Objectives This paper presents detailed analysis of the global and regional burden of chronic respiratory disease arising from occupational airborne exposures, as estimated in the Global Burden of Disease 2016 study.
Methods The burden of chronic obstructive pulmonary disease (COPD) due to occupational exposure to particulate matter, gases and fumes, and secondhand smoke, and the burden of asthma resulting from occupational exposure to asthmagens, was estimated using the population attributable fraction (PAF), calculated using exposure prevalence and relative risks from the literature. PAFs were applied to the number of deaths and disability-adjusted life years (DALYs) for COPD and asthma. Pneumoconioses were estimated directly from cause of death data. Age-standardised rates were based only on persons aged 15 years and above.
Results The estimated PAFs (based on DALYs) were 17% (95% uncertainty interval (UI) 14%–20%) for COPD and 10% (95% UI 9%–11%) for asthma. There were estimated to be 519 000 (95% UI 441,000–609,000) deaths from chronic respiratory disease in 2016 due to occupational airborne risk factors (COPD: 460,100 [95% UI 382,000–551,000]; asthma: 37,600 [95% UI 28,400–47,900]; pneumoconioses: 21,500 [95% UI 17,900–25,400]. The equivalent overall burden estimate was 13.6 million (95% UI 11.9–15.5 million); DALYs (COPD: 10.7 [95% UI 9.0–12.5] million; asthma: 2.3 [95% UI 1.9–2.9] million; pneumoconioses: 0.58 [95% UI 0.46–0.67] million). Rates were highest in males; older persons and mainly in Oceania, Asia and sub-Saharan Africa; and decreased from 1990 to 2016.
Conclusions Workplace exposures resulting in COPD, asthma and pneumoconiosis continue to be important contributors to the burden of disease in all regions of the world. This should be reducible through improved prevention and control of relevant exposures.
- occupational exposure
- occupational asthma
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Collaborators Collaborators details are as follows: Tim Driscoll, Kyle Steenland, Neil Pearce, Lesley Rushton, Sally J. Hutchings, Kurt Straif, Degu Abate, Dilaram Acharya, Anurag Agrawal, Fares Alahdab, Kefyalew Addis Alene, Sofia Androudi, Mina Anjomshoa, Carl Abelardo T. Antonio, Olatunde Aremu, Zerihun Ataro, Alaa Badawi, Joseph Adel Mattar Banoub, Suzanne Lyn Barker-Collo, Neeraj Bedi, Derrick A. Bennett, Robert Bernstein214, Mircea Beuran, Krittika Bhattacharyya, Ali Bijani, Zahid A. Butt, Juan J. Carrero, Carlos A. Castañeda-Orjuela, Odgerel Chimed-Ochir, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Ahmad Daryani, Beruk Berhanu Desalegn, Samath Dhamminda Dharmaratne, Shirin Djalalinia, Eleonora Dubljanin, Soheil Ebrahimpour, Ziad El-Khatib, Mohammad Fareed, Andre Faro, Eduarda Fernandes, Florian Fischer, Takeshi Fukumoto, Silvano Gallus, Teklu Gebrehiwo Gebremichael, Kebede Embaye Gezae, Ayman Grada, Yuming Guo, Rahul Gupta, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Samer Hamidi, Mehedi Hasan, Milad Hasankhani, Simon I. Hay, Chi Linh Hoang, Michael K. Hole, H Dean Hosgood, Mihaela Hostiuc, Sorin Hostiuc, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Mihajlo Jakovljevic, Ravi Prakash Jha, Jost B. Jonas, Amaha Kahsay, Amir Kasaeian, Norito Kawakami, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Ejaz Ahmad Khan, Mohammad Hossein Khosravi, Jagdish Khubchandani, Yun Jin Kim, Ruth W. Kimokoti, Adnan Kisa, Manolis Kogevinas215, Soewarta Kosen, Parvaiz A. Koul, Ai Koyanagi, Barthelemy Kuate Defo, G Anil Kumar, Dharmesh Kumar Lal, Arman Latifi, James Leigh, Miriam Levi, Shanshan Li, Shai Linn, Narayan Bahadur Mahotra, Marek Majdan, Reza Malekzadeh, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Benjamin Ballard Massenburg, Varshil Mehta, Addisu Melese, Mulugeta Melku, Ziad A. Memish, Walter Mendoza, Tuomo J. Meretoja, Tomislav Mestrovic, GK Mini, Erkin M. Mirrakhimov, Babak Moazen, Naser Mohammad Gholi Mezerji, Shafiu Mohammed, Ali H Mokdad, Lorenzo Monasta, Yoshan Moodley, Mahmood Moosazadeh, Ghobad Moradi, Lidia Morawska, Shane Douglas Morrison, Seyyed Meysam Mousavi, Ghulam Mustafa, Vinay Nangia, Ionut Negoi, Ruxandra Irina Negoi, Cuong Tat Nguyen, Trang Huyen Nguyen, Molly R. Nixon, Richard Ofori-Asenso, Felix Akpojene Ogbo, Andrew T. Olagunju, Bolajoko Olubukunola Olusanya, Mahesh P A, Songhomitra Panda-Jonas, Eun-Kee Park, Sanghamitra Pati, Mostafa Qorbani, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Fatemeh Rajati, Robert C. Reiner, Satar Rezaei, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Basema Saddik, Saeid Safiri, Mohammad Ali Sahraian, Abdallah M. Samy, David C. Schwebel, Sadaf G. Sepanlou, Berrin Serdar, Masood Ali Shaikh, Aziz Sheikh, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Si Si, João Pedro Silva, Dhirendra Narain Sinha, Moslem Soofi, Joan B. Soriano, Chandrashekhar T. Sreeramareddy, Jeffrey D. Stanaway, Mark A. Stokes, Mu'awiyyah Babale Sufiyan, Ipsita Sutradhar, Rafael Tabarés-Seisdedos, Ken Takahashi, Yonatal Mesfin Tefera, Mohamad-Hani Temsah, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Lorainne Tudor Car, Irfan Ullah, Pascual R. Valdez, Job F. M. van Boven, Tommi Juhani Vasankari, Francesco S. Violante, Giang Thu Vu, Gregory R. Wagner, Yasir Waheed, Yuan-Pang Wang, Biruck Desalegn Yirsaw, Naohiro Yonemoto, Chuanhua Yu, Mohammad Zamani, and Stephen S. Lim (online supplementary file)
Contributors The draft manuscript was prepared by Tim Driscoll, with input from Sally Hutchings, Lesley Rushton, Kyle Steenland and Kurt Straif. All listed authors have contributed appropriately to the GBD project and to the review and modification of the manuscript. The final manuscript was prepared by TD following comments from co-authors and Journal reviewers and editors.
Funding The overall GBD study is partly funded by the Bill & Melinda Gates Foundation. The work reported in this paper was partly supported by funding from the World Health Organization. The funders had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The authors had access to the data in the study and the final responsibility to submit the paper.
Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests CATA reports personal fees from Johnson & Johnson (Philippines), Inc., outside the submitted work. NK reports personal fees from Junpukai Foundation and Softbank, Co.; and grants from Fujitsu, LTD, Fujitsu Software Technologies, LTD and Softbank, Co., outside the submitted work. JK reports grants from Merck Pharmaceuticals, outside the submitted work. TJM reports grants from Cancer Foundation Finland sr., during the conduct of the study.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. The data on which this analysis is based are available on the GBD Compare web site (https://vizhub.healthdata.org/gbd-compare/). Some of the raw data (where data owners give permission or where it is already public access) is available on the data section of the IHME GBD web site (http://www.healthdata.org/gbd/data).
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