Burden of non-CO poisoning in 204 countries and territories, 1990-2021: results from the global burden of disease study 2021

Abstract

Background: Non-carbon monoxide (non-CO) poisoning remains a significant global public health issue, contributing to considerable morbidity and mortality. However, there is a lack of comprehensive analysis regarding the global burden and trends of non-CO poisoning.

Methods: Data from the Global Burden of Disease (GBD) 2021 study were used to assess the global, regional, and national prevalence, mortality, and disability-adjusted life years (DALYs) associated with non-CO poisoning from 1990 to 2021. Descriptive statistical methods were applied to assess global, regional, and national trends in non-CO poisoning burden, with estimates of prevalence, mortality, and DALYs. Smoothing splines models were used to examine the relationship between non-CO poisoning burden and the Socio-Demographic Index (SDI).

Results: In 2021, global non-CO poisoning accounted for 3.58 million prevalent cases (ASPR: 43.34/100,000), 27.26 thousand deaths (ASDR: 0.35/100,000), and 1.65 million DALYs (ASR: 21.72/100,000), with respective declines of 43.9, 38.9, and 43.5% since 1990. The burden of non-CO poisoning varies significantly across countries and regions, overall, the burden of non-CO poisoning shows a negative correlation with the SDI, with regions and countries with lower SDI values experiencing higher rates of poisoning-related harm. Children under 5 years old and the older adult bear a higher disease burden, with males generally experiencing higher disease burden than females.

Conclusion: Although the global burden of non-CO poisoning has decreased, low- and middle-income countries (LMICs), especially those with lower SDI, continue to experience a disproportionately high burden. Future research should focus on agent-specific epidemiology, improving data collection in LMICs, and examining the impact of agricultural and environmental exposures. Targeted interventions for vulnerable populations, such as children and the older adult, as well as the integration of mental health considerations into prevention strategies, are essential for reducing the global burden.

Keywords: disability-adjusted life years; global disease burden; mortality; non-carbon monoxide poisoning; prevalence; public health strategies; socio-demographic index; vulnerable populations.

Figure 1

Age-standardized prevalence rate of non-CO poisoning per 100,000 population in 2021, by country.

Figure 2

Number of prevalent cases globally and prevalence of non-CO poisoning per 100,000 population, by age and sex in 2021. Lines indicate the prevalence with 95% uncertainty intervals for males and females across different age groups.

Figure 3

Global number of deaths and death rate of non-CO poisoning per 100,000 population, by age and sex in 2021. Lines show the death rates with 95% uncertainty intervals for males and females across different age groups.

Figure 4

Global number of DALYs and DALY rate of non-CO poisoning per 100,000 population, by age and sex in 2021. Lines represent the DALY rate with 95% uncertainty intervals for males and females across different age groups.

Figure 5

Age-standardized disability-adjusted life year (DALY) rates of non-CO poisoning by Socio-Demographic Index for 21 Global Burden of Disease regions, 1990–2021. Each region is represented by 32 data points corresponding to observed age-standardized DALY rates from 1990 to 2021. The solid line indicates the expected DALY rates based on the SDI and global patterns. Regions above the line represent a higher than expected burden of non-CO poisoning, while those below the line indicate a lower than expected burden.