respectively. The burden of disease induced by exposure to SUVR caused relatively low geographical inequality in health status in Iran. Due to increasing trends of the SUVR as well as the attributable burden of disease, the preventive interventions against the SUVR overexposure should be considered in the public health action plan all across the country.
估算因过度暴露于太阳紫外线辐射（SUVR）而导致的疾病负担有助于优先考虑环境卫生干预措施。本研究旨在估算 2005-2019 年伊朗全国和次国家级因过度暴露于 SUVR 导致的年龄性别特异性和病因特异性死亡率和伤残调整生命年（DALY）。通过以下四个步骤来量化因过度暴露于 SUVR 而导致的疾病负担：（1）估算 SUVR 暴露情况，（2）估算目标病因的总发病数和死亡数，（3）评估目标病因的 SUVR 归因分数，（4）计算归因疾病负担。2005 年全国归因 DALY 为 21896，归因死亡为 252，年龄标化 DALY 率为 42.59，年龄标化死亡率为 0.56，2019 年分别变为 28665，377，38.76，0.53。2019 年，全国归因 DALY 中各病因的构成比因性别和年份而异，男女两性均为：白内障 46.15%，恶性皮肤黑素瘤 20.36%，晒伤 16.07%，鳞状细胞癌 12.41%，其他五种病因 5.01%。人口增长、人口老龄化、风险暴露和风险调整 DALY 率在全国归因疾病负担的时间变化中的贡献率分别为+20.73%、+20.68%、+2.01%和-12.51%。2019 年，法尔斯省和阿尔达比勒省的归因年龄标化 DALY 率最高（46.8）和最低（32.7）。暴露于 SUVR 导致的疾病负担在伊朗的健康状况方面造成的地域不平等程度相对较低。由于 SUVR 的上升趋势以及归因疾病负担的上升趋势，应在全国公共卫生行动计划中考虑针对过度暴露于 SUVR 的预防干预措施。
