Disease Burden Attributable to Six Occupational Risk Factors in China, 1990-2035: A Quantitative Assessment and Future Projection.

Trends in Smoking-Attributable Disease Burden in China, 1990-2021: Age, Sex, and Risk Factors in a Global Context.

INTRODUCTION Smoking remains one of the leading preventable causes of morbidity and mortality worldwide. Understanding long-term trends in smoking-related diseases is essential for evaluating policy effectiveness and guiding prevention efforts. This study assessed the burden of disease attributable to smoking in China from 1990 to 2021, comparing its trends with global and sociodemographic index (SDI) patterns to identify policy priorities. METHODS Age-, sex-, and SDI-stratified analyses were conducted using mortality and disability-adjusted life years (DALYs) data from the Global Burden of Disease Study 2021. Temporal trends were evaluated with Joinpoint regression and multiple visualization methods. RESULTS Globally, age-standardized smoking-attributable death rates declined, but China showed a steeper decline (average annual percent change = -2.00 vs. -1.77). However, China's absolute smoking-related deaths rose by 57.5% to 2.30 million in 2021, accounting for 37.3% of the global total. Males bore a disproportionately higher burden, with an age-standardized death rate nearly 10 times that of females. Burden peaked at ages 65-74 for death counts and at ages 90-94 for rates. Unlike the global pattern where cardiovascular diseases dominate, neoplasms were the leading cause in China. Age-standardized DALYs rates for diabetes and kidney diseases showed a rising trend. CONCLUSION From 1990 to 2021, China experienced faster declines in standardized smoking burden than the global average, yet its absolute burden and global share increased substantially. Sustained, targeted tobacco control-especially among older males and for cancer prevention-is urgently needed.

Temporal Trends and Future Projections of Occupational Asthma and Lung Cancer in Southeast Asia: Insights From the Global Burden of Disease Study 1990-2021.

AIMS/BACKGROUND Exposure to occupational hazards remains a significant driver of asthma- and lung cancer-related morbidity and mortality, particularly in rapidly industrializing regions such as Southeast Asia. However, comprehensive assessments of long-term regional trends and future projections of occupational respiratory diseases remain limited. This study aimed to evaluate the temporal dynamics of occupational asthma and occupational lung cancer burden in Southeast Asia from 1990 to 2021 and to project future trends through 2035. METHODS Data were obtained from the Global Burden of Disease (GBD) Study 2021 to assess mortality and disability-adjusted life years (DALYs) attributable to occupational asthma and lung cancer in Southeast Asia. To enhance model validation, additional metrics, including the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC), were applied, together with K-fold cross-validation to assess model generalizability. Sensitivity analyses were conducted to examine the robustness of findings under alternative assumptions. RESULTS From 1990 to 2021, the age-standardised DALY rate of occupational asthma declined by 33.45%, although the absolute number of DALYs increased due to population growth and ageing. In contrast, occupational lung cancer exhibited a persistent upward trend in both absolute burden and age-standardised rates, with older men disproportionately affected. Decomposition analyses identified that population ageing and population growth were the key contributors to the overall increase in disease burden. Projections through 2035 suggest that asthma-related burden will continue to decrease, whereas occupational lung cancer burden is expected to increase further. CONCLUSION Although age-standardised rates of occupational asthma have improved, the overall burden remains substantial, largely due to population growth and ageing, which continue to place considerable pressure on occupational health systems.

Tuberculosis burden attributable to smoking in China 1990–2021 and projections to 2040: A secondary analysis of GBD 2021 data

