Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050

BackgroundWhile hypertension dominates intracerebral hemorrhage (ICH) risk globally, PM2.5 exacerbates health inequities through distinct ambient (APMP) and household (HAP) exposure pathways. Quantifying PM2.5-attributable burden across socioeconomic gradients remains critical for targeted intervent...

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Main Authors: Erman Wu, Riqing Su, Tong Tang, Guohua Zhu, Dangmurenjiafu Geng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1615934/full
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author Erman Wu
Erman Wu
Riqing Su
Tong Tang
Guohua Zhu
Dangmurenjiafu Geng
author_facet Erman Wu
Erman Wu
Riqing Su
Tong Tang
Guohua Zhu
Dangmurenjiafu Geng
author_sort Erman Wu
collection DOAJ
description BackgroundWhile hypertension dominates intracerebral hemorrhage (ICH) risk globally, PM2.5 exacerbates health inequities through distinct ambient (APMP) and household (HAP) exposure pathways. Quantifying PM2.5-attributable burden across socioeconomic gradients remains critical for targeted intervention.MethodsUsing Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized mortality (ASMR), disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) for PM2.5-attributable ICH. Joinpoint regression assessed trends (AAPC), while Bayesian Age-Period-Cohort modeling projected burdens to 2050. Pollution sources (APMP/HAP) were stratified by Socio-demographic Index (SDI).ResultsGlobally, PM2.5 caused 995,650 ICH - related deaths and 24,015,340 DALYs in 2021. From 1990 to 2021, the ASMR and disability rates for ICH due to PM2.5 exposure showed consistent declines globally (ASMR: −52.4%, DALYs: −53.1%, YLL: −53.4%, YLD: −40.7%), driven by HAP reductions. However, the absolute number of deaths and YLDs rose. The AAPC of the PM2.5 - related ICH burden also declined in the past 30 years. Nevertheless, projections indicate that by 2050, the PM2.5 - related ICH burden will increase. Low SDI regions exhibited 24.7 times higher ASMR than those in high SDI areas. Regionally, Asian regions (East/South/Southeast Asia) had the highest death counts of ICH due to PM2.5. APMP dominated in High SDI regions (e.g., Western Europe, North America, and Australasia), whereas HAP remained prevalent in low-SDI settings (e.g., Sub-Saharan Africa). Mortality disparities extended to demographics, with males experiencing 1.8 times higher ASMR than females, and the peak of fatalities shifting to older age groups (from 65–69 to 70–74 years). A strong inverse correlation emerged between SDI and the burden (ASMR-SDI: r = −0.76, p < 0.001).ConclusionAnalysis of GBD 2021 data reveals PM2.5-attributable ICH mortality in Low SDI regions is 24.7 times higher than High SDI areas, driven by HAP vs. APMP. Despite declining age-standardized rates globally (1990–2021), absolute DALYs and YLDs rose. Projections indicate burden resurgence by 2050. Considering population aging, gender and regional disparities (Asia and Sub-Saharan Africa bears highest burden), it is urgent to develop targeted strategies for APMP and HAP.
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spelling doaj-art-443b217c09fa4ec28e892fb2e15b473e2025-08-20T02:35:57ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.16159341615934Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050Erman Wu0Erman Wu1Riqing Su2Tong Tang3Guohua Zhu4Dangmurenjiafu Geng5Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, ChinaDepartment of Computer Science and Information Technologies, Elviña Campus, University of A Coruña, A Coruña, SpainDepartment of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, ChinaDepartment of Computer Science and Information Technologies, Elviña Campus, University of A Coruña, A Coruña, SpainDepartment of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, ChinaBackgroundWhile hypertension dominates intracerebral hemorrhage (ICH) risk globally, PM2.5 exacerbates health inequities through distinct ambient (APMP) and household (HAP) exposure pathways. Quantifying PM2.5-attributable burden across socioeconomic gradients remains critical for targeted intervention.MethodsUsing Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized mortality (ASMR), disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) for PM2.5-attributable ICH. Joinpoint regression assessed trends (AAPC), while Bayesian Age-Period-Cohort modeling projected burdens to 2050. Pollution sources (APMP/HAP) were stratified by Socio-demographic Index (SDI).ResultsGlobally, PM2.5 caused 995,650 ICH - related deaths and 24,015,340 DALYs in 2021. From 1990 to 2021, the ASMR and disability rates for ICH due to PM2.5 exposure showed consistent declines globally (ASMR: −52.4%, DALYs: −53.1%, YLL: −53.4%, YLD: −40.7%), driven by HAP reductions. However, the absolute number of deaths and YLDs rose. The AAPC of the PM2.5 - related ICH burden also declined in the past 30 years. Nevertheless, projections indicate that by 2050, the PM2.5 - related ICH burden will increase. Low SDI regions exhibited 24.7 times higher ASMR than those in high SDI areas. Regionally, Asian regions (East/South/Southeast Asia) had the highest death counts of ICH due to PM2.5. APMP dominated in High SDI regions (e.g., Western Europe, North America, and Australasia), whereas HAP remained prevalent in low-SDI settings (e.g., Sub-Saharan Africa). Mortality disparities extended to demographics, with males experiencing 1.8 times higher ASMR than females, and the peak of fatalities shifting to older age groups (from 65–69 to 70–74 years). A strong inverse correlation emerged between SDI and the burden (ASMR-SDI: r = −0.76, p < 0.001).ConclusionAnalysis of GBD 2021 data reveals PM2.5-attributable ICH mortality in Low SDI regions is 24.7 times higher than High SDI areas, driven by HAP vs. APMP. Despite declining age-standardized rates globally (1990–2021), absolute DALYs and YLDs rose. Projections indicate burden resurgence by 2050. Considering population aging, gender and regional disparities (Asia and Sub-Saharan Africa bears highest burden), it is urgent to develop targeted strategies for APMP and HAP.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1615934/fullPM2.5intracerebral hemorrhagehealth disparitiesGBD 2021temporal trends
spellingShingle Erman Wu
Erman Wu
Riqing Su
Tong Tang
Guohua Zhu
Dangmurenjiafu Geng
Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050
Frontiers in Public Health
PM2.5
intracerebral hemorrhage
health disparities
GBD 2021
temporal trends
title Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050
title_full Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050
title_fullStr Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050
title_full_unstemmed Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050
title_short Ambient versus household PM2.5 exposure and socioeconomic disparities in intracerebral hemorrhage burden: a 32-year global analysis (1990–2021) with projections to 2050
title_sort ambient versus household pm2 5 exposure and socioeconomic disparities in intracerebral hemorrhage burden a 32 year global analysis 1990 2021 with projections to 2050
topic PM2.5
intracerebral hemorrhage
health disparities
GBD 2021
temporal trends
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1615934/full
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