Clark Sierra N, Anenberg Susan C, Brauer Michael
School of Health & Medical Sciences, City St George's, University of London, London, United Kingdom.
Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Annu Rev Public Health. 2025 Apr;46(1):233-251. doi: 10.1146/annurev-publhealth-071823-105338. Epub 2024 Dec 17.
Estimation of the disease burden attributable to environmental factors is a powerful tool for prioritizing environmental and pollution management and public health actions around the world. The World Health Organization (WHO) began estimating the environmental disease burden in 2000, which has formed the basis for the modern estimation approach conducted in the Global Burden of Disease, Injuries, and Risk Factor (GBD) study. In 2021, environmental and occupational risk factors in the GBD were responsible for 18.9% (12.8 million) of global deaths and 14.4% of all disability-adjusted life years (DALYs), led by ambient PM air pollution (4.2% DALYs, 4.7 million deaths) and household air pollution from the use of solid fuels for cooking (3.9% DALYs, 3.1 million deaths). Climate change exacerbates many environmental hazards, leading to increased disease burdens from heat, air pollution, vector-borne diseases, storms, and flooding. Other environmental risk factors not included in the GBD, such as poor indoor air quality, various chemical exposures, and environmental noise pollution, also significantly contribute to disease burden in many countries, though more efforts are needed to generate and integrate data resources for inclusion in global estimations.
估算环境因素导致的疾病负担是在全球范围内确定环境与污染管理以及公共卫生行动优先次序的有力工具。世界卫生组织（WHO）于2000年开始估算环境疾病负担，这为全球疾病、伤害及风险因素负担（GBD）研究中采用的现代估算方法奠定了基础。2021年，GBD中的环境和职业风险因素导致了全球18.9%（1280万）的死亡以及14.4%的伤残调整生命年（DALYs），其中以环境细颗粒物空气污染（4.2% DALYs，470万例死亡）和使用固体燃料烹饪导致的家庭空气污染（3.9% DALYs，310万例死亡）最为突出。气候变化加剧了许多环境危害，导致因高温、空气污染、媒介传播疾病、风暴和洪水造成的疾病负担增加。GBD未涵盖的其他环境风险因素，如室内空气质量差、各种化学物质暴露和环境噪声污染，在许多国家也对疾病负担有显著影响，不过需要做出更多努力来生成和整合数据资源，以便纳入全球估算。
