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. 2022 Jul 27:378:e069679.
doi: 10.1136/bmj-2021-069679.

Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019

Saeid Safiri  1   2   3 , Kristin Carson-Chahhoud  4   5 , Maryam Noori  6 , Seyed Aria Nejadghaderi  7   8 , Mark J M Sullman  9   10 , Javad Ahmadian Heris  11 , Khalil Ansarin  12 , Mohammad Ali Mansournia  13 , Gary S Collins  14   15 , Ali-Asghar Kolahi  16 , Jay S Kaufman  17
Affiliations

Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019

Saeid Safiri et al. BMJ. .

Abstract

Objective: To report the global, regional, and national burden of chronic obstructive pulmonary disease (COPD) and its attributable risk factors between 1990 and 2019, by age, sex, and sociodemographic index.

Design: Systematic analysis.

Data source: Global Burden of Disease Study 2019.

Main outcome measures: Data on the prevalence, deaths, and disability adjusted life years (DALYs) of COPD, and its attributable risk factors, were retrieved from the Global Burden of Disease 2019 project for 204 countries and territories, between 1990 and 2019. The counts and rates per 100 000 population, along with 95% uncertainty intervals, were presented for each estimate.

Results: In 2019, 212.3 million prevalent cases of COPD were reported globally, with COPD accounting for 3.3 million deaths and 74.4 million DALYs. The global age standardised point prevalence, death, and DALY rates for COPD were 2638.2 (95% uncertainty intervals 2492.2 to 2796.1), 42.5 (37.6 to 46.3), and 926.1 (848.8 to 997.7) per 100 000 population, which were 8.7%, 41.7%, and 39.8% lower than in 1990, respectively. In 2019, Denmark (4299.5), Myanmar (3963.7), and Belgium (3927.7) had the highest age standardised point prevalence of COPD. Egypt (62.0%), Georgia (54.9%), and Nicaragua (51.6%) showed the largest increases in age standardised point prevalence across the study period. In 2019, Nepal (182.5) and Japan (7.4) had the highest and lowest age standardised death rates per 100 000, respectively, and Nepal (3318.4) and Barbados (177.7) had the highest and lowest age standardised DALY rates per 100 000, respectively. In men, the global DALY rate of COPD increased up to age 85-89 years and then decreased with advancing age, whereas for women the rate increased up to the oldest age group (≥95 years). Regionally, an overall reversed V shaped association was found between sociodemographic index and the age standardised DALY rate of COPD. Factors contributing most to the DALYs rates for COPD were smoking (46.0%), pollution from ambient particulate matter (20.7%), and occupational exposure to particulate matter, gases, and fumes (15.6%).

Conclusions: Despite the decreasing burden of COPD, this disease remains a major public health problem, especially in countries with a low sociodemographic index. Preventive programmes should focus on smoking cessation, improving air quality, and reducing occupational exposures to further reduce the burden of COPD.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: support from Shahid Beheshti University of Medical Sciences for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
Age standardised point prevalence of chronic obstructive pulmonary disease per 100 000 population in 2019, by country (generated from data available at https://ghdx.healthdata.org/gbd-results-tool)
Fig 2
Fig 2
Age standardised death rate of chronic obstructive pulmonary disease per 100 000 population in 2019, by country (generated from data available at https://ghdx.healthdata.org/gbd-results-tool)
Fig 3
Fig 3
Number of prevalent cases globally and prevalence of chronic obstructive pulmonary disease per 100 000 population, by age and sex in 2019. Lines indicate prevalent case with 95% uncertainty intervals for men and women (generated from data available at https://ghdx.healthdata.org/gbd-results-tool)
Fig 4
Fig 4
Age standardised disability adjusted life year (DALY) rates of chronic obstructive pulmonary disease for the 21 Global Burden of Disease regions by sociodemographic index, 1990–2019. Thirty points are plotted for each region and show the observed age standardised DALY rates from 1990 to 2019 for that region. Expected values, based on sociodemographic index and disease rates in all locations, are shown as a solid line. Regions above the solid line represent a higher than expected burden (eg, South Asia) and regions below the line show a lower than expected burden (eg, western sub-Saharan Africa) (generated from data available at https://ghdx.healthdata.org/gbd-results-tool)
Fig 5
Fig 5
Percentage of disability adjusted life years (DALYs) due to chronic obstructive pulmonary disease attributable to each risk factor for the 21 Global Burden of Disease regions in 2019 (generated from data available at https://ghdx.healthdata.org/gbd-results-tool)
See this image and copyright information in PMC

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