INTRODUCTION Smoking is a well-established modifiable risk factor for tuberculosis (TB). However, the evolving smoking-attributable TB burden in China remains to be fully characterized. The objective was to examine temporal trends in the smoking-attributable TB burden in China from 1990 to 2021. METHODS A secondary analysis was conducted on the 2021 Global Burden of Disease Study data. Data on the number of deaths and disability adjusted life years (DALYs) due to smoking-attributable TB, as well as age-standardized rates, were extracted for the overall Chinese population, males, and females from 1990 to 2021. Joinpoint regression and age-period-cohort analyses described 32-year trends. A Bayesian age-period-cohort (BAPC) model was used to forecast the TB burden from 2022 to 2040. Drivers behind the burden trends were investigated through a decomposition analysis. RESULTS Between 1990 and 2021, TB deaths, DALYs, age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed significant reductions, with the ASMR and ASDR declining from 5.10/100000 (95% UI: 3.64–6.73) and 158.48/100000 (95% UI: 114.49–203.94) in 1990 to 0.52/100000 (95% UI: 0.37–0.76) and 19.15/100000 (95% UI: 13.85–26.70) in 2021, respectively. Declines in ASMR (-95.26% vs -89.35%) and ASDR (-93.69% vs -87.35%) were larger in females than in males. Age-period-cohort analyses revealed that mortality and DALY rates peaked at ages 30–34 years and then declined. Male mortality increased slightly at ages 65–69 years. Both period and cohort effects demonstrated consistent downward trends. BAPC projections indicated that after 2022, deaths and DALYs would decline initially but rise again, whereas ASMR and ASDR would continue to fall. CONCLUSIONS The smoking-attributable TB burden in China exhibits significant age- and sex-specific patterns. Despite overall attenuation, projected rebounds in deaths by 2040 call for sustained public health interventions.

Burden of Stroke and Its Subtypes in Young Adults in China: A Systematic Analysis from 1990 to 2023 and Projections to 2050.

Burden of chronic kidney disease and its attributable risk factors in 204 countries and territories, 1990–2021: Results from the Global Burden of Disease study 2021

Chronic kidney disease (CKD) remains a major contributor to global mortality and morbidity. This study reports the global, regional, and national burden of CKD and its attributable risk factors from 1990 to 2021. Data were systematically analyzed using the Global Burden of Disease 2021 study. CKD prevalence, deaths, and disability-adjusted life years (DALYs), along with their attributable risk factors, were retrieved for 204 countries and territories from 1990 to 2021. Temporal trends were assessed using the percentage change in age‑standardized rates, with stratified analyses by Global Burden of Disease super‑region, country, age, sex, and sociodemographic index quintiles. In 2021, CKD affected 673.7 million people worldwide, resulting in 1.53 million deaths and causing 44.45 million DALYs. Key findings include: first, the global age-standardized prevalence rate of CKD was 8006 per 100,000 people, a 4.5% decrease since 1990. However, the age-standardized mortality rate increased by 24.6% to 18.5 per 100,000. Second, the highest CKD prevalence was observed in Central Asia, Southeast Asia, and South Asia, while the lowest was found in Western Europe and Eastern Sub-Saharan Africa. Third, high blood glucose, hypertension, and obesity were identified as the leading contributors to CKD-related DALYs globally. The global burden of CKD continues to rise, with mortality and DALYs increasing particularly in low- and middle-income countries. Urgent public health strategies targeting high blood glucose, hypertension, and obesity are critical to reducing the rising global burden of CKD.

Disease burden and attributable risk factors of Tuberculosis among adults aged 60 years and older in China from 1990 to 2021 and its prediction to 2041.

BACKGROUND TB continues to pose considerable threats to elderly populations worldwide. Drawing on the Global Burden of Disease 2021 dataset spanning three decades, this investigation explores how TB burden has shifted among Chinese seniors aged 60 and above. METHODS Standardized epidemiological metrics for incidence, prevalence, mortality, disability-adjusted life years, age-standardised rate and average annual percent change were calculated. Joinpoint regression analysis was applied to identify periods manifesting notable changes and an age-period-cohort framework was employed to estimate the age, period, and cohort effects. Modifiable contributors were measured through attributable fraction analysis, and Bayesian modeling were used to predict long-term trends to 2041. RESULTS Drug-susceptible TB declined steadily (-8.07%), whereas drug-resistant TB escalated dramatically, with XDR-TB rising 2133.81% and MDR-TB increasing by and 20.29% relative to 1990, respectively. Men carried roughly twice the disease burden of women, driven largely by smoking and alcohol. Conversely, obesity and diabetes became the prominent drivers among older women after 2006. HIV-associated TB in the elderly patients showed no signs of abating. Projections suggest drug-susceptible TB will keep declining, whereas drug-resistant TB will keep growing. CONCLUSIONS Older Chinese adults confront a multifaceted TB epidemic marked by declining drug-susceptible TB cases, rising drug‑resistant cases, gender-specific risk profiles, and an emerging HIV-TB syndemic. Addressing sex-differentiated risk profiles and strengthening resistance surveillance are essential steps toward national elimination goals.