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. 2017 Sep 1;39(3):464-475.
doi: 10.1093/pubmed/fdw085.

Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health

A Prüss-Ustün  1 , J Wolf  2   3   4 , C Corvalán  5 , T Neville  1 , R Bos  1 , M Neira  1
Affiliations

Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health

A Prüss-Ustün et al. J Public Health (Oxf). .

Abstract

Background: The update of the global burden of disease attributable to the environment is presented. The study focuses on modifiable risks to show the potential health impact from environmental interventions.

Methods: Systematic literature reviews on 133 diseases and injuries were performed. Comparative risk assessments were complemented by more limited epidemiological estimates, expert opinion and information on disease transmission pathways. Population attributable fractions were used to calculate global deaths and global disease burden from environmental risks.

Results: Twenty-three percent (95% CI: 13-34%) of global deaths and 22% (95% CI: 13-32%) of global disability adjusted life years (DALYs) were attributable to environmental risks in 2012. Sixty-eight percent of deaths and 56% of DALYs could be estimated with comparative risk assessment methods. The global disease burden attributable to the environment is now dominated by noncommunicable diseases. Susceptible ages are children under five and adults between 50 and 75 years. Country level data are presented.

Conclusions: Nearly a quarter of global disease burden could be prevented by reducing environmental risks. This analysis confirms that eliminating hazards and reducing environmental risks will greatly benefit our health, will contribute to attaining the recently agreed Sustainable Development Goals and will systematically require intersectoral collaboration to be successful.

Keywords: environment; morbidity and mortality; public health.

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Figures

Fig.1
Fig.1
Environmental fraction of burden of selected diseases (percentages relate to the environmental share of the respective disease).
Fig. 2
Fig. 2
Environmental disease burden of overall; infectious, parasitic, neonatal and nutritional nutritional; noncommunicable diseases and injuries by age.
Fig. 3
Fig. 3
Environmental burden of disease (deaths per 100 000 population, y-axis) by gross national income per capita (x-axis); each bubble represents a country, bubble size represents population size; BRICS: Brazil, Russia, India, China, South Africa; OECD: Organisation for Economic Co-operation and Development.
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References

    1. Prüss-Üstün A, Corvalán C. Preventing disease through healthy environments [Internet]. World Health Organization Geneva; 2006. Available from: http://cdrwww.who.int/entity/quantifying_ehimpacts/publications/preventi...(20 December 2015, date last accessed).
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    1. IHME. GBD 2013, GBD Compare [Internet]. Available from: http://vizhub.healthdata.org/gbd-compare/(13 January 2016, date last accessed).
    1. Prüss-Ustün A, Wolf J, Corvalán C et al. Preventing disease through healthy environments: A global assessment of the environmental burden of disease from environmental risks [Internet]. World Health Organization; 2016. Available from: http://www.who.int/quantifying_ehimpacts/publications/preventing-disease... (18 March 2016, date last accessed).
    1. World Health Organization Environmental health [Internet]. undated. Available from: http://www.who.int/topics/environmental_health/en/(16 July 2015, date last accessed).

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