Cancer burden and health inequalities attributable to occupational arsenic exposure: A 32-year global, regional, and national observational study with projections to 2036
Focused interventions in low- and middle-SDI countries and rapidly industrializing regions are needed, including strengthened occupational exposure regulations, improved workplace arsenic monitoring, engineering controls, personal protective equipment, and regular health surveillance for workers in high-risk industries, to reduce inequalities and mitigate public health threats.
Abstract
Occupational arsenic exposure (OEA), mainly through inhalation in workplace settings, is an established carcinogenic hazard associated with lung, skin, and bladder cancers. However, long-term trends and the global cancer burden attributable to OEA remain insufficiently characterized. Data from the Global Burden of Disease Study 2021 were used to analyze the cancer burden attributable to OEA from 1990 to 2021. Indicators included summary exposure values (SEVs), deaths, years lived with disability (YLDs), and disability-adjusted life years (DALYs) at global, regional, and national levels. Estimates were reported with 95% uncertainty intervals (UIs) generated from 1000 Monte Carlo simulations. Age-standardized indicators, Joinpoint regression, inequality analysis, decomposition analysis, and frontier analysis were used to assess spatiotemporal trends, drivers, and disparities. Seven forecasting models were evaluated to predict trends from 2022 to 2036. Between 1990 and 2021, global OEA SEV increased from 0.408% to 0.496% (average annual percentage change [AAPC] = 0.288). Cancer deaths rose from 5.5 to 10.5 thousand, YLD from 1.5 to 3.3 thousand, and DALYs from 169.6 to 298.7 thousand. In contrast, age-standardized death rate (AAPC = −0.300) and DALYs rate (AAPC = −0.531) declined. Men bore higher overall burdens, but women experienced faster increases (AAPC 0.428 vs 0.171). High-socio-demographic index (SDI) countries showed continuous improvement, whereas middle- and low-SDI regions-particularly East, South, and Southeast Asia-experienced substantial increases. In East Asia, the AAPCs for age-standardized SEVs, age-standardized death rates, age-standardized YLDs rates, and DALYs rates were 0.953, 1.067, 1.849, and 0.809, respectively. Inequality analysis indicated stable absolute gaps but reduced relative disparities, with burdens still concentrated in low-SDI countries. Decomposition suggested that population growth was the main driver of global burden increases, and frontier analysis highlighted limited improvement potential in low-SDI regions. Forecasting models indicated that the absolute burden of occupational arsenic exposure will continue to rise over the next 15 years. The cancer burden attributable to OEA is still increasing globally, with persistent prevention gaps and socioeconomic disparities. Focused interventions in low- and middle-SDI countries and rapidly industrializing regions are needed, including strengthened occupational exposure regulations, improved workplace arsenic monitoring, engineering controls, personal protective equipment, and regular health surveillance for workers in high-risk industries, to reduce inequalities and mitigate public health threats.
Background Lung cancer is the leading cause of cancer-related death worldwide, with significant regional and sex differences in incidence and mortality. Although age-standardized rates are commonly used for comparisons, they do not reflect the cumulative lifetime risk, which is important for understanding the full burden of the disease because it captures the probability of an individual developing or dying from lung cancer over their lifetime. Methods This study estimates global lifetime risk of incidence (LRI) and lifetime risk of mortality (LRM) using GLOBOCAN 2022 data and the adjusted for multiple primaries method. Socioeconomic indicators (Human Development Index, national income) came from the UN Development Programme and World Bank; air pollutant exposures from global environmental databases; and smoking-related indicators from the WHO Global Health Observatory. Associations between LRI/LRM and these factors were then explored. Results In 2022, global LRI was 4.91%, and LRM was 4.07%. Regionally, North America exhibited the highest LRI (7.30%) and LRM (5.38%), while Africa had the lowest (LRI: 0.99%, LRM: 0.93%). Globally and across all continents, lifetime risks were significantly higher in males than in females. Regression analysis revealed that smoking prevalence was positively associated with both LRI (β = 0.001, P < 0.001) and LRM (β = 0.0002, P < 0.01). Exposure to PM1 was strongly linked to higher LRI (β = 0.40, P = 0.001) and LRM (β = 0.20, P = 0.006); PM2.5 showed similar associations (LRI: β = 0.36, P = 0.002; LRM: β = 0.18, P = 0.015). The strongest associations were observed for fine particles (PM1 and PM2.5). Furthermore, higher national socioeconomic development was positively correlated with increased LRI and LRM. Conclusion These findings suggest that socioeconomic and environmental factors may be associated with regional disparities in lung cancer burden. This evidence could offer insights for targeted prevention policies, including smoking control and air quality management.
