The global burden of breast cancer in women from 1990 to 2030: assessment and projection based on the global burden of disease study 2019.

Background and aim: This study aims to analyze the worldwide prevalence, mortality rates, and disability-adjusted life years (DALYs) attributed to breast cancer in women between 1990 and 2019. Additionally, it seeks to forecast the future trends of these indicators related to the burden of breast cancer in women from 2020 to 2030. Methods: Data from the Global Burden of Disease Study (GBD) 2019 was analyzed to determine the age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of DALYs due to breast cancer in women across 204 countries and territories from 1990 to 2019. Socio-economic development levels of countries and regions were assessed using Socio-demographic Indexes, and trends in the burden of breast cancer in women worldwide from 2020 to 2030 were projected using generalized additive models (GAMs). Results: The estimated annual percentage change (EAPC) in the ASIR breast cancer in women globally was 0.36 from 1990 to 2019 and is expected to increase to 0.44 from 2020 to 2030. In 2019, the ASIR of breast cancer in women worldwide was 45.86 and is projected to reach 48.09 by 2030. The burden of breast cancer in women generally rises with age, with the highest burden expected in the 45-49 age group from 2020 to 2030. The fastest increase in burden is anticipated in Central sub-Saharan Africa (EAPC in the age-standardized death rate: 1.62, EAPC in the age-standardized DALY rate: 1.52), with the Solomon Islands (EAPC in the ASIR: 7.25) and China (EAPC in the ASIR: 2.83) projected to experience significant increases. Furthermore, a strong positive correlation was found between the ASIR breast cancer in women globally in 1990 and the projected rates for 2030 (r = 0.62). Conclusion: The anticipated increase in the ASIR of breast cancer in women globally by 2030 highlights the importance of focusing on women aged 45-49 in Central sub-Saharan Africa, Oceania, the Solomon Islands, and China. Initiatives such as breast cancer information registries, raising awareness of risk factors and incidence, and implementing universal screening programs and diagnostic tests are essential in reducing the burden of breast cancer and its associated morbidity and mortality.

The Impact of Human Cystic Echinococcosis in the Central Asian Region, 1990-2019.

Objective: This research aims to update knowledge on the regional and national sickness burden attributable to cystic echinococcosis (CE) from 1990 to 2019, as well as epidemiology and disease control, with a particular emphasis on the People's Central Asian Regions. Methods: We calculated the morbidity, mortality, and disability-adjusted life years at the global, regional, and national levels for CE in all central Asian countries from 1990 to 2019, and we analyzed the association between GDP per capita and the disease burden of CE. Results: In 2019, the three greatest numbers of CE cases were recorded in Kazakhstan [23986; 95% uncertainty interval (UI); 19796; 28908]; Uzbekistan (41079; 18351; 76048); and Tajikistan (10887; 4891; 20170) among all 9 countries. The three countries with the greatest ASIR of CE were estimated to be Kazakhstan (127.56; 95% UI: 105.34-153.8), Uzbekistan (123.53; 95% UI: 58.65-219.16), and Tajikistan (121.88; 58.57-213.93). Kyrgyzstan, Tajikistan, and Uzbekistan had the biggest increases (125%, 97%, and 83%, respectively) in the number of incident cases of CE, whereas Georgia, Kazakhstan, and Armenia saw the largest decreases (45%, 8%, and 3%, respectively). Conclusion: To reduce the illness burden caused by CE, our findings may help public health professionals and policymakers design cost-benefit initiatives. To lessen the impact of CE on society, it is suggested that more money be given to the region's most endemic nations. Echinococcosis, cystic, negative health effects, life-years lost due to disability, rate of occurrence as a function of age, rate of death as a function of age.

Age Group-Wise Burden of Non-Communicable Diseases Among Shrimp Cultivators in India: A Retrospective Analysis of Disability-Adjusted Life Years Method.

