Xin Yiliang, Dou Jianrui, Yang Ruohan, Wang Yan, Li Peixuan, Zhang Xiyan, Liu Xin, Yang Jie
Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu Provincial Academy of Preventive Medicine), Nanjing, Jiangsu Province, China.
Department of Occupational Hygiene, Yangzhou City Center for Disease Prevention and Control, Yangzhou, Jiangsu Province, China.
Eur J Pediatr. 2025 Sep 5;184(9):601. doi: 10.1007/s00431-025-06433-w.
Long-term lead exposure damages the central nervous system, with chronic poisoning strongly linked to intellectual developmental disability (IDD) and disproportionately affecting children and adolescents. Using the Global Burden of Disease (GBD) 2021 database, this study analyzed temporal, spatial, and population-specific trends in lead-attributable IDD burden among global children/adolescents (1990-2021) and projected trends to 2040 to inform global public health strategies. GBD 2021 data characterized global, regional, and national distributions of lead-attributable IDD burden. Associations with sex, age, and Socio-Demographic Index (SDI) were evaluated via Years Lived with Disability (YLDs) and Age-Standardized YLD Rate (ASYR). Joinpoint regression quantified annual burden changes, and the Nordpred model projected 2021-2040 trends. Globally, ASYR fell from 58.088 to 38.718 per 100,000 (AAPC = -1.297%, P < 0.001), with high-SDI countries seeing a 54.0% reduction (AAPC = -2.486%) versus 32.8% in low-SDI regions. Paradoxically, low-SDI YLDs rose by 39.7%. In 2021, ASYR peaked in 15-19-year-olds at 39.906 (males) and 41.146 (females). South Asia, led by India (119.30 per 100,000), remained a high-burden hotspot. SDI correlated negatively with ASYR (ρ = -0.76, P < 0.001), with projections showing global YLDs declining to 863,352 person-years by 2040 (ASYR = 33.057).
While global progress has been made in reducing lead exposure-induced IDD, South Asia and low-SDI nations bear persistently high burdens. Strengthened international collaboration and targeted lead reduction policies are critical to advancing health equity for young people.
• Trend of the global disease burden of IDD attributed to lead exposure in the total population from 1990 to 2019.
• Trend of the global disease burden of IDD attributed to lead exposure in children and adolescents from 1990 to 2021, with projections up to 2040.
长期铅暴露会损害中枢神经系统，慢性铅中毒与智力发育障碍（IDD）密切相关，且对儿童和青少年的影响尤为严重。本研究利用《2021年全球疾病负担（GBD）》数据库，分析了全球儿童/青少年（1990 - 2021年）中铅所致IDD负担的时间、空间和特定人群趋势，并预测了到2040年的趋势，以为全球公共卫生战略提供参考。GBD 2021数据描述了铅所致IDD负担的全球、区域和国家分布情况。通过残疾生存年数（YLDs）和年龄标准化YLD率（ASYR）评估了与性别、年龄和社会人口指数（SDI）的关联。Joinpoint回归量化了年度负担变化，Nordpred模型预测了2021 - 2040年的趋势。在全球范围内，ASYR从每10万人58.088降至38.718（年度百分比变化率[AAPC] = -1.297%，P < 0.001），高SDI国家下降了54.0%（AAPC = -2.486%），而低SDI地区下降了32.8%。矛盾的是，低SDI地区的YLDs上升了39.7%。2021年，ASYR在15 - 19岁人群中达到峰值，男性为39.906，女性为41.146。以印度为首的南亚地区（每10万人119.30）仍然是高负担热点地区。SDI与ASYR呈负相关（ρ = -0.76，P < 0.001），预测显示到2040年全球YLDs将降至863,352人年（ASYR =
