Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors

Rachel M Shaffer¹, Samuel P Sellers², Marissa G Baker¹, Rebeca de Buen Kalman³, Joseph Frostad^{4

5}, Megan K Suter⁶, Susan C Anenberg⁷, John Balbus⁸, Niladri Basu⁹, David C Bellinger¹⁰, Linda Birnbaum¹¹, Michael Brauer^{4

12}, Aaron Cohen^{4

13}, Kristie L Ebi², Richard Fuller¹⁴, Philippe Grandjean^{15

16}, Jeremy J Hess², Manolis Kogevinas¹⁷, Pushpam Kumar¹⁸, Philip J Landrigan^{19

20}, Bruce Lanphear²¹, Stephanie J London²², Andrew A Rooney²³, Jeffrey D Stanaway⁴, Leonardo Trasande^{24

25}, Katherine Walker¹², Howard Hu^{1

26}

Affiliations

¹ Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
² Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA.
³ Evans School of Public Policy and Governance, University of Washington, Seattle, Washington, USA.
⁴ Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
⁵ Department of Health Metrics Sciences, University of Washington, Seattle, Washington, USA.
⁶ Department of Epidemiology, University of Washington, Seattle, Washington, USA.
⁷ Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
⁸ Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
⁹ Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada.
¹⁰ Department of Neurology, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA.
¹¹ Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
¹² School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
¹³ Health Effects Institute, Boston, Massachusetts, USA.
¹⁴ Pure Earth, New York, New York, USA.
¹⁵ Department of Public Health, University of Southern Denmark, Odense, Denmark.
¹⁶ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
¹⁷ Barcelona Institute for Global Health, Barcelona, Spain.
¹⁸ United Nations Programme on the Environment, Nairobi, Kenya.
¹⁹ Program in Global Public Health and the Common Good, Boston College, Chestnut Hill, Massachusetts, USA.
²⁰ Global Observatory on Pollution and Health, Boston College, Chestnut Hill, Massachusetts, USA.
²¹ Simon Fraser University, Vancouver, British Columbia, Canada.
²² Epidemiology Branch, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
²³ Division of the National Toxicology Program, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
²⁴ Department of Pediatrics, New York University School of Medicine, New York, New York, USA.
²⁵ NYU Global Institute of Public Health, New York University, New York, New York, USA.
²⁶ Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

PMID: 31626566
PMCID: PMC6867191
DOI: 10.1289/EHP5496

Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors

Rachel M Shaffer et al. Environ Health Perspect. 2019 Oct.

. 2019 Oct;127(10):105001.

doi: 10.1289/EHP5496. Epub 2019 Oct 18.

Authors

Affiliations

¹ Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
² Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA.
³ Evans School of Public Policy and Governance, University of Washington, Seattle, Washington, USA.
⁴ Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
⁵ Department of Health Metrics Sciences, University of Washington, Seattle, Washington, USA.
⁶ Department of Epidemiology, University of Washington, Seattle, Washington, USA.
⁷ Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
⁸ Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
⁹ Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada.
¹⁰ Department of Neurology, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA.
¹¹ Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
¹² School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
¹³ Health Effects Institute, Boston, Massachusetts, USA.
¹⁴ Pure Earth, New York, New York, USA.
¹⁵ Department of Public Health, University of Southern Denmark, Odense, Denmark.
¹⁶ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
¹⁷ Barcelona Institute for Global Health, Barcelona, Spain.
¹⁸ United Nations Programme on the Environment, Nairobi, Kenya.
¹⁹ Program in Global Public Health and the Common Good, Boston College, Chestnut Hill, Massachusetts, USA.
²⁰ Global Observatory on Pollution and Health, Boston College, Chestnut Hill, Massachusetts, USA.
²¹ Simon Fraser University, Vancouver, British Columbia, Canada.
²² Epidemiology Branch, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
²³ Division of the National Toxicology Program, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
²⁴ Department of Pediatrics, New York University School of Medicine, New York, New York, USA.
²⁵ NYU Global Institute of Public Health, New York University, New York, New York, USA.
²⁶ Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

PMID: 31626566
PMCID: PMC6867191
DOI: 10.1289/EHP5496

Abstract

Background: The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals.