OBJECTIVE: Despite generating huge employment opportunities and profitable business, fishing is considered a dangerous occupation due to challenging weather conditions and exposure to unhealthy occupational factors and lifestyles, which contribute to various health issues. However, few studies have examined the health status of shrimp cultivators. Consequently, this study aims to estimate the age group-wise burden of non-communicable diseases (NCDs) among shrimp cultivators. METHODS: Simple random sampling was employed for collecting data. The sample size was 357 shrimp cultivators. Disability-adjusted life years (DALY) and relative risk (RR) methods were used to measure the burden of NCDs among shrimp cultivators. This study reported the burden of NCDs per 100,000 shrimp cultivators. RESULTS: The top five prevalence of NCDs per 100,000 shrimp cultivators were mental disorders (85,434), musculoskeletal diseases (26,325), digestive diseases (9,803), diabetes (5,882), and cardiovascular diseases (4,481). DALY per 100,000 shrimp cultivators was 33,407.59, while at the national level, it was 24,775.99 per 100,000 people across all age groups. The RR of NCDs among shrimp cultivators in terms of DALY was 1.35, indicating a 0.35 times higher burden of NCDs among shrimp cultivators than at the national level. The largest RR of NCDs was found among shrimp cultivators aged 15-49 years (1.85), followed by 50-69 years (1.09). The highest percentage changes in the burden of NCDs among shrimp cultivators, resulting from changes in the methods of estimating DALY, was observed in the age group of 70 years and above (-48.36%) followed by 15-49 years (-46.08%) and 50-69 years (-40.33%) when compared to the baseline method of estimating DALY without utilizing age weightage and discount rate. CONCLUSIONS: Focus should be given to improving the lifestyle and occupational factors of shrimp cultivators to mitigate the burden of NCDs.

Global impact of particulate matter on ischemic stroke.

Objective: This study assesses the worldwide impact of ischemic stroke caused by ambient particulate matter pollution between 1990 and 2019, utilizing data from the Global Burden of Disease (GBD) 2019. Methods: An analysis was conducted across various subgroups, including region, Socio-demographic Index (SDI) level, country, age, and gender. The study primarily examined metrics such as death cases, death rate, Disability-Adjusted Life Years (DALYs), DALY rate, and age-standardized indicators. The Estimated Annual Percentage Change (EAPC) was calculated to assess trends over time. Results: The study found a moderate increase in the global burden of ischemic stroke attributed to ambient particulate matter, with the age-standardized DALY rate showing an EAPC of 0.41. Subgroup analyses indicated the most substantial increases in Western Sub-Saharan Africa (EAPC 2.64), East Asia (EAPC 2.77), and Eastern Sub-Saharan Africa (EAPC 3.80). Low and middle SDI countries displayed the most notable upward trends, with EAPC values of 3.36 and 3.58 for age-standardized death rate (ASDR) and DALY rate, respectively. Specifically, countries like Equatorial Guinea, Timor-Leste, and Yemen experienced the largest increases in ASDR and age-standardized DALY rate. Furthermore, both death and DALY rates from ischemic stroke due to particulate matter showed significant increases with age across all regions. Conclusion: The study highlights the increasing worldwide health consequences of ischemic stroke linked to particulate matter pollution, particularly in Asia and Africa. This emphasizes the critical necessity for tailored public health interventions in these regions.

Quantifying the neglected: Initial estimation of the global burden and economic impact of human toxocariasis.

