Global, regional, and national burden and attributable risk factors of chronic respiratory diseases from 1990 to 2021 and projections to 2030.

Chronic respiratory diseases (CRDs) constitute a major global health burden, yet comprehensive assessments of their long-term trends, attributable risks, and future trajectories are still needed to inform public health strategies. Comprehensively analysing the global, regional, and national burden of CRDs from 1990 to 2021, evaluating the risk factors, and forecasting future trends to guide public health policies. Using the Global Burden of Diseases (GBD) 2021 data, we estimated the incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of CRDs from 1990 to 2021. The estimated annual percentage change (EAPC) was calculated to evaluate burden trends, and a Bayesian age-period-cohort model predicted the trends in age-standardized rates (ASRs). In 2021, global CRD incidence reached 55.21 million, with 4.41 million deaths. Among all CRDs, asthma exhibited the highest incidence and prevalence, whereas chronic obstructive pulmonary disease (COPD) caused the highest mortality and DALY. Regionally, High-income North America had the highest ASIR and ASPR of CRDs, while Oceania showed the highest ASMR and ASDR in 2021. In terms of age distribution, the incidences of COPD, interstitial lung disease and pulmonary sarcoidosis (ILD & PS), and pneumoconiosis (PNE) were the highest number of incident cases occurred in the 65-74 age group. Asthma, however, showed the highest incidence in the < 9 age group. Regarding risk factors, smoking caused 31.04% of all CRD-related deaths globally in 2021, while high body mass index accounted for 14.36% of asthma-related deaths. From 2022 to 2030, CRDs' ASIRs are projected to decline overall, with male ASIRs higher than female ASIRs. The findings reveal significant and uneven global CRD burden, and their mitigation warrants policy focus on tobacco control and obesity management.