1990—2019年中国归因于固体燃料室内空气污染死亡负担及变化趋势

Mortality burden attributable to household air pollution from solid fuels and its change trend of China in 1990—2019

目的分析中国归因于固体燃料室内空气污染(household air pollution from solid fuels,HAPSF)的死亡负担、变化情况及对公众健康的影响。方法基于2019年全球疾病负担(Global Burden of Disease,GBD2019)数据,本研究采用死亡率和因早死所致的寿命损失年(years of life lost,YLL)描述死亡负担,通过Joinpoint回归模型分析1990—2019年中国归因于HAPSF的死亡负担时间变化趋势。结果2019年,中国归因于HAPSF的总死亡率25.52/10万,YLL率509.32/10万;非传染性疾病的归因死亡率和归因YLL率高于传染性疾病(24.66/10万vs.0.86/10万、480.86/10万vs.28.47/10万),呼吸道感染和缺血性心脏病在各自疾病分类中的死亡率和YLL率最高。2019年,归因死亡率和YLL率随年龄增长而增加,≥85岁人群达到最高点,男性死亡负担高于女性。1990—2019年,归因于标化死亡率和标化YLL率均随年份呈下降趋势,总人群平均年度变化百分比分别为-7.4%(95%CI:-7.7%~-7.1%)、-8.1%(95%CI:-8.3%~-7.9%)。结论1990—2019年,中国由HAPSF导致的死亡负担有所缓解,但呼吸道感染、缺血性心脏病、男性和≥85岁高龄老年群体仍然面临较高的风险,建议采取多样化且有针对性的干预措施,以进一步减少HAPSF造成的死亡负担。

Objective To understand the effect of indoor air pollution of solid fuel on population health by analyzing the burden of deaths attributed to indoor air pollution of solid fuels in China from 1990 to 2019 and its changes.Methods Based on the 2019 Global Burden of Disease data,the mortality burden was characterized using mortality rate and years of life lost(YLL)rate,while the temporal trend of death burden attributed to household air pollution in China from 1990 to 2019 was analyzed using the Joinpoint regression model.Results In 2019,the total mortality rate attributed to HAPSF-related illness in China was 25.52 per 100000 population,with a corresponding years of life lost(YLL)rate of 509.32 per 100000 population.Notably,the mortality and YLL rates associated with non-communicable diseases were significantly higher compared to those linked to communicable diseases(24.66 per 100000 us.0.86 per 100000 and 480.86 per 100000 us.28.47 per 100000).Respiratory infections and ischemic heart disease had the highest mortality rate and YLL rate in their respective disease categories.In 2019,the mortality and YLL rates attributed to HAPSF increased with age,and reached the peak in people aged 85 years and above.The mortality and YLL rates attributed to HAPSF were significantly higher in males compared to females.From 1990 to 2019,the age-standardized mortality rate and age-standardized YLL rate attributed to HAPSF showed a decreasing trend with each year,and the AAPC was-7.4%(95%CI:-7.7%-7.1%)and-8.1%(95%CI:-8.3%-7.9%)respectively.Chronic obstructive pulmonary disease exhibited the most significant changes.Conclusions From 1990 to 2019,there was a decline in the mortality burden associated with HAPSF in China.However,respiratory infections,ischemic heart disease,males,and individuals aged 85 and above remained at elevated risk.It is imperative to implement diverse and targeted interventions to further mitigate the mortality burden attributed to HAPSF.