Toxocariasis is a parasitic zoonotic infection caused by Toxocara spp., ascarid nematodes of companion animals (dogs and cats) affecting people in both high-income and low/middle-income countries. Toxocariasis can manifest as several distinct syndromes. The most frequent, often termed common toxocariasis, is a self-limiting and mild febrile illness. Ocular and visceral larva migrans are severe disease manifestations affecting the eye and other internal organs, respectively, but their reported occurrence is rare. The vast majority of symptomatic cases are thought due to common toxocariasis, which has also been associated with cognitive impairment in children. Few studies to date have sought to quantity the health burden of toxocariasis in humans. In this study we provide a preliminary estimation using the Disability-Adjusted Life Year (DALY) approach. We estimate a total of 23,084 DALYs are lost annually in 28 selected countries due to common toxocariasis. Extrapolating based on a global average seroprevalence rate of 19%, we estimate 91,714 DALYs per year are lost across all countries due to toxocariasis, of which 40,912 are attributable to less severe forms, i.e. common toxocariasis, and 50,731 to cognitive impairment in children. Clinically diagnosed and reported ocular and visceral larva migrans represent a small proportion of estimated total health burden. We also found a positive correlation at national level between prevalence in cats or dogs and seroprevalence in humans, but no correlation between estimated soil contamination and seroprevalence in humans. Finally, we estimate the potential economic impact of toxocariasis in selected countries at 2.5 billion USD per annum, from costs of medical treatment and lost income. These preliminary estimates should serve as a call to action for further research and evidence-based measures to tackle toxocariasis.

Public Health Impacts of Ambient Particulate Matter Pollution in Libya from 1990 to 2019: An Analysis of the 2019 Global Burden of Disease (GBD) Study.

Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM2.5 concentration in Libya was 38.6 µg/m3 in 2019, marking a 3% increase since 1990. In the same year, PM2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services.

The burden of disease due to dietary exposure to acrylamide in Italy: A risk assessment-based approach.

The aim of this study was to assess Italian consumers' risk of cancer and burden of disease due to dietary exposure to acrylamide. Our model considered six age groups such as infants, toddlers, other children, adolescents, adults, and the elderly, and the consumption of 31 food items. Using a risk-assessment-based approach, we first characterized the risk of neoplastic effects using the margin of exposure method. Then the risk of kidney, endometrial, breast, ovarian cancer, and total cancer was estimated using adjusted cancer slope factors while the burden of disease was quantified using Disability-adjusted Life Years (DALYs). The highest risk for females was related to breast cancer while the lowest was for kidney cancer. We found a comparable risk of total cancer among Italian males and females, estimated at around 1.59 to 3.57 cases per 100,000 individuals annually with the burden ranging between 12.3 - 25.4 and 11.4 - 24.1 DALYs respectively. Our findings provide insights on the multifaceted impact of acrylamide on public health by offering detailed insights into age-specific exposure levels, diverse cancer risks, and the dietary burden of disease related to acrylamide. Targeted interventions and policies can be developed towards mitigating the health risks associated with acrylamide exposure.

Disease burden of Parkinson's disease in China and its provinces from 1990 to 2021: findings from the global burden of disease study 2021.

Background: Parkinson's disease (PD) has become a public health concern with global ageing. However, comprehensive assessments of the temporal and geographical trend of PD disease burden in China remain insufficient. This study aimed to examine the burden of PD by age, gender, and geographical region in China during 1990-2021. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we analysed the incidence, prevalence, mortality, and DALY burden of PD in 33 Chinese provinces/regions. We compared the national figure with the global average and the corresponding estimates from the G20 countries. The estimated annual percentage change (EAPC) was used to quantify the temporal trends of PD burden during 1990-2021. We further assessed the PD burden by age and gender during 1990-2021. We used a decomposition analysis to investigate the changes in the number of new cases, patients, and deaths of PD during 1990-2021. Findings: In 2021, China recorded the highest age-standardised incidence and prevalence of PD among the G20 countries, at 24.3 per 100,000 and 245.7 per 100,000, respectively, figures that were much higher than the global average. During 1990-2021, the age-standardised incidence of PD in China increased by 89.7%, and the age-standardised prevalence by 167.8%, both marking the largest increases among the G20 countries. In contrast, the age-standardised mortality for PD has significantly decreased since 1990, whereas the age-standardised DALY rate for PD has remained relatively unchanged since 1990. The PD burden gradually increased with age, especially in the elderly population aged ≥65 years. During 1990-2021, the burden in males consistently surpassed that in females, with the gender difference widening over time. The increase in new cases and patients of PD was primarily driven by changes in age-specific rates, while the rise in PD-related deaths was largely attributable to population ageing. The disease burden of PD varied considerably across the Chinese provinces. In 2021, age-standardised incidence and prevalence of PD were generally higher in China's southeastern coastal regions than in the western regions, and age-standardised DALY rates were higher in the northern regions than in other regions. Interpretation: The disease burden of PD in China has consistently risen over the past three decades, particularly among elderly men. The increasing causative factors and population aging highlight the need for enhancing public health intervention and resource allocation, especially in etiological research, early diagnosis, preventive strategies, and region-specific management for PD. Funding: Ministry of Science and Technology of the People's Republic of China (2022YFC2304900, 2022YFC2505100); National Key R&D Program of China (2022YFC2505100, 2022YFC2505103, 2018YFC1315300); Outstanding Young Scholars Support Program (grant number: 3111500001); Epidemiology modeling and risk assessment (grant number: 20200344), and Xi'an Jiaotong University Young Scholar Support Grant (grant number: YX6J004).

