Global, regional, and national burden of chronic obstructive pulmonary disease and its attributable risk factors from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021

Background: Chronic obstructive pulmonary disease (COPD) continues to be a significant issue, leading to premature death or reduced quality of life. It's important to assess the current burden of COPD and its risk factors on a geographical basis to guide health policy.

Methods: Data on the prevalence, deaths, and disability-adjusted life years (DALYs) related to COPD, and risk-attributable burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database. The relationship between COPD DALYs and the sociodemographic index (SDI) was estimated using Smoothing Splines models.

Results: Between 1990 and 2021, the changes were -1.46% (95% uncertainty interval [UI] -3.36% to 0.39%) in age-standardized prevalence, -37.12% (-43.37% to -27.68%) in mortality, and -36.98% (-42.37% to -28.54%) in DALYs rate. In 2021, a total of 213.39 million prevalent cases of COPD were estimated. The age-standardized prevalence of COPD increased with age and was more common in males. The age-standardized COPD DALYs had a reversed U-shaped relationship with SDI at the regional level, with the highest burden at an SDI of about 0.45. At the global level, smoking had the highest influence on COPD DALYs, accounting for 34.8%, followed by ambient particulate matter pollution (22.2%), household air pollution from solid fuels (19.5%), and occupational particulate matter, gases, and fumes (15.8%).

Conclusions: The overall burden of COPD has been increasing despite improvements in some rates since 1990. It's crucial to focus on interventions such as smoking cessation and addressing environmental and occupational exposures.