Abstract Background Chronic Obstructive Pulmonary Disease (COPD) remains a major global health challenge, with over half of its burden attributable to modifiable environmental and occupational risk factors (ER/OR) such as air pollution, ambient ozone, and workplace exposures. Despite advances in care, the impact of ER/OR on COPD persists, especially in low-resource settings. Methods We analyzed mortality and disability-adjusted life years (DALYs) due to COPD attributable to ER/OR using the Global Burden of Disease 2023 comparative risk assessment framework. Population Attributable Fractions (PAFs) were derived by integrating relative risk estimates with global exposure distributions and applied to COPD outcomes to estimate the attributable burden. Temporal trends from 1990 to 2023 were assessed using the Annualized Average Percent Change (AAPC), estimated through log-linear regression models, with 95% uncertainty intervals (UIs) calculated across 1,000 draws, stratified by age, sex, year, and location for all 204 countries and territories. Results As of 2023, ER/OR factors accounted for 53.5% of all global COPD deaths and 51.3% of COPD-related DALYs. Among specific risk factors, high temperature exposure showed the steepest rise in mortality (AAPC = +3.84%, 95% UI: nan to 3.16), followed by ambient particulate matter (AAPC = +0.72%, 95% UI: 0.61-0.83) and ambient ozone (AAPC = +0.43%, 95% UI: 0.35-0.52). In contrast, household air pollution from solid fuels and occupational particulate/gas/fume exposure declined significantly (AAPC = -1.29% and -0.72%, respectively). Regionally, COPD mortality attributable to ER/OR risks decreased in high-income (-0.42%) and upper-middle-income (-0.18%) regions, remained stable in lower-middle-income regions (+0.27%), and rose in low-income countries (+0.61%). Age-wise trends revealed a mild decline among individuals aged 20-54 years (-0.2%), but a significant rise in the 55+ age group (+0.93%). Gender-wise, the burden grew faster in females (+1.97%) compared to males (+0.16%). For disability metrics, YLDs increased annually for both males (+1.58%) and females (+1.49%), while YLLs rose in females (+1.62%) but declined in males (-0.28%), suggesting widening sex disparities in both fatal and non-fatal COPD outcomes. Conclusions Despite global progress in reducing select environmental and occupational exposures, rising COPD mortality and disability among women, the elderly, and residents of low-income countries highlight persistent inequalities. Climate-sensitive and pollution-targeted interventions—especially in vulnerable geographies—are urgently needed to reverse these escalating trends. This abstract is funded by: None
Aleem et al. (Fri,) studied this question.
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