[Analysis of disease burden of welder's pneumoconiosis in Jiangsu Province].

Objective: To investigate the current status of disease burden and its influencing factors among welder's pneumoconiosis patients, and provide scientific basis for taking targeted intervention measures. Methods: From June 2022 to June 2023, the patients with welder's pneumoconiosis in Jiangsu Province were selected from 1956 to 2020 as the research objects, and disability adjusted life years (DALY) were used as the comprehensive index to study the disease burden. The direct and indirect economic losses caused by the diseases were calculated, and the factors affecting the disease burden were discussed by multiple linear regression method. Results: A total of 974 cases of welder's pneumoconiosis were reported in Jiangsu Province, the cumulative loss of DALY was 6300.73 person-years, and the per capita loss was 6.47 person-years. Among them, the healthy life years lost due to disability (YLD) was 6156.50 person-years (97.71%) , and the healthy life years lost due to premature death (YLL) was 144.23 person-years (2.29%) . Multiple linear regression analysis showed that the main factors affecting DALY were disability grade, diagnostic age, pneumoconiosis grade and length of dust exposure (P<0.05) . The total economic loss caused by 974 welder's pneumoconiosis patients was 1831838160.18 yuan, and the per capita loss was 1880737.33 yuan. Among them, the direct economic loss was 970917563.75 yuan (53.00%) , and the indirect economic loss was 860920596.43 yuan (47.00%) . Conclusion: Welder's pneumoconiosis causes serious disease burden to patients, and at the same time causes huge economic losses to individuals and society, which seriously hinders the development of society. Taking effective control measures to prevent the incidence of welder's pneumoconiosis is the key to reduce the disease burden.

Evaluating Health Expenditure Trends and Disease Burden in India: A Cost per DALY Approach.

Background: Efficient allocation of healthcare resources requires a comprehensive evaluation of healthcare spending and its impact on disease burden. This study aims to estimate the costs-per disability-adjusted life years (DALY) in India. Data from 2010 to 2019 on DALYs and health expenditure per capita (HEp) for individual states in India were utilised. Design and Methods: We followed the CHEERS statement 2022 to present our study's methodology and outcomes. Pearson's product-moment correlations were used to analyse associations between DALYs and HEp. A panel regression analysis was conducted using a log regression model to estimate changes in DALYs due to health expenditure changes. All costs are reported in Indian rupee (₹) along with its 95% CI, with a conversion factor of 1 US$ = ₹82.4 applied. Results: The costs-per-DALY were estimated for each state and India. DALY was negatively correlated with HEp. The estimated mean cost-per-DALY for India was ₹82,112 (₹55,810 to ₹1,08,413) [$997 ($667 to $1316)]. The mean cost per-DALY varied across states, with value of ₹27,058 (₹22,250 to ₹31,866) [$328 ($270 to $387)] for states in the first quartile based on Human Development Index (HDI) and ₹2,69,175 (₹1,05,946 to ₹4,32,404) [$3267 ($1286 to $5248)] for those in fourth HDI quartile. States such as Gujarat (0.16), Karnataka (0.17) and Maharashtra (0.22) have lower, and Arunachal Pradesh has the highest cost-per-DALY to Gross state domestic product per-capita ratio (2.41), followed by Nagaland (1.45). Conclusion: Higher healthcare investment has a lower disease burden; however, reduction in DALY varies across states. Study findings provide evidence to aid the setting up of differential willingness-to-pay thresholds across Indian states for efficient and equitable healthcare resource allocation.

