1990—2019年中国室外臭氧暴露致慢性阻塞性肺部疾病的疾病负担分析

Disease burden analysis of chronic obstructive pulmonary disease caused by outdoor ozone exposure in China during 1990-2019

目的分析1990—2019年中国室外臭氧暴露致慢性阻塞性肺部疾病(chronic obstructive pulmonary disease,COPD)的疾病负担。方法基于2019年全球疾病负担研究(global burden of disease study,GBD)数据,分析1990—2019年中国室外臭氧暴露致COPD死亡例数、死亡率、伤残调整寿命年(disability adjusted life years,DALY)以及DALY率变化情况,并通过世界标准人口的年龄结构对死亡率和DALY率进行标化,与全球及各级社会人口学指数(socio-demographic index,SDI)国家平均水平进行比较。结果2019年中国15岁及以上人群中,6.99%的COPD死亡是由室外臭氧暴露导致,归因死亡人数(9.33万例)占同期全球水平(36.52万例)的25.54%,其中男性5.34万例,女性3.98万例,归因DALY(137.29万人年)占同期全球水平(621.01万人年)的22.11%;标化死亡率和DALY率较中等SDI国家分别高出25.61%和10.92%,较高SDI国家分别高出373.88%和284.63%。1990—2019年,随年龄增长,人群归因分值(population attributable fraction,PAF)、归因死亡率和DALY率均呈上升趋势,≥70岁年龄组达高峰,且男性均明显高于女性。结论中国归因于室外臭氧暴露致COPD的疾病负担沉重,且存在性别和年龄组差异。

OBJECTIVE To analyze the disease burden of chronic obstructive pulmonar ydisease caused by outdoor ozone exposure in China from 1990 to 2019.METHODS Based on the global burden of disease study data in 1990-2019,the number of chronic obstructive pulmonary disease(COPD)deaths,mortality,disability-adjusted life years(DALY)and DALY rates caused by outdoor ozone exposure in China from 1990 to 2019 were analyzed,and the mortality and DALY rates were standardized through the age structure of the world standard population,and compared with the national average of global and all levels of social demographic index(SDI).RESULTS In 2019,6.99%of COPD deaths among people aged 15 and over in China were caused by outdoor ozone exposure,and the number of attributable deaths(93300)accounted for 25.54%of the global level(365200)in the same period,including 53400 males and 39800 females,and attributable DALY(1.3729 million person-years)accounted for 22.11%of the global level(6.2101 million person-years)in the same period.The standardized mortality rate and DALY rate were 25.61%and 10.92%higher than those of medium SDI countries,and 373.88%and 284.63%higher than those of high SDI countries,respectively.From 1990 to 2019,the population attribution score(population attributable fraction,PAF),attributable mortality and DALY rate increased with the increase of age,and reached the peak in the age group≥70 years old,and the scores of males were significantly higher than those of females.CONCLUSION China is attributed to the heavy disease burden of COPD caused by outdoor ozone exposure,and there are differences in gender and age groups.