Potential Drivers for the Spatiotemporal Patterns of the Global Burden of Chronic Obstructive Pulmonary Disease Attributable to Ambient Ozone, 1990-2019

Int J Public Health. 2024 Jul 23:69:1606062. doi: 10.3389/ijph.2024.1606062. eCollection 2024.

Abstract

Objectives: To identify the long-term spatiotemporal trend of ozone-related chronic obstructive pulmonary disease (COPD) burden by sex and country and to explore potential drivers.

Methods: We retrieved data of ozone-related COPD death and disability adjusted life year (DALY) from the Global Burden of Disease 2019. We used a linear regression of natural logarithms of age-standardized rates (ASRs) with calendar year to examine the trends in ASRs and a panel regression to identify country-level factors associated with the trends.

Results: Global ozone-attributable COPD deaths increased from 117,114 to 208,342 among men and from 90,265 to 156,880 among women between 1990 and 2019. Although ASRs of ozone-related COPD death and DALY declined globally, they increased in low and low-middle Socio-demographic Index (SDI) regions, with faster rise in women. Elevated average maximum temperature was associated with higher ozone-attributable COPD burden, while more green space was associated with lower burden.

Conclusion: More efforts are needed in low and low-middle SDI regions, particularly for women, to diminish inter-country inequality in ozone-attributable COPD. Global warming may exacerbate the burden. Expanding green space may mitigate the burden.

Keywords: GBD; chronic obstructive pulmonary disease; global warming; green space; ozone.

MeSH terms

  • Aged
  • Air Pollutants / adverse effects
  • Air Pollution / adverse effects
  • Disability-Adjusted Life Years
  • Environmental Exposure / adverse effects
  • Female
  • Global Burden of Disease*
  • Global Health*
  • Humans
  • Male
  • Middle Aged
  • Ozone* / adverse effects
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Sex Factors
  • Spatio-Temporal Analysis

Substances

  • Ozone
  • Air Pollutants

Grants and funding

The authors declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Youth Science Foundation of Chinese Center for Diseases Control and Prevention (grant number: 2022A201). The funders had no role in the study design, data collection, and analysis, decision to publish or preparation of the manuscript.