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Global, regional, andnational comparativerisk assessment of 79behavioural,environmental andoccupational, andmetabolic risks orclusters of risks,1990… Mohammad H ForouzanfarLily AlexanderH Ross Anderson2016 год

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
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Аннотация: BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context.MethodsWe used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI).FindingsBetween 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa.InterpretationDeclines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden.FundingBill & Melinda Gates Foundation.
Год издания: 2016
Авторы: Mohammad H Forouzanfar, Lily Alexander, H Ross Anderson, Victoria F Bachman, Stan Biryukov, Michael Bräuer, Richard Burnett, Daniel Casey, Matthew M Coates, Aaron J. Cohen, Kristen Delwiche, Kara Estep, Joseph Frostad, Alize J Ferrari, Hmwe Hmwe Kyu, Maziar Moradi‐Lakeh, Marie Ng, Erica Leigh Slepak, Bernadette A Thomas, Joseph Wagner, Gunn Marit Aasvang, Cristiana Abbafati, Eyal Oren, Foad Abd-Allah, Semaw Ferede Abera, Victor Aboyans, Biju Abraham, Jerry Puthenpurakal Abraham, Ibrahim Abubakar, Niveen M E Abu-Rmeileh, Tania C Aburto, Tom Achoki, Ademola Adelekan, Koranteng Adofo, Arsène Kouablan Adou, José Carmelo Adsuar, Ashkan Afshin, Emilie Agardh, Mazin J Al Khabouri, Faris Lami, Khurshid Alam, Deena Alasfoor, Mohammed I Albittar, Miguel Alegretti, Alicia V Aleman, Zewdie Aderaw Alemu, Rafael Alfonso‐Cristancho, Samia Alhabib, Raghib Ali, Mohammed K. Ali, François Alla, Peter Allebeck, Peter J. Allen, Ubai Alsharif, Elena Álvarez, Nelson Alvis‐Guzmán, Adansi A. Amankwaa, Azmeraw T. Amare, Emmanuel A Ameh, Omid Ameli, Heresh Amini, Walid Ammar, Benjamin O. Anderson, Carl Abelardo T. Antonio, Palwasha Anwari, Solveig Argeseanu Cunningham, Johan Ärnlöv, Valentina Arsić‐Arsenijević, Al Artaman, Rana J Asghar, Reza Assadi, Lydia S Atkins, Charles Atkinson, Marco A Avila, Baffour Awuah, Alaa Badawi, Maria C Bahit, Talal Bakfalouni, Kalpana Balakrishnan, Shivanthi Balalla, Ravi Kumar Balu, Amitava Banerjee, Ryan M Barber, Suzanne L Barker-Collo, Sı́món Barquera, Lars Barregard, Lope H Barrero, Tonatiuh Barrientos-Gutierrez, Ana Basto‐Abreu, Arindam Basu, Sanjay Basu, Mohammed Basulaiman, Carolina Batis, Justin Beardsley, Neeraj Bedi, Tolesa Bekele, Michelle L. Bell, Corina Benjet, Derrick Bennett, Habib Benzian, Eduardo Bernabé, Tariku J. Beyene, Neeraj Bhala, Ashish Bhalla, Zulfiqar A Bhutta, Boris Bikbov, Aref A. Bin Abdulhak, Jed D Blore, Fiona Blyth, Megan A Bohensky, Berrak Bora Başara, Guilherme Borges, Natan M. Bornstein, Dipan Bose, Soufiane Boufous, Rupert R Bourne, Michael Brainin, Alexandra Bražinová, Nicholas J Breitborde, Hermann Brenner, Adam Briggs, David M. Broday, Peter M Brooks, Nigel Bruce, Traolach Brugha, Bert Brunekreef, Rachelle Buchbinder, Linh N Bui, Gene Bukhman, Andrew GM Bulloch, Michael Burch, Peter Burney, Ismael Campos‐Nonato, Julio C Campuzano, Alejandra J Cantoral, Jack Caravanos, Rosario Cárdenas, Elisabeth Cardis, David O. Carpenter, Valeria Caso, Carlos A Castañeda-Orjuela, Rubén Castro, Ferrán Catalá-López, Fiorella Cavalleri, Alanur Çavlin, Vineet K Chadha, Jung-Chen Chang, Fiona J Charlson, Honglei Chen, Wanqing Chen, Zhengming Chen, Peggy Pei-Chia Chiang, Odgerel Chimed‐Ochir, Rajiv Chowdhury, Costas A Christophi, Ting-Wu Chuang, Sumeet S. Chugh, Massimo Círillo, Thomas Claßen, Valentina Colistro, Mercedes Colomar, Samantha Colquhoun, Alejandra Contreras‐Manzano, Cyrus Cooper, Kimberly Cooperrider, Leslie T Cooper, Josef Coresh, Karen Courville, Michael H Criqui, Lucía Cuevas‐Nasú, James Damsere-Derry, Hadi Danawi, Lalit