Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015.
Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015.
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DOI：
10.1016/s0140-6736(17)30505-6
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发表时间：
2017-05-13
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影响因子：
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通讯作者：
Forouzanfar MH
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文献类型：
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作者：
Cohen AJ;Brauer M;Burnett R;Anderson HR;Frostad J;Estep K;Balakrishnan K;Brunekreef B;Dandona L;Dandona R;Feigin V;Freedman G;Hubbell B;Jobling A;Kan H;Knibbs L;Liu Y;Martin R;Morawska L;Pope CA 3rd;Shin H;Straif K;Shaddick G;Thomas M;van Dingenen R;van Donkelaar A;Vos T;Murray CJL;Forouzanfar MH
暴露于环境空气污染会增加发病率和死亡率，是造成全球疾病负担的主要因素。我们探讨了1990年至2015年全球、区域和国家各级环境空气污染导致的死亡率和疾病负担的时空趋势。我们估计了全球人口加权平均浓度的颗粒物的空气动力学直径小于2.5 μm（PM2.5）和臭氧在约11公里× 11公里的分辨率与卫星为基础的估计，化学传输模型，和地面测量。 我们使用每种死因的综合死亡率-反应函数，估计缺血性心脏病、脑血管病、慢性阻塞性肺疾病、肺癌和下呼吸道感染的死亡率相对风险，这些死亡率来自使用非线性死亡率-反应函数的流行病学研究，涵盖全球暴露范围。PM2·5是2015年第五大死亡风险因素。2015年，暴露于PM2·5导致420万（95%不确定性区间[UI] 370万至480万）死亡和1.031亿（9080万1.151亿）残疾调整生命年（DADs），占全球死亡总数的7.6%和全球DADs的4.2%，其中59%在东亚和南亚。可归因于环境PM2·5的死亡人数从1990年的350万（95% UI 300万至400万）增加到2015年的420万（370万至480万）。2015年，暴露于臭氧导致额外的254000（95%UI 97000 - 422000）例死亡和410万（160万至680万）DALLS因慢性阻塞性肺病而损失。 2015年，由于人口老龄化、非传染性疾病发病率的变化以及低收入和中等收入国家空气污染的增加，环境空气污染对全球疾病负担的贡献很大。除非PM2·5值大幅下降，否则污染最严重的国家的负担将略有减轻，但减少暴露可能会带来重大健康益处。比尔和梅林达盖茨基金会和健康影响研究所。
Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels. We estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM2·5) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements. Using integrated exposure–response functions for each cause of death, we estimated the relative risk of mortality from ischaemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infections from epidemiological studies using non-linear exposure–response functions spanning the global range of exposure. Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015. Ambient air pollution contributed substantially to the global burden of disease in 2015, which increased over the past 25 years, due to population ageing, changes in non-communicable disease rates, and increasing air pollution in low-income and middle-income countries. Modest reductions in burden will occur in the most polluted countries unless PM2·5 values are decreased substantially, but there is potential for substantial health benefits from exposure reduction. Bill & Melinda Gates Foundation and Health Effects Institute.