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

背景(考古学) 可归因风险 环境卫生 人口 估计 相对风险 风险评估 医学 人口学 地理 置信区间 经济 内科学 社会学 考古 管理
作者
Mohammad H. Forouzanfar,Ashkan Afshin,Lily Alexander,Hugh Anderson,Zulfiqar A. Bhutta,Stan Biryukov,Michael Bräuer,Richard T. Burnett,Kelly Cercy,Fiona J Charlson,Aarón Cohen,Lalit Dandona,Kara Estep,Alize J. Ferrari,Joseph Frostad,Nancy Fullman,Peter W. Gething,William W Godwin,Max Griswold,Simon I Hay,Yohannes Kinfu,Hmwe Hmwe Kyu,Heidi J. Larson,Xiaofeng Liang,Stephen S Lim,Patrick Y Liu,Alan D. López,Rafael Lozano,Laurie B. Marczak,George A. Mensah,Ali H Mokdad,Maziar Moradi‐Lakeh,Mohsen Naghavi,B Neal,Marissa B Reitsma,Gregory A. Roth,Joshua A. Salomon,Patrick J Sur,Theo Vos,Joseph A. Wagner,Haidong Wang,Yi Zhao,Maigeng Zhou,Gunn Marit Aasvang,Amanuel Alemu Abajobir,Kalkidan Hassen Abate,Cristiana Abbafati,Kaja Abbas,Foad Abd‐Allah,Abdishakur Abdulle,Semaw Ferede Abera,Biju Abraham,Laith J Abu-Raddad,Gebre Yitayih Abyu,Akindele Olupelumi Adebiyi,Isaac Akinkunmi Adedeji,Zanfina Ademi,Arsène Kouablan Adou,José Adsuar,Emilie Agardh,Arnav Agarwal,Anurag Agrawal,Aliasghar Ahmad Kiadaliri,Oluremi N Ajala,Tomi Akinyemiju,Ziyad Al‐Aly,Khurshid Alam,Noore Alam,Saleh Fahed Aldhahri,Robert W Aldridge,Zewdie Aderaw Alemu,Raghib Ali,Ala’a Alkerwi,François Alla,Peter Allebeck,Ubai Alsharif,Khalid A Altirkawi,Elena Álvarez Martín,Nelson Alvis‐Guzmán,Azmeraw T Amare,Alemayehu Amberbir,A. Kofi Amegah,Heresh Amini,Walid Ammar,Stephen Marc Amrock,Hjalte Holm Andersen,Benjamin O. Anderson,Carl Abelardo T. Antonio,Palwasha Anwari,Johan Ärnlöv,Al Artaman,Hamid Asayesh,Rana Jawad Asghar,Reza Assadi,Suleman Atique,Euripide Frinel G Arthur Avokpaho,Ashish Awasthi,Beatriz Paulina Ayala Quintanilla,Peter Azzopardi,Umar Bacha,Alaa Badawi,María Cecilia Bahit,Kalpana Balakrishnan,Aleksandra Barać,Ryan M Barber,Suzanne Barker‐Collo,Till Bärnighausen,Sı́món Barquera,Lars Barregård,Lope H Barrero,Sanjay Basu,Carolina Batis,Shahrzad Bazargan‐Hejazi,Justin Beardsley,Neeraj Bedi,Ettore Beghi,Brent Bell,Michelle L. Bell,Aminu K. Bello,Derrick Bennett,Isabela Judith Martins Benseñor,Adugnaw Berhane,Eduardo Bernabé,Balem Demtsu Betsu,Addisu Shunu Beyene,Neeraj Bhala,Anil Bhansali,Samir Bhatt,Sibhatu Biadgilign,Boris Bikbov,Donal Bisanzio,Espen Bjertness,Jed D Blore,Rohan Borschmann,Soufiane Boufous,Rupert R A Bourne,Michael Brainin,Alexandra Bražinová,Nicholas J K Breitborde,Hermann Brugger,David M. Broday,Traolach Brugha,Bert Brunekreef,Zahid A Butt,Leah Cahill,Bianca Calabria,Ismael Campos-Nonato,Rosario Cárdenas,David O. Carpenter,Juan Jesús Carrero,Daniel Casey,Carlos Castañeda-Orjuela,Jacqueline Castillo Rivas,Rubén Castro,Ferrán Catalá‐López,Jung-Chen Chang,Peggy Pei-Chia Chiang,Mirriam Chibalabala,Odgerel Chimed‐Ochir,Vesper Hichilombwe Chisumpa,Abdulaal Chitheer,Jee‐Young Jasmine Choi,Hanne Christensen,Devasahayam Jesudas Christopher,Liliana G Ciobanu,Matthew M