Objectives: We review key aspects of the GBD for the EH community and introduce the Global Burden of Disease-Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden-both current and projected.

Methods: We discuss strategies for improving GBD quantification of specific EH risk factors, including air pollution, lead, and climate change. We highlight key methodological challenges, including new EH risk factors, notably evidence rating and global exposure assessment.

Discussion: A number of issues present challenges to the scope and accuracy of current GBD estimates for EH risk factors. For air pollution, minimal data exist on the exposure-risk relationships associated with high levels of pollution; epidemiological studies in high pollution regions should be a research priority. For lead, the GBD's current methods do not fully account for lead's impact on neurodevelopment; innovative methods to account for subclinical effects are needed. Decisions on inclusion of additional EH risk-outcome pairs need to be guided by findings of systematic reviews, the size of exposed populations, feasibility of global exposure estimates, and predicted trends in exposures and diseases. Neurotoxicants, endocrine-disrupting chemicals, and climate-related factors should be high priorities for incorporation into upcoming iterations of the GBD study. Enhancing the scope and methods will improve the GBD's estimates and better guide prevention policy. https://doi.org/10.1289/EHP5496.

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Figures

A tabular representation of the risk factors hierarchy under three groups: metabolic risks, behavioral risks, and environmental/occupational risks. — **Figure 1.**
Global Burden of Disease Study (GBD) risk factor hierarchy (adapted from Stanaway et al. 2018).

A world map illustrates the unique country, source, and years of data on blood lead levels. The key is as follows: unique location/years: 0 to 1, 1 to 5, 5 to 10, 10 to 15, 15 to 20, 20 to 25, 25 to 30, 35 to 40, and 40 to 95. — **Figure 2.**
Map of unique country, source, and years of data on blood lead levels for the Global Burden of Disease Study (GBD) (Stanaway et al. 2018).

See this image and copyright information in PMC

References

1. Achakulwisut P, Brauer M, Hystad P, Anenberg SC. 2019. Global, national, and urban burdens of paediatric asthma incidence attributable to ambient NO₂ pollution. Lancet Planet Health 3(4):e166–e178, PMID: 30981709, 10.1016/S2542-5196(19)30046-4. - DOI - PubMed
1. Achakulwisut P, Mickley LJ, Anenberg SC. 2018. Drought-sensitivity of fine dust in the US Southwest: implications for air quality and public health under future climate change. Environ Res Lett 13(5):054025, 10.1088/1748-9326/aabf20. - DOI
1. Allen RW, Barn PK, Lanphear BP. 2015. Randomized controlled trials in environmental health research: unethical or underutilized? PLoS Med 12(1):e1001775, PMID: 25562846, 10.1371/journal.pmed.1001775. - DOI - PMC - PubMed
1. Amato MS, Moore CF, Magzamen S, Imm P, Havlena JA, Anderson HA, et al. 2012. Lead exposure and educational proficiency: moderate lead exposure and educational proficiency on end-of-grade examinations. Ann Epidemiol 22(10):738–743, PMID: 22902043, 10.1016/j.annepidem.2012.07.004. - DOI - PMC - PubMed
1. Anenberg SC, Henze DK, Tinney V, Kinney PL, Raich W, Fann N, et al. 2018. Estimates of the global burden of ambient PM_2.5, ozone, and NO₂ on asthma incidence and emergency room visits. Environ Health Perspect 126(10):107004, PMID: 30392403, 10.1289/EHP3766. - DOI - PMC - PubMed

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Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors

Affiliations

Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors

Authors

Affiliations

Abstract

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References

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MeSH terms

Grants and funding

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Full Text Sources

Medical