A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Lim, Stephen S., Vos, Theo, Flaxman, Abraham D., Danaei, Goodarz, Shibuya, Kenji, Adair-Rohani, Heather, Amann, Markus, Anderson, H. Ross, Andrews, Kathryn G., Aryee, Martin, Atkinson, Charles, Bacchus, Loraine J., Bahalim, Adil N., Balakrishnan, Kalpana, Balmes, John, Barker-Collo, Suzanne, Baxter, Amanda, Bell, Michelle L., Blore, Jed D., Blyth, Fiona, Bonner, Carissa, Borges, Guilherme, Bourne, Rupert, Boussinesq, Michel, Brauer, Michael, Brooks, Peter, Bruce, Nigel G., Brunekreef, Bert, Bryan-Hancock, Claire, Bucello, Chiara, Buchbinder, Rachelle, Bull, Fiona, Burnett, Richard T., Byers, Tim E., Calabria, Bianca, Carapetis, Jonathan, Carnahan, Emily, Chafe, Zoe, Charlson, Fiona, Chen, Honglei, Chen, Jian Shen, Cheng, Andrew Tai-Ann, Child, Jennifer Christine, Cohen, Aaron, Colson, K. Ellicott, Cowie, Benjamin C., Darby, Sarah, Darling, Susan, Davis, Adrian, Degenhardt, Louisa, Dentener, Frank, Des Jarlais, Don C., Devries, Karen, Dherani, Mukesh, Ding, Eric L., Dorsey, E. Ray, Driscoll, Tim, Edmond, Karen, Ali, Suad Eltahir, Engell, Rebecca E., Erwin, Patricia J., Fahimi, Saman, Falder, Gail, Farzadfar, Farshad, Ferrari, Alize, Finucane, Mariel M., Flaxman, Seth, Fowkes, Francis Gerry R., Freedman, Greg, Freeman, Michael K., Gakidou, Emmanuela, Ghosh, Santu, Giovannucci, Edward, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R., Hall, Wayne, Hoek, Hans W., Hogan, Anthony, Hosgood, H. Dean, III, Hoy, Damian, Hu, Howard, Hubbell, Bryan J., Hutchings, Sally J., Ibeanusi, Sydney E., Jacklyn, Gemma L., Jasrasaria, Rashmi, Jonas, Jost B., Kan, Haidong, Kanis, John A., Kassebaum, Nicholas, Kawakami, Norito, Khang, Young-Ho, Khatibzadeh, Shahab, Khoo, Jon-Paul, Kok, Cindy, Laden, Francine, Lalloo, Ratilal, Lan, Qing, Lathlean, Tim, Leasher, Janet L., Leigh, James, Li, Yang, Lin, John Kent, Lipshultz, Steven E., London, Stephanie, Lozano, Rafael, Lu, Yuan, Mak, Joelle, Malekzadeh, Reza, Mallinger, Leslie, Marcenes, Wagner, March, Lyn, Marks, Robin, Martin, Randall, McGale, Paul, McGrath, John, Mehta, Sumi, Mensah, George A., Merriman, Tony R., Micha, Renata, Michaud, Catherine, Mishra, Vinod, Hanafiah, Khayriyyah Mohd, Mokdad, Ali A., Morawska, Lidia, Mozaffarian, Dariush, Murphy, Tasha, Naghavi, Mohsen, Neal, Bruce, Nelson, Paul K., Miquel Nolla, Joan, Norman, Rosana, Olives, Casey, Omer, Saad B., Orchard, Jessica, Osborne, Richard, Ostro, Bart, Page, Andrew, Pandey, Kiran D., Parry, Charles D. H., Passmore, Erin, Patra, Jayadeep, Pearce, Neil, Pelizzari, Pamela M., Petzold, Max, Phillips, Michael R., Pope, Dan, Pope, C. Arden, III, Powles, John, Rao, Mayuree, Razavi, Homie, Rehfuess, Eva A., Rehm, Juergen T., Ritz, Beate, Rivara, Frederick P., Roberts, Thomas, Robinson, Carolyn, Rodriguez-Portales, Jose A., Romieu, Isabelle, Room, Robin, Rosenfeld, Lisa C., Roy, Ananya, Rushton, Lesley, Salomon, Joshua A., Sampson, Uchechukwu, Sanchez-Riera, Lidia, Sanman, Ella, Sapkota, Amir, Seedat, Soraya, Shi, Peilin, Shield, Kevin, Shivakoti, Rupak, Singh, Gitanjali M., Sleet, David A., Smith, Emma, Smith, Kirk R., Stapelberg, Nicolas J. C., Steenland, Kyle, Stoeckl, Heidi, Stovner, Lars Jacob, Straif, Kurt, Straney, Lahