THE BURDEN OF CHRONIC NON-COMMUNICABLE LUNG DISEASES IN THE UNITED STATES: AN ANALYSIS OF THE GLOBAL BURDEN OF DISEASES DATABASE 1990-2019

SESSION TITLE: Lung Pathology Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: The burden of chronic lung diseases (CLDs) continues to increase worldwide, particularly in affluent nations (Lancet 2020). However, little is known about specific trends in the United States (US). We aim to describe the prevalence, mortality rate and disease burden in terms of disability adjusted life years (DALYs) of CLDs in the US. METHODS: We analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2019 study. The source data is freely available at the Global Health Data Exchange. The GBD database categorizes CLDs as follows: asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. Age standardized rates per 100,000 population for mortality, prevalence and DALYs for years 1990 and 2019 were obtained for each CLD. We performed comparative analyses for these variables for each state. We also evaluated the changes in these variables between 1990 and 2019 along with the changes in the sociodemographic index for each state using temporal trend analyses. Risk factors attributed to each CLD related DALYs were examined for the 2019 data. These risk factors included smoking, exposure to second-hand smoke, household air pollution from solid fuels, ambient particulate matter pollution, ambient ozone pollution, and occupational exposures. RESULTS: In 2019, CLDs accounted for 6.7% of all non-communicable diseases with COPD as the leading cause followed by asthma. Asthma accounted for majority of DALYs until age 45 after which COPD was the major contributor. Age standardized mortality rates increased by 19.3% between 1990 and 2019. Women accounted for majority of increased mortality rate compared to men, 41% vs 12.9%, respectively. The highest mortality rate and DALYs (descending order) were seen in West Virginia (WV), Kentucky and Alabama while the lowest mortality rate and DALYs (ascending order) was seen in Hawaii, District of Columbia and California (CA). CA had the highest reduction in age adjusted mortality between 1990 and 2019. Regarding risk factors related DALYs, smoking was the most frequent contributor followed by occupational exposures nationwide. Interestingly, in WV, occupational exposures had the most significant contribution to DALYs as compared to other states. CONCLUSIONS: We found that the prevalence and mortality rates of CLDs continue to increase in the US. Interestingly, some midwestern and southern states carry a larger burden of CLDs and DALYs. Potential reasons include higher poverty rates and higher smoking prevalence in these states compared to the national average (CDC). Another reason could be lower adoption of Medicaid in these states and thus lower access to healthcare leading to increased DALYs due to CLD. CLINICAL IMPLICATIONS: Understanding the regional prevalence, burden, mortality and risk factors for CLDs provides valuable information to guide policy development and interventions. DISCLOSURES: No relevant relationships by Saeed Abughazaleh No relevant relationships by Saqr Alsakarneh No relevant relationships by Hamza Alzghoul No relevant relationships by Bashar Alzghoul No relevant relationships by Christopher Bray No relevant relationships by Mohammed Ghazzawi No relevant relationships by Mohammad Khrais No relevant relationships by Borna Mehrad No relevant relationships by Omar Obeidat No relevant relationships by Raju Reddy No relevant relationships by Lauran Zeineddine