不同社会人口转变下 COPD 和 LRI 疾病的水和卫生、PM 污染和气候变化的影响。
Effect of water and sanitation, PM pollution and climate change of COPD and LRIs under different sociodemographic transitions.
机构信息
Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, China.
出版信息
Public Health. 2024 Dec;237:150-159. doi: 10.1016/j.puhe.2024.10.012. Epub 2024 Oct 14.
OBJECTIVES
To estimate the burden of chronic obstructive pulmonary disease (COPD) and lower respiratory tract infections (LRIs) stratified by geographic location, and social-demographic status for 21 regions across the world from 1990 to 2019.
STUDY DESIGN
The analysis utilized data from the Global Burden of Disease (GBD) Study, focusing on mortality and disability-adjusted life years (DALYs) as measures of COPD and LRI burden. Trend analyses using the Joinpoint model were conducted across five socio-demographic index (SDI) quintiles.
METHODS
We investigated the burden of COPD and LRIs employing restricted cubic splines to flexibly identify relationships between DALY rates and SDI. This method allowed for detailed examination of trends over time across different regions and socio-demographic contexts.
RESULTS
From 1990 to 2019, the ASMR of COPD attributed to PM for global and five SDI quintiles decreased 61.80 %, 53.41 %, 63.04 %, 63.00 %, 40.98 %, 12.14 % respectively. In terms of PM Pollution, there was an inverted U-shaped association between the DALY and SDI for COPD, the DALY rate associated with LRIs due to PM pollution exhibited a progressive decline as SDI increased.
CONCLUSION
Even though the trend in mortality and DALY of COPD and LRIs decreased globally, the COPD and LRI burden attributed to PM pollution remains high, particularly in lower SDI quintiles.
目的
估计全球 21 个地区 COPD 和下呼吸道感染（LRIs）的负担，并按地理位置和社会人口统计学进行分层，时间范围为 1990 年至 2019 年。
研究设计
该分析利用全球疾病负担（GBD）研究的数据，重点关注死亡率和残疾调整生命年（DALYs），作为 COPD 和 LRI 负担的衡量指标。使用 Joinpoint 模型对五个社会人口统计学指数（SDI）五分位数进行趋势分析。
方法
我们使用受限立方样条来调查 COPD 和 LRI 的负担，以灵活识别 DALY 率与 SDI 之间的关系。这种方法允许在不同的地区和社会人口统计学背景下详细检查随时间的趋势。
结果
从 1990 年到 2019 年，全球和五个 SDI 五分位数的 COPD 归因于 PM 的 ASMR 分别下降了 61.80%、53.41%、63.04%、63.00%、40.98%、12.14%。就 PM 污染而言，COPD 的 DALY 与 SDI 之间存在着倒 U 形关系，PM 污染导致的 LRI 的 DALY 率随着 SDI 的增加而逐渐下降。
结论
尽管全球 COPD 和 LRI 的死亡率和 DALY 呈下降趋势，但 PM 污染导致的 COPD 和 LRI 负担仍然很高，特别是在 SDI 五分位数较低的地区。
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