Coates,Samantha Colquhoun,Alejandra G Contreras Manzano,Leslie T. Cooper,Kimberly Cooperrider,Leslie Cornaby,Monica Cortinovis,John A. Crump,Lucía Cuevas‐Nasú,Albertino Damasceno,Rakhi Dandona,Sarah C. Darby,Paul I. Dargan,José das Neves,Adrian Davis,Kairat Davletov,Erika Castro,Vanessa De la Cruz‐Góngora,Diego De Leo,Louisa Degenhardt,Liana C Del Gobbo,Borja del Pozo‐Cruz,Robert P. Dellavalle,Amare Deribew,Don C. Des Jarlais,Samath Dhamminda Dharmaratne,Preet K. Dhillon,Cèsar Díaz-Torné,Daniel Dicker,Eric L. Ding,E. Ray Dorsey,Kerrie Doyle,Tim Driscoll,Leilei Duan,Manisha Dubey,Bruce Bartholow Duncan,Iqbal Elyazar,Aman Yesuf Endries,Sergey Petrovich Ermakov,Holly E. Erskine,Babak Eshrati,Alireza Esteghamati,Saman Fahimi,Emerito Jose A Faraon,Talha Farid,Carla Sofia e Sá Farinha,André Faro,Maryam S. Farvid,Farshad Farzadfar,Valery L. Feigin,Seyed‐Mohammad Fereshtehnejad,Jefferson Gomes Fernandes,Florian Fischer,Joseph R A Fitchett,Tom P. Fleming,Nataliya Foigt,Kyle J Foreman,F. G. R. Fowkes,Richard C. Franklin,T. H. Furst,Neal D. Futran,Emmanuela Gakidou,Alberto L. García‐Basteiro,Tsegaye Tewelde Gebrehiwot,Amanuel Tesfay Gebremedhin,J.M. Geleijnse,Bradford D. Gessner,Ababi Zergaw Giref,Maurice Giroud,Melkamu Dedefo Gishu,Giorgia Giussani,Shifalika Goenka,Mari Carmen Gómez-Cabrera,Héctor Gómez–Dantés,Philimon Gona,Amador Goodridge,Sameer Vali Gopalani,Carolyn Gotay,Atsushi Goto,Hebe Gouda,H. C. Gugnani,Françis Guillemin,Yuming Guo,Rahul Gupta,Rajeev Gupta,Reyna Alma Gutiérrez,Juanita A. Haagsma,Nima Hafezi‐Nejad,Demewoz Haile,Gessessew Bugssa Hailu,Yara A. Halasa,Randah Ribhi Hamadeh,Samer Hamidi,Alexis J. Handal,Graeme J. Hankey,Yuantao Hao,Hilda L Harb,Sivadasanpillai Harikrishnan,Josep María Haro,Mohammad Sadegh Hassanvand,Tahir Ahmed Hassen,Rasmus Havmoeller,Ileana Heredia-Pi,Norberto Francisco Hernández-Llanes,Pouria Heydarpour,Hans W. Hoek,Howard J. Hoffman,Masako Horino,Nobuyuki Horita,H. Dean Hosgood,Damian Hoy,Mohamed Hsaïri,Aung Soe Htet,Guoqing Hu,John J. Huang,Abdullatif Husseini,Sally Hutchings,Inge Huybrechts,Kim Moesgaard Iburg,Bulat Idrisov,Bogdan Ileanu,Manami Inoue,Troy Jacobs,Kathryn H. Jacobsen,Nader Jahanmehr,Mihajlo Jakovljević,Henrica A. F. M. Jansen,Simerjot K Jassal,Mehdi Javanbakht,Sudha Jayaraman,Achala Upendra Jayatilleke,Sun Ha Jee,Panniyammakal Jeemon,Vivekanand Jha,Ying Jiang,Tariku Jibat,Jin Ye,Catherine O. Johnson,Jost B. Jonas,Zubair Kabir,Yogeshwar Kalkonde,Ritul Kamal,Haidong Kan,André Karch,Corine Karema,Chanté Karimkhani,Amir Kasaeian,Anil Kaul,Norito Kawakami,Dhruv S. Kazi,Peter Njenga Keiyoro,Laura Kemmer,Andrew H. Kemp,André Pascal Kengne,Andre Keren,Chandrasekharan Nair Kesavachandran,Yousef Khader,Abdur Rahman Khan,Ejaz Ahmad Khan,Gulfaraz Khan,Young‐Ho Khang,Shahab Khatibzadeh,Sahil Khera,Tawfik Khoja,Jagdish Khubchandani,Christian Kieling,Cho‐il Kim,Daniel Kim,Ruth W Kimokoti,Niranjan Kissoon,Miia Kivipelto,Luke