Jiawei Zhai, Huijuan Zheng, Lan-Gang Xue· Frontiers in Public Health· 0 citations
Background Tracheal, bronchial, and lung (TBL) cancer attributable to environmental and behavioral exposures remains a major global health concern. However, evidence on long-term trends, inequalities, and future burden among women remains limited. This study used Global Burden of Disease (GBD) 2023 data to address these gaps. Methods We analyzed female TBL cancer data from the GBD 2023 (1990–2023) to assess mortality and disability-adjusted life year (DALY) patterns associated with five rountine inhalation-related risk factors. We further evaluated associations with the socio-demographic index (SDI) using smoothing and deviation analyses, quantified SDI-related inequalities through concentration indices, decomposed burden changes by demographic and epidemiological factors, and projected the burden to 2030. Results In 2023, smoking remained the leading contributor to female TBL cancer mortality, followed by ambient particulate matter and secondhand smoke. Between 1990 and 2023, mortality attributable to household solid fuel declined most markedly, whereas mortality related to particulate matter increased slightly. Comparable trends were observed for DALYs. Marked cross-country and regional heterogeneity was observed by risk factors, with China standing out for particulate matter-related burden. Along socio-demographic gradients, burdens from radon and tobacco-related hazards rose with SDI alongside elevated concentration indices, whereas solid fuel burdens declined with increasingly negative concentration indices, and particulate matter displayed a rising burden but diminishing inequality. Population growth and aging drove increases in burdens from particulate matter, radon, and tobacco, whereas epidemiological change reduced solid fuel-related burden. By 2030, burdens attributable to particulate matter, radon, and secondhand smoke are projected to continue increasing, whereas the burden related to solid fuel is expected to decline. Although the number of smoking-related cases is projected to increase, the corresponding rate is expected to decrease. Conclusions Our findings underscore the need to prioritize surveillance of inhalation-related hazards for female TBL cancer, especially in resource-limited and rapidly developing regions beyond traditionally industrialized settings.
Songsong Wang, Congcong Zhao, Hanpeng Lai· Frontiers in Global Women's...· 0 citations
BACKGROUND
Cardiovascular disease (CVD) remains a leading cause of mortality worldwide. Emerging evidence indicates that environmental and occupational risk factors (EORF) are significantly associated with its onset. However, the current global burden of CVD attributable to these exposures remains unclear.
METHOD
Using data from the Global Burden of Disease (GBD) Study, we estimated the number of deaths, disability-adjusted life years (DALYs), age-standardized death and DALY rates attributable to EORF from 1990 to 2021. Estimates were stratified by sex, region, and year. Additionally, we assessed the association between the EORF-related CVD burden and sociodemographic index (SDI).
RESULT
We found that CVD mortality due to EORF increased from 4.42million in 1990 to 6.44 million in 2021 (95% UI: 4.99-7.77), representing a 45.7% increase, while DALYs rose from 103million in 1990 to 138 million in 2021 (95% UI: 109-165), marking a 34.0% rise. During this period, age-standardized death and DALY rates globally showed a downward trend, decreasing by 38.5% and 38.9% respectively. At the national and regional levels, Western Australia and high SDI regions in Australia demonstrated significant improvements in EORF-related CVD burden. Additionally, men exhibit higher CVD burdens compared to women.
CONCLUSION
Our findings indicate that the overall burden of CVD attributable to EORF has increased substantially in the current population, highlighting significant room for improvement in prevention and control strategies. There is an urgent need to implement effective interventions targeting major EORF to mitigate the global CVD burden associated with these modifiable risks.
OBJECTIVE
To evaluate the temporal trends and future burden of six occupational risk factors in China from 1990 to 2035.
METHODS
Data were obtained from the Global Burden of Disease Study 2021. Age-standardized rates, age-period-cohort analysis, and Bayesian age-period-cohort models were used to assess trends and project disease burden.
RESULTS
In 2021, six occupational risk factors accounted for 17.90 million disability-adjusted life years in China. The age-standardized rate declined by 58.8%, from 2,362.18 in 1990 to 974.00 per 100,000 population in 2021. Chronic obstructive pulmonary disease, low back pain, and age-related and other hearing loss accounted for 59.5% of the burden. Age-standardized rates attributable to occupational asthmagens and carcinogens were projected to increase through 2035, particularly among women.
CONCLUSIONS
Although China has substantially reduced occupational disease burden, chronic conditions and vulnerable populations require greater attention through targeted strategies.