Rabies incidence and burden in three cities of Cameroon (2004-2013).

Rabies is a fatal disease occurring worldwide and especially in almost all the countries in Asia and Africa including Cameroon. Though animal and human rabies is prevalent in Cameroon, the epidemiology and socio-economic burden of the disease in the country is not known. Therefore, a 10-year (October 2004-April 2013) retrospective study on the incidence of animal and human rabies and its burden in Garoua, Ngaoundéré and Yaoundé in Cameroon was carried out. Records of human cases were extracted from the database of the regional hospitals, and animal cases from the databases of Centre Pasteur and National Veterinary Laboratory. The burden of the disease was assessed through the estimation of costs linked to preventive measures (vaccination), corrective procedures (Post Exposure Treatment), Disability-Adjusted Life Year (DALY) and overall societal cost of the disease. Overall, 56 rabies-suspected human deaths, corresponding to an incidence of 0.02 ± 0.00 ‱ and Animal Rabies Incidence (ARI) of 0.37 ± 0.00 % among 1844 suspected animal cases were recorded. The economic loss due to preventive measures of 326,046 ± 28,130.85 USD, related to corrective procedures of 806,741.25 ± 2,466.08 USD, and DALY of 1690.28 ± 4.76 years were estimated. This is the first study that highlights the enormous socio-economic burden associated with animal and human rabies in endemic parts of Cameroon and emphasizes on enhancing rabies eradication strategy focusing on the One Health approach.

Health Hazard Among Shrimp Cultivators in India: A Quantitative Burden of Disease Study.

Background: The lack of focus on the health status of shrimp cultivators by previous studies while the production of shrimp has been rising over the years after the introduction of the blue revolution in India. The present study estimated the burden of diseases among shrimp cultivators in India. Methods: Primary data were collected by using simple random sampling. The sample size was 357. The classification of diseases were made by using the international classification of diseases, tenth revision (ICD-10), version 2019. Disability-adjusted life years (DALY) were used to measure the health status of shrimp cultivators. DALY is the summation of the burden of disease from mortality and morbidity. Sensitive and uncertainty analysis was used by changing the value of the parameter and method, respectively. Results: The burden of disease among shrimp cultivators in 2020 ranges from 101.03 DALY based on equal age weightage, without discount rate, and potential life expectancy (DALY0,0,PLE) to 84.02 DALY based on unequal age weightage, discount rate, and standardized life expectancy (DALY1,0.03,SLE). The burden of disease per 100,000 shrimp cultivators was 28,477.74 DALY and 23,600.84 DALY when calculated by using DALY0,0,PLE and DALY1,0.03,SLE method, respectively. The higher burden of diseases from non-communicable diseases was followed by injury and communicable diseases for both methods. The disease burden from mortality was more than two-thirds of the total burden of disease and the rest from morbidity. The burden of disease among shrimp cultivators was sensitive to parameter changes because it changes between 92.10 DALY and 63.03 DALY with the change in the parameter. Uncertainty in the burden of disease among them was due to method variation, which ranges from 120.03 DALY to 74.06 DALY. Conclusion: The higher burden of non-communicable diseases, and the lower burden of communicable, and injuries per 100,000 shrimp cultivators compared to the national level in India.

Burden of psoriasis in young adults worldwide from the global burden of disease study 2019.

