Yang Rui, Wang Xingke, Hao Panpan
Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Cardiology, Wuzhong People's Hospital Affiliated to Ningxia Medical University, Wuzhong, Ningxia, China.
BMC Public Health. 2025 Jul 15;25(1):2467. doi: 10.1186/s12889-025-23531-4.
To assess the impact of ambient particulate matter exposure on the burden of intracerebral hemorrhage (ICH) in the world, China, Indonesia, North Korea, Myanmar and Vietnam from 1990 to 2021 in different population, and to reveal regional heterogeneity and policy effects.
Based on the GBD 2021 data, we integrated the Joinpoint, Age-period-cohort model, Decomposition Analysis, Health Inequality Analysis and BAPC model chain achieved a complete cycle analysis including trend mutation detection, analysis of driving factors and long-term prediction.
The global age-standardized mortality rate decreased by 3.22% annually after 2015. In China, the mortality rate decreased by 6.41% annually (95% CI:-8.08 to-4.71) due to policy measures. In Vietnam, the DALY rate increased by 170.53% (RR = 2.33), with 53.10% attributable to epidemiological changes. There were significant gender differences, with the DALYs rate for men being 2.9 times higher than for women. The age-period-cohort model showed that the mortality risk of the 85-year-old population (RR = 7.40) was 67.7 times higher than that of the 25-year-old group (RR = 0.04), and that the pre-1947 birth cohort was at high risk. The decomposition analysis revealed that aging contributed 53.80% to the increase in disease burden in China, while Vietnam was mainly driven by epidemiologicalchanges.
This study confirmed that pollution control can rapidly reduce mortality, but it is necessary to specifically address emerging pollution sources in Southeast Asia and the synergistic risks of aging to establish an interdisciplinary evidence chain for accurate prevention and control.
评估1990年至2021年期间，全球、中国、印度尼西亚、朝鲜、缅甸和越南不同人群暴露于环境颗粒物对脑出血（ICH）负担的影响，并揭示区域异质性和政策效应。
基于全球疾病负担研究（GBD）2021数据，我们整合了连接点分析、年龄-时期-队列模型、分解分析、健康不平等分析和贝叶斯层次泊松回归模型链，实现了包括趋势突变检测、驱动因素分析和长期预测的完整周期分析。
2015年后，全球年龄标准化死亡率每年下降3.22%。在中国，由于政策措施，死亡率每年下降6.41%（95%置信区间：-8.08至-4.71）。在越南，伤残调整生命年（DALY）率增加了170.53%（相对风险RR = 2.33），其中53.10%归因于流行病学变化。存在显著的性别差异，男性的DALY率是女性的2.9倍。年龄-时期-队列模型显示，85岁人群的死亡风险（RR = 7.40）比25岁组（RR = 0.04）高67.7倍，且1947年前出生的队列风险较高。分解分析表明，在中国，老龄化对疾病负担增加的贡献率为53.80%，而在越南，主要驱动因素是流行病学变化。
本研究证实污染控制可迅速降低死亡率，但有必要特别关注东南亚新出现的污染源以及老龄化的协同风险，以建立跨学科的证据链进行精准防控。
