Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Environ Health. 2022 Oct 29;21(1):105. doi: 10.1186/s12940-022-00914-3.
Lead exposure (LE) and its attributable deaths and disability-adjusted life years (DALYs) have declined in the recent decade; however, it remains one of the leading public health concerns, particularly in regions with low socio-demographic index (SDI) such as the North Africa and Middle East (NAME) region. Hence, we aimed to describe the attributable burden of the LE in this region.
Data on deaths, DALYs, years of life lost (YLLs), and years lived with disability (YLDs) attributable to LE in the NAME region and its 21 countries from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) 2019 study.
In 2019, the age-standardized death and DALY rates attributable to LE were 23.4 (95% uncertainty interval: 15.1 to 33.3) and 489.3 (320.5 to 669.6) per 100,000 in the region, respectively, both of which were higher among men than women. The overall age-standardized death and DALY rates showed 27.7% and 36.8% decreases, respectively, between 1990 and 2019. In this period, Bahrain, the United Arab Emirates, and Turkey had the highest decreases in the age-standardized death and DALY rates, while Afghanistan, Egypt, and Yemen had the lowest ones. Countries within high SDI quintile had lower attributable burden to LE compared with the low SDI quintile. Cardiovascular diseases and chronic kidney diseases accounted for the 414.2 (258.6 to 580.6) and 28.7 (17.7 to 41.7) LE attributable DALYs per 100,000 in 2019, respectively. The attributable YLDs was 46.4 (20.7 to 82.1) per 100,000 in 2019, which shows a 25.7% reduction (-30.8 to -22.5%) over 1990-2019.
The overall LE and its attributed burden by cause have decreased in the region from 1990-2019. Nevertheless, the application of cost-effective and long-term programs for decreasing LE and its consequences in NAME is needed.
近年来，铅暴露（LE）及其归因死亡人数和伤残调整生命年（DALYs）有所下降，但它仍是主要的公共卫生问题之一，特别是在社会人口指数（SDI）较低的北非和中东（NAME）地区。因此，我们旨在描述该地区 LE 的归因负担。
从 2019 年全球疾病负担（GBD）研究中提取了 1990 年至 2019 年期间 NAME 地区及其 21 个国家因 LE 导致的死亡、DALYs、生命损失年（YLLs）和残疾生活年（YLDs）的归因数据。
2019 年，该地区 LE 归因死亡率和 DALY 率的年龄标准化率分别为每 10 万人 23.4（95%置信区间：15.1 至 33.3）和 489.3（320.5 至 669.6），均高于女性。1990 年至 2019 年间，总体年龄标准化死亡率和 DALY 率分别下降了 27.7%和 36.8%。在此期间，巴林、阿拉伯联合酋长国和土耳其的年龄标准化死亡率和 DALY 率下降幅度最大，而阿富汗、埃及和也门的下降幅度最小。高 SDI 五分位数组的国家与低 SDI 五分位数组相比，LE 归因负担较低。心血管疾病和慢性肾脏病分别占 2019 年每 10 万人归因于 LE 的 414.2（258.6 至 580.6）和 28.7（17.7 至 41.7）个 DALY。2019 年，LE 归因 YLDs 为每 10 万人 46.4（20.7 至 82.1），1990-2019 年间下降了 25.7%（-30.8 至-22.5%）。
1990-2019 年，该地区的 LE 及其归因负担总体呈下降趋势。然而，需要在 NAME 地区实施具有成本效益和长期性的降低 LE 及其后果的方案。