Dandona, Rakhi Dandona, Paul I. Dargan, Adrian Davis, Dragoș Davițoiu, Anand Dayama, E. Castro, Vanessa De La Cruz-Góngora, Diego De Leo, Graça de Lima, Louisa Degenhardt, Borja del Pozo Cruz, Robert P Dellavalle, Kebede Deribe, Sarah Derrett, Don C Des Jarlais, Muluken Dessalegn, Gabrielle deVeber, Karen Devries, Samath D Dharmaratne, Mukesh Dherani, Daniel Dicker, Eric L. Ding, Клара Докова, E. Ray Dorsey, Tim Driscoll, Leilei Duan, Adnan M Durrani, Beth E Ebel, Richard G. Ellenbogen, Yousef M Elshrek, Matthias Endres, Sergey Petrovich Ermakov, Holly E Erskine, Babak Eshrati, Alireza Esteghamati, Saman Fahimi, Emerito Jose A Faraon, Farshad Farzadfar, Derek F J Fay, Valery L. Feigin, Andrea B Feigl, Seyed-Mohammad Fereshtehnejad, Alize J Ferrari, Cleusa P. Ferri, Abraham D Flaxman, Thomas Fleming, Nataliya A Foigt, Kyle J Foreman, Urbano Fra Paleo, Richard C. Franklin, Belinda Gabbe, Lynne Gaffikin, Emmanuela Gakidou, Amiran Gamkrelidze, Fortuné Gankpe, Ron T. Gansevoort, Francisco A García-Guerra, Evariste Gasana, Johanna M. Geleijnse, Bradford D. Gessner, Peter W. Gething, Katherine B Gibney, Richard F Gillum, Ibrahim a M Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ketevan Goginashvili, Héctor Gómez Dantés, Philimon Gona, Teresita González de Cosío, Dinorah González-Castell, Carolyn Gotay, Atsushi Goto, Hebe N Gouda, Richard L. Guerrant, H. C. Gugnani, Francis Guillemin, David Gunnell, Rahul Gupta, Rajeev Gupta, Reyna Alma Gutiérrez, Nima Hafezi‐Nejad, Holly Hagan, Maria Hagstromer, Yara A. Halasa, Randah R Hamadeh, Mouhanad Hammami, Graeme J. Hankey, Yuantao Hao, Hilda L Harb, Tilahun Nigatu Haregu, Josep Maria Haro, Rasmus Havmoeller, Simon I Hay, Mohammad T Hedayati, Ileana Heredia-Pi, Lucía Hernández, Kyle R Heuton, Pouria Heydarpour, Martha Hı́jar, Hans W. Hoek, Howard J. Hoffman, John Hornberger, Hung Chak Ho, Damian G Hoy, Mohamed Hsaïri, Guoqing Hu, Howard Hu, Cheng Huang, John J Huang, Bryan J Hubbell, Laetitia Huiart, Abdullatif Husseini, Marissa Iannarone, Kim M Iburg, Bulat Idrisov, Nayu Ikeda, Kaire Innos, Manami Inoue, Farhad Islami, Samaya Ismayilova, Kathryn H. Jacobsen, Henrica A. F. M. Jansen, Deborah Jarvis, Simerjot K Jassal, Alejandra Jauregui, Sudha Jayaraman, Panniyammakal Jeemon, Paul N. Jensen, Vivekanand Jha, Fan Jiang, Guohong Jiang, Ying Jiang, Jost B. Jonas, Knud Juel, Haidong Kan, Sidibe S Kany Roseline, Nadim E Karam, André Karch, Corine Karema, Ganesan Karthikeyan, Anil Kaul, Norito Kawakami, Dhruv S Kazi, Andrew H. Kemp, André Pascal Kengne, Andre Keren, Yousef Khader, Shams Eldin Ali Hassan Khalifa, Ejaz Ahmad Khan, Young‐Ho Khang, Shahab Khatibzadeh, Irma Khonelidze, Christian Kieling, Daniel Kim, Sungroul Kim, Yunjin Kim, Ruth W Kimokoti, Yohannes Kinfu, Jonas M Kinge, Brett M Kissela, Miia Kivipelto, Luke D. Knibbs, Ann Kristin Knudsen, Yoshihiro Kokubo, Parvaiz A Koul, Soewarta Kosen, Alexander Kraemer, Michael Kravchenko, Sanjay Krishnaswami, Hans Kromhout, Tiffany Ku, Barthélémy Kuate Defo, Burcu Küçük Biçer, Ernst J. Kuipers, Chanda Kulkarni, Veena S Kulkarni, G Anil Kumar, Gene F. Kwan, Taavi Lai, Arjun Lakshmana Balaji, Ratilal Lalloo, Tea Lallukka, Hilton Y. Lam, Qing Lan, Van Charles Lansingh, Heidi J. Larson, Anders Larsson, Dennis Odai Laryea, Pablo M Lavados, Alicia Elena Beatriz Lawrynowicz, Janet L Leasher, Jong-Tae Lee, James Leigh, Janni Leung, Miriam Levi, Li Y, Yongmei Li, Juan Liang, Xiaofeng Liang, Stephen S Lim, M. Patrice Lindsay, Steven E. 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Издательство: Elsevier BV
Источник: The Lancet
Ключевые слова: Climate Change and Health Impacts, Health disparities and outcomes, Air Quality and Health Impacts
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