Background: To determine the global burden of psoriasis in young adults, i.e., those aged 15-49, from 1990 to 2019 and predict trends in this burden for 2020 to 2030. Methods: Age-standardized disease burden indicators and their estimated annual percentage changes were assessed and used to compare the estimated burden between regions. In addition, generalized additive models were used to predict the burden in this population from 2020 to 2030. Results: From 1990 to 2019, the overall burden of psoriasis in young adults worldwide trended downward, as the age-standardized incidence rate and the age-standardized disability-adjusted life year rate decreased. From 1990 to 2019, there were gender differences in the burden of psoriasis between regions with different Socio-demographic index. Specifically, there was a smaller increase in the burden in young men than in young women in middle- and low-middle-Socio-demographic index areas. In 2019, Western Europe, Australasia, and Southern Latin America had the highest age-standardized incidence rate of psoriasis in young adults, whereas age-standardized disability-adjusted life year rates of psoriasis in young adults were highest in high-income North America. In 2019, the psoriasis burden in young adults was the highest in high-Socio-demographic index areas and the lowest in low-Socio-demographic index regions. We predict that from 2020 to 2030, the incidence rate and disability-adjusted life year rate of psoriasis in all age groups of young adults will continue to decline, but the burden in those aged 30-39 will increase. Conclusion: From 1990 to 2019, the overall burden of psoriasis in each age group trended downward in this period. We predict that from 2020 to 2030, the burden of psoriasis in those aged 30-39 will increase.

Spatial epidemiological analysis of the burden of liver cancer in China.

Background: Liver cancer is one of the most common cancers in the world, with unique regional variations in disability-adjusted life years (DALY) rate, nearly 50% of liver cancer cases occur in China. Therefore, understanding the epidemiological characteristics of liver cancer is of utmost importance. In this study, to analyze the spatial distribution characteristics and clustering of the DALY rate of liver cancer in 1990 and 2017 in China based on provincial administrative divisions, and to explore its possible influencing factor. Methods: The DALY rate data of liver cancer at the provincial level in China were collected, the global autocorrelation of the DALY rate was analyzed by Moran's I, the local autocorrelation of the DALY rate was analyzed by Getis-Ord-Gi*, and the influencing factors related to the DALY rate were analyzed by the least squares regression model. Results: The DALY rate of liver cancer in China generally showed an increasing trend. The DALY rate increased in 22 provinces and decreased in nine provinces. In 2017, the distribution of DALY rate in all provinces showed heterogeneity, with the highest DALY rate in Guangxi (1,363.37/100,000) and the lowest in Beijing (315.78/100,000). In 2017, the low and low clustering were mainly concentrated in Inner Mongolia, Ningxia, Shanxi, Hebei, and Tianjin. The low and high clustering in Yunnan, Guizhou, and Guangdong, were surrounded by the high clustering in neighboring provinces, high and high concentration is mainly concentrated in Hunan and neighboring provinces. The results of the least square regression model showed that the per capita years of education, hepatitis B incidence and the proportion of population over 65 years old had an impact on the DALY rate of liver cancer (P<0.05). Conclusions: The DALY rate of liver cancer in China showed an overall increasing trend. In 2017, the DALY rate of liver cancer in China had a spatial aggregation in the whole country, and the per capita years of education, the incidence of hepatitis B and the proportion of population over 65 years old had an impact on the DALY rate of liver cancer in space.

Burden of silica-attributed pneumoconiosis and tracheal, bronchus & lung cancer for global and countries in the national program for the elimination of silicosis, 1990-2019: a comparative study.