D. Knibbs,Yoshihiro Kokubo,Jacek A. Kopec,Parvaiz A Koul,Ai Koyanagi,Michael Kravchenko,Hans Kromhout,Hans Krueger,Tiffany Ku,Barthelemy Kuate Defo,Ricardo Kuchenbecker,Burcu Küçük Biçer,Ernst J. Kuipers,G Anil Kumar,Gene F. Kwan,Dharmesh Kumar Lal,Ratilal Lalloo,Tea Lallukka,Qing Lan,Anders Larsson,Asma Latif,Alicia Elena Beatriz Lawrynowicz,Janet Leasher,James Leigh,Janni Leung,Miriam Levi,Xiaohong Li,Yichong Li,Juan Liang,Shiwei Liu,Belinda Lloyd,Giancarlo Logroscino,Paulo A Lotufo,Raimundas Lunevičius,Michael F. MacIntyre,Mahdi Mahdavi,Marek Majdán,Azeem Majeed,Reza Malekzadeh,Déborah Carvalho Malta,Wondimu Ayele Manamo,Chabila C Mapoma,Wagner Marcenes,Randall V. Martin,José Martínez‐Raga,Felix Masiye,Kunihiro Matsushita,Richard Matzopoulos,Bongani M. Mayosi,John McGrath,Martin McKee,Peter A Meaney,Catalina Medina,Alem Mehari,Fabiola Mejía‐Rodríguez,Alemayehu Mekonnen,Yohannes Adama Melaku,Ziad A. Memish,Walter Mendoza,Gert Mensink,Atte Meretoja,Tuomo J Meretoja,Yonatan Moges Mesfin,Francis Mhimbira,Anoushka Millear,Ted R. Miller,Edward J. Mills,Mojde Mirarefin,Awoke Misganaw,Charles Mock,Alireza Mohammadi,Shafiu Mohammed,Glen Mola,Lorenzo Monasta,Julio Cesar Montañez Hernandez,Marcella Montico,Lidia Morawska,Rintaro Mori,Dariush Mozaffarian,U. Muêller,Erin C Mullany,John Everett Mumford,Gudlavalleti Venkata Satyanarayana Murthy,Jean B. Nachega,Aliya Naheed,Vinay Nangia,Nariman Nassiri,John Newton,Marie Ng,Quyen Le Nguyen,Muhammad Imran Nisar,Patrick Martial Nkamedjie Pete,Ole Frithjof Norheim,Rosana Norman,Bo Norrving,Luke Nyakarahuka,Carla Makhlouf Obermeyer,Felix Akpojene Ogbo,In‐Hwan Oh,Olanrewaju Oladimeji,Pedro Olivares,Helen Elizabeth Olsen,Bolajoko Olubukunola Olusanya,Jacob Olusegun Olusanya,John Nelson Opio,Eyal Oren,Ricardo Orozco,Alberto Ortíz,Erika Ota,Mahesh Pa,Adrian Pană,Eun‐Kee Park,Charles Parry,Mahboubeh Parsaeian,Tejas Patel,Angel J Paternina Caicedo,Snehal T Patil,Scott B. Patten,George C Patton,Neil Pearce,Paula B. Andrade,Norberto Perico,Konrad Pesudovs,Max Petzold,Michael R. Phillips,Frédéric B. Piel,Julian David Pillay,Dietrich Plaß,Suzanne Polinder,Constance Dimity Pond,C. Arden Pope,Daniel Pope,Svetlana Popova,Richie Poulton,Farshad Pourmalek,Noela M Prasad,Mostafa Qorbani,Rynaz H S Rabiee,Amir Radfar,Anwar Rafay,Vafa Rahimi‐Movaghar,Mahfuzar Rahman,Mohammad Hifz Ur Rahman,Sajjad Ur Rahman,Rajesh Kumar,Sasa Rajsic,Murugesan Raju,Usha Ram,Saleem M Rana,Kavitha Ranganathan,Puja C Rao,Christian Aspacia Razo García,Amany Refaat,Colin D. Rehm,Jürgen Rehm,Nikolas Reinig,Giuseppe Remuzzi,Serge Resnikoff,Antônio Luiz Pinho Ribeiro,Juan Rivera,Hirbo Shore Roba,Alina Rodriguez,Sonia Rodríguez‐Ramírez,David Rojas-Rueda,Yesenia Román,Luca Ronfani,Gholamreza Roshandel,Dietrich Rothenbacher,Ambuj Roy,Muhammad Muhammad Saleh,Juan Sanabria,Lídia Sànchez-Riera,María D. Sánchez-Niño,Tania G Sánchez‐Pimienta,Logan Sandar,Damian Santomauro,Itamar S Santos,Rodrigo