H. Lou, Ji-mi Zhang, Xin Wang et al.· Journal of Occupational and...· 0 citations
Background Lung cancer remains the leading cause of cancer mortality worldwide. While incidence and mortality describe population burden, they do not fully capture disease severity at the level of the individual patient. This study quantified the contemporary global burden, temporal trends, and future trajectory of tracheal, bronchus, and lung (TBL) cancer, and applied a multidimensional severity framework integrating fatal and non-fatal outcomes. Methods A global ecological analysis was conducted across 185 countries and territories using harmonized data from GLOBOCAN 2022, the Global Burden of Disease (GBD) 2023 study, and the UN World Population Prospects 2024. Contemporary burden was assessed using incident cases, deaths, age-standardized incidence and mortality rates (ASIR/ASMR), disability-adjusted life years (DALYs), mortality-to-incidence ratio (MIR), and DALYs per incident case. Temporal trends in ASIR and ASMR (2010–2023) were estimated using log-linear regression to derive average annual percent change (AAPC). Projections to 2050 were generated under two scenarios: (1) constant 2022 rates reflecting demographic change only, and (2) trend-based projections extrapolating country-specific AAPCs. Disease severity was evaluated using a two-dimensional framework combining MIR and DALYs-per-case, which captures average lifetime health loss per diagnosed individual independent of population size or age structure. Results In 2022, an estimated 2.48 million new TBL cancer cases and 1.82 million deaths occurred globally, corresponding to ASIR and ASMR of 23.6 and 16.8 per 100,000, respectively. Global DALYs reached 46.7 million, yielding 18.8 DALYs per case, with substantially higher burden in males and in higher-SDI regions. From 2010-2023, age-standardized rates increased in most low- and middle-income countries and declined predominantly in high-income settings. By 2050, demographic change alone is projected to drive large increases in burden in many low-resource countries, with further amplification under trend-based scenarios. DALYs-per-case showed a moderate positive correlation with MIR (Spearman’s r_s = 0.46), revealing marked heterogeneity in severity profiles across countries. Conclusions Global lung cancer burden is projected to rise substantially in many regions despite declining rates in high-income settings. Integrating DALYs-per-case with MIR provides a complementary severity lens that highlights inequities not captured by incidence and mortality alone and supports more targeted prevention, treatment, and survivorship strategies.
O. Freihat, M. Aamir, Z. Cselik et al.· PLoS ONE· 0 citations
INTRODUCTION Musculoskeletal disorders (MSDs) are a leading source of disability worldwide, but the population-level burden attributable to smoking remains insufficiently characterized. The aim of this study was to quantify global, regional, and national smoking-attributable burden of MSDs from 1990 to 2021, and to explore socioeconomic inequalities and projections to 2050. METHODS This secondary dataset analysis used Global Burden of Disease Study 2021 estimates for smoking-attributable DALYs due to MSDs. Eligible estimates included both sexes combined, the risk factor smoking, the aggregate cause category of MSDs, all-age DALYs, age-standardized DALYs rate (ASDR), age-specific rates, global, sociodemographic index (SDI), regional, and national locations, for years 1990–2021. Temporal trends were summarized using estimated annual percentage change (EAPC) and joinpoint regression. Socioeconomic inequality, frontier performance, and exploratory autoregressive integrated moving average projections to 2050 were assessed; Bayesian age-period-cohort forecasts were used as sensitivity analysis for global DALYs. RESULTS Global smoking-attributable DALYs due to MSDs increased from 6.82 million (95% UI: 3.85–10.12) in 1990 to 8.89 million (95% UI: 4.72–13.68) in 2021, whereas ASDR decreased from 153.57 (95% UI: 85.94–228.28) to 102.44 (95% UI: 54.60–157.30). The global EAPC in ASDR was -1.20% (95% CI: -1.24 – -1.16). The largest relative increases in DALYs occurred in Middle-SDI regions (89.15%) and Low-SDI regions (71.71%). High-SDI regions retained the highest ASDR in 2021 (154.13; 95% UI: 81.19–231.32). Exploratory projections suggested that global ASDR may decline to 45.40 (95% UI: 29.06–61.74) by 2050, while DALYs may reach 7.53 million (95% UI: 4.12–10.93). CONCLUSIONS Smoking-attributable MSDs remain a measurable component of global disability burden. The persistence of absolute burden despite declining ASDR may warrant greater consideration in future tobacco-related burden assessments and rehabilitation planning, while causal and policy interpretations warrant cautious interpretation as this is an ecological modelling study.