BACKGROUND: In industries worldwide, crystalline silica is pervasive and poses risks of pneumoconiosis and respiratory malignancies, with the latter being a knowledge gap in disease burden research that this study aims to address. By integrating both diseases, we also seek to provide an in-depth depiction of the silica-attributed disease burden. METHODS: Data from the Global Burden of Disease 2019 were extracted to analyze the disease burden due to silica exposure. The trends of age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) from 1990 to 2019, as well as the age-specific number and rate of deaths and disability-adjusted life years (DALYs) in 1990 and 2019, were presented using GraphPad Prism software. The average annual percentage changes (AAPCs) on ASMR and ASDR were calculated using joinpoint regression models. RESULTS: The global trends of disease burden due to silica exposure from 1990 to 2019 showed a significant decrease, with AAPCs on ASMR and ASDR of -1.22 (-1.38, -1.06) and - 1.18 (-1.30, -1.05), respectively. Vietnam was an exception with an unprecedented climb in ASMR and ASDR in general over the years. The age-specific deaths and DALYs mainly peaked in the age group 60-64. In comparison to 1990, the number of deaths and DALYs became higher after 45 years old in 2019, while their rates stayed consistently lower in 2019. Males experienced an elevated age-specific burden than females. China's general age-standardized burden of pneumoconiosis and tracheal, bronchus & lung (TBL) cancer ranked at the forefront, along with the highest burden of pneumoconiosis in Chilean males and South African females, as well as the prominent burden of TBL cancer in Turkish males, Thai females, and overall Vietnamese. The age-specific burden of TBL cancer surpassed that of pneumoconiosis, and a delay was presented in the pneumoconiosis pinnacle burden compared to the TBL cancer. Besides, the burden of pneumoconiosis indicated a sluggish growth trend with advancing age. CONCLUSION: Our research highlights the cruciality of continuous enhancements in occupational health legislation for countries seriously suffering from industrial silica pollution and the necessity of prioritizing preventive measures for male workers and elderly retirees.

The 30 Years of Shifting in The Indonesian Cardiovascular Burden-Analysis of The Global Burden of Disease Study.

IMPORTANCE: Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity. Compared with disease burden rates in 1990, significant reductions in Disability-Adjusted Life Years (DALYs) burden rates for CVD have been recorded. However, general DALYs rates have not changed in Indonesia in the past 30 years. Thus, assessing Indonesian CVD burdens will be an essential first step in determining primary disease interventions. OBJECTIVE: To determine the national and province-level burden of CVD from 1990 to 2019 in Indonesia. DESIGN, SETTING, AND PARTICIPANTS: A retrospective observational study was conducted using data from the Global Burden of Disease (GBD) 2019, provided by the Institute of Health Metrics and Evaluation (IHME), to analyze trends in the burden of CVD, including mortality, morbidity, and prevalence characteristics of 12 underlying CVDs. EXPOSURES: Residence in Indonesia. MAIN OUTCOMES AND MEASURES: Mortality, incidence, prevalence, death, and DALYs of CVD. RESULTS: CVD deaths have doubled from 278 million in 1990 to 651 million in 2019. All CVDs recorded increased death rates, except for rheumatic heart disease (RHD) (- 69%) and congenital heart disease (CHD) (- 37%). Based on underlying diseases, stroke and ischemic heart disease (IHD) are still the leading causes of mortality and morbidity in Indonesia, whereas stroke and peripheral artery disease (PAD) are the most prevalent CVDs. Indonesia has the second worst CVD DALYs rates compared to ASEAN countries after Laos. At provincial levels, the highest CVD DALY rates were recorded in Bangka Belitung, South Kalimantan, and Yogyakarta. In terms of DALYs rate changes, they were recorded in West Nusa Tenggara (24%), South Kalimantan (18%), and Central Java (11%). Regarding sex, only RHD, and PAD burdens were dominated by females. CONCLUSIONS: CVD mortality, morbidity, and prevalence rates increased in Indonesia from 1990 to 2019, especially for stroke and ischemic heart disease. The burden is exceptionally high, even when compared to other Southeast Asian countries and the global downward trend. GBD has many limitations. However, these data could provide policymakers with a broad view of CVD conditions in Indonesia.

Daly/Cost comparison in the management of peripheral arterial disease at 17 Belgian hospitals.