Sarmiento-Suárez,Benn Sartorius,Maheswar Satpathy,Miloje Savic,Monika Sawhney,Josef Schmidhuber,María Inês Schmidt,Ione Jayce Ceola Schneider,Ben Schöttker,Aletta E. Schutte,David C. Schwebel,James G. Scott,Soraya Seedat,Sadaf G Sepanlou,Edson Serván‐Mori,Gavin Shaddick,Amira Shaheen,Saeid Shahraz,Masood Ali Shaikh,Teresa Shamah Levy,Rajesh Sharma,Jun She,Sara Sheikhbahaei,Jiabin Shen,Kevin N Sheth,Peilin Shi,Kenji Shibuya,Mika Shigematsu,Min Jeong Shin,Rahman Shiri,Kawkab Shishani,Ivy Shiue,Mark G. Shrime,Inga Dóra Sigfúsdóttir,Diego Augusto Santos Silva,Dayane Gabriele Alves Silveira,Jonathan I. Silverberg,Edgar P. Simard,Shireen Sindi,Abhishek Singh,Jasvinder A Singh,Prashant Kumar Singh,Erica Leigh Slepak,Michael Soljak,Samir Soneji,Reed J D Sorensen,Luciano A. Sposato,Chandrashekhar T Sreeramareddy,Vasiliki Stathopoulou,Nadine Steckling,Nicholas Steel,Dan J. Stein,Murray B. Stein,Heidi Stöckl,Saverio Stranges,Konstantinos Stroumpoulis,Bruno F. Sunguya,Soumya Swaminathan,Bryan L. Sykes,Cassandra Szoeke,Rafael Tabarés‐Seisdedos,Ken Takahashi,Roberto Tchio Talongwa,Nikhil Tandon,David Tanné,Mohammad Tavakkoli,Belaynew Wasie Taye,Hugh R. Taylor,Bemnet Amare Tedla,Worku Tefera,Teketo Kassaw Tegegne,Dejen Yemane Tekle,Abdullah Sulieman Terkawi,JS Thakur,Bernadette Thomas,Matthew L. Thomas,A. J. Thomson,Andrew L. Thorne‐Lyman,Amanda G Thrift,George D. Thurston,Taavi Tillmann,Ruoyan Tobe-Gai,Myriam Tobollik,Roman Topór‐Mądry,Fotis Topouzis,Jeffrey A. Towbin,Bach Xuan Tran,Zacharie Tsala Dimbuene,Nikolaos Tsilimparis,Abera Kenay Tura,E. Murat Tuzcu,Stefanos Tyrovolas,Kingsley N Ukwaja,Eduardo A. Undurraga,Chigozie Jesse Uneke,Olalekan A. Uthman,Aaron van Donkelaar,Jim van Os,Yuri Y Varakin,Tommi Vasankari,J. Lennert Veerman,Narayanaswamy Venketasubramanian,Francesco Saverio Violante,Stein Emil Vollset,Gregory R. Wagner,Stephen G. Waller,Jianli Wang,Lınhong Wang,Yanping Wang,Scott Weichenthal,Elisabete Weiderpass,Robert G. Weintraub,Andrea Werdecker,Ronny Westerman,Harvey Whiteford,Tissa Wijeratne,Charles Shey Wiysonge,Charles D A Wolfe,Sungho Won,Anthony D. Woolf,Mamo Wubshet,Denis Xavier,Gelin Xu,Ajit Kumar Yadav,Bereket Yakob,Ayalnesh Zemene Yalew,Yuichiro Yano,Mehdi Yaseri,Pengpeng Ye,Paul Yip,Naohiro Yonemoto,Seok-Jun Yoon,Mustafa Z Younis,Chuanhua Yu,Zoubida Zaidi,Maysaa El Sayed Zaki,Jun Zhu,Ben Zipkin,Sanjay Zodpey,Liesl Zühlke,Christopher J L Murray
出处
期刊:Faculty of Health; Institute of Health and Biomedical Innovation 被引量:1
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摘要

BACKGROUND The 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. METHODS We 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). FINDINGS Between 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. INTERPRETATION Declines 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. FUNDING Bill & Melinda Gates Foundation.
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