Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021
Objectives This study aims to systematically assess the global, regional, and national burden of asthma attributable to nitrogen dioxide (NO₂) pollution.Design and setting Analysis of population-level data from 1990 to 2021 obtained from the Global Burden of Disease Study 2021, covering 204 countrie...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e095210.full |
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| author | Chunyi Zhang Jian Sun Jingli Li E Qin Lingjing Liu Guimei Pu |
| author_facet | Chunyi Zhang Jian Sun Jingli Li E Qin Lingjing Liu Guimei Pu |
| author_sort | Chunyi Zhang |
| collection | DOAJ |
| description | Objectives This study aims to systematically assess the global, regional, and national burden of asthma attributable to nitrogen dioxide (NO₂) pollution.Design and setting Analysis of population-level data from 1990 to 2021 obtained from the Global Burden of Disease Study 2021, covering 204 countries and territories.Participants Participants included patients with asthma attributable to NO₂ pollution.Main outcomes and measures Asthma-related disability-adjusted life-years (DALYs) and age-standardised DALY rates (ASDR) attributable to NO₂ pollution across 204 countries and territories. The estimated annual percentage change (EAPC) was used to assess temporal trends to identify regions with increasing or decreasing asthma burdens.Results In 2021, NO₂ pollution contributed to approximately 176.73 thousand DALYs globally, with an ASDR of 2.48 per 100 000 population (95% uncertainty interval (UI) −2.26 to 10.30). The global ASDR declined significantly from 1990 to 2021, with an EAPC of −1.93% (95% CI −2.14% to −1.72%). High-income North America had the highest ASDR (10.74 per 100 000; 95% UI 10.12 to 46.56), while Australasia experienced the most significant reduction in ASDR over the study period (EAPC −3.92%; 95% CI −4.46% to −3.37%). In contrast, Oceania and Southeast Asia showed increasing trends in asthma burden, with EAPCs of 2.33% (95% CI 1.57% to 3.10%) and 1.14% (95% CI 0.81% to 1.47%), respectively. The 5–9 age group carried the highest asthma burden, reflecting the vulnerability of younger children to NO₂ exposure. A positive correlation between ASDR and sociodemographic index (SDI) was observed (R=0.637, p<0.001), indicating a greater asthma burden in higher SDI regions.Conclusion The findings highlight significant regional and demographic disparities in asthma burden attributable to NO₂ pollution. Tailored public health strategies are needed to address the rising burden in vulnerable regions. Future research should focus on identifying effective interventions to reduce NO₂ exposure and improve asthma outcomes, especially in rapidly developing areas. |
| format | Article |
| id | doaj-art-8d36f9eea43c4ce384332c93514ad59e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-8d36f9eea43c4ce384332c93514ad59e2025-02-07T06:25:13ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-095210Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021Chunyi Zhang0Jian Sun1Jingli Li2E Qin3Lingjing Liu4Guimei Pu51 Shaoxing People`s Hospital, Shaoxing, Zhejiang, China1 Shaoxing People`s Hospital, Shaoxing, Zhejiang, China1 Shaoxing People`s Hospital, Shaoxing, Zhejiang, China1 Shaoxing People`s Hospital, Shaoxing, Zhejiang, China2 Wenzhou Medical University First Affiliated Hospital, Wenzhou, Zhejiang, China1 Shaoxing People`s Hospital, Shaoxing, Zhejiang, ChinaObjectives This study aims to systematically assess the global, regional, and national burden of asthma attributable to nitrogen dioxide (NO₂) pollution.Design and setting Analysis of population-level data from 1990 to 2021 obtained from the Global Burden of Disease Study 2021, covering 204 countries and territories.Participants Participants included patients with asthma attributable to NO₂ pollution.Main outcomes and measures Asthma-related disability-adjusted life-years (DALYs) and age-standardised DALY rates (ASDR) attributable to NO₂ pollution across 204 countries and territories. The estimated annual percentage change (EAPC) was used to assess temporal trends to identify regions with increasing or decreasing asthma burdens.Results In 2021, NO₂ pollution contributed to approximately 176.73 thousand DALYs globally, with an ASDR of 2.48 per 100 000 population (95% uncertainty interval (UI) −2.26 to 10.30). The global ASDR declined significantly from 1990 to 2021, with an EAPC of −1.93% (95% CI −2.14% to −1.72%). High-income North America had the highest ASDR (10.74 per 100 000; 95% UI 10.12 to 46.56), while Australasia experienced the most significant reduction in ASDR over the study period (EAPC −3.92%; 95% CI −4.46% to −3.37%). In contrast, Oceania and Southeast Asia showed increasing trends in asthma burden, with EAPCs of 2.33% (95% CI 1.57% to 3.10%) and 1.14% (95% CI 0.81% to 1.47%), respectively. The 5–9 age group carried the highest asthma burden, reflecting the vulnerability of younger children to NO₂ exposure. A positive correlation between ASDR and sociodemographic index (SDI) was observed (R=0.637, p<0.001), indicating a greater asthma burden in higher SDI regions.Conclusion The findings highlight significant regional and demographic disparities in asthma burden attributable to NO₂ pollution. Tailored public health strategies are needed to address the rising burden in vulnerable regions. Future research should focus on identifying effective interventions to reduce NO₂ exposure and improve asthma outcomes, especially in rapidly developing areas.https://bmjopen.bmj.com/content/15/2/e095210.full |
| spellingShingle | Chunyi Zhang Jian Sun Jingli Li E Qin Lingjing Liu Guimei Pu Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021 BMJ Open |
| title | Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021 |
| title_full | Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021 |
| title_fullStr | Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021 |
| title_full_unstemmed | Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021 |
| title_short | Global, regional and national burden of asthma attributable to NO2 from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021 |
| title_sort | global regional and national burden of asthma attributable to no2 from 1990 to 2021 an analysis from the global burden of disease study 2021 |
| url | https://bmjopen.bmj.com/content/15/2/e095210.full |
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