OBJECTIVE: Peripheral arterial disease (PAD) is a manifestation of atherosclerosis that affects the lower extremities and afflicts more than 200 million people worldwide. Because of limited resources, the need to provide quality care associated with cost control is essential for health policies. Our study concerns an interhospital comparison among seventeen Belgian hospitals that integrates the weighting of quality indicators and the costs of care, from the hospital perspective, for a patient with this pathology in 2018. METHODS: The disability-adjusted life years (DALYs) were calculated by adding the number of years of life lost due to premature death and the number of years of life lost due to disability for each in-hospital stay. The DALY impact was interpreted according to patient safety indicators. We compared the hospitals using the adjusted values ​​of costs and DALYs for their case mix index, obtained by relating the observed value to the predicted value obtained by linear regression. RESULTS: We studied 2,437 patients and recorded a total of 560.1 DALYs in hospitals. The in-hospital cost average [standard deviation (SD)] was €8,673 (€10,893). Our model identified the hospitals whose observed values were higher than predicted; six needed to reduce the costs and impacts of DALYs, six needed to improve one of the two factors, and four seemed to have good results. The average cost (SD) for the worst performing hospitals amounted to €27,803 (€28,358). CONCLUSIONS: Studying the costs of treatment according to patient safety indicators permits us to evaluate the entire chain of care using a comparable unit of measurement.

Inclusion of microbiological food safety as a novel aspect in life cycle assessments of food production.

The life cycle assessment (LCA) methodology currently covers a limited number of human health-related impact categories. Microbiological food safety is an essential aspect for the selection of an appropriate food production system and has been neglected in the LCA so far. A framework for the inclusion of a microbiological food safety indicator, expressed as disability-adjusted life year (DALY) value of the consumed food product to the human health damage category (end-point) was created, and applied in a case study model on the cooked-chilled meals as the ready-to-eat meals can be associated with the occurrence of foodborne illness cases and outbreaks. This study suggests a framework for the inclusion of microbiological risk caused by Bacillus cereus associated with the consumption of ready-to-eat meals (in Belgium) in the LCA. The results indicated that the microbiological risk of one package of the investigated ready-to-eat meal was 1.95 × 10-6 DALY, and the obtained DALY value was included as an impact category in the LCA methodology. Inclusion of other categories of food safety (including chemical safety hazards, pesticide residues, heavy metals, and mycotoxins) in LCA could be done in the same fashion.

Evaluating the health impact of increased linseed consumption in the Danish population.

Consumption of linseeds has been suggested to have beneficial effects on human health. However, toxic constituents of linseed may compromise these benefits. We conducted a quantitative risk-benefit assessment to evaluate the overall health impact of increasing linseed intake up to 45 g/day in the Danish population (15-74 years). We quantified the risks associated with increased cadmium exposure and the benefits associated with increased intake of dietary fibre. Increased intakes of alpha-linoleic acid (ALA) were included in a sensitivity analysis. The overall health impact of different linseed intake scenarios was estimated in terms of Disability-Adjusted Life Years (DALYs). We found that the beneficial effects of linseed due to increased intake of dietary fibre outweighed the adverse health effects due to increased cadmium exposure in all scenarios. Up to 670 DALYs/100,000 individuals could be averted per year by increasing linseed consumption in the Danish population. The estimated beneficial health impact increased further when including ALA in the assessment. Different sources of uncertainty might affect the results, and more research is needed on both the health effects associated with intake of linseed and its constituents, and the bioavailability of ALA and cadmium from linseed to further improve the risk-benefit assessment.

Harm from Residential Indoor Air Contaminants.

This study presents a health-centered approach to quantify and compare the chronic harm caused by indoor air contaminants using disability-adjusted life-year (DALY). The aim is to understand the chronic harm caused by airborne contaminants in dwellings and identify the most harmful. Epidemiological and toxicological evidence of population morbidity and mortality is used to determine harm intensities, a metric of chronic harm per unit of contaminant concentration. Uncertainty is evaluated in the concentrations of 45 indoor air contaminants commonly found in dwellings. Chronic harm is estimated from the harm intensities and the concentrations. The most harmful contaminants in dwellings are PM2.5, PM10-2.5, NO2, formaldehyde, radon, and O3, accounting for over 99% of total median harm of 2200 DALYs/105 person/year. The chronic harm caused by all airborne contaminants in dwellings accounts for 7% of the total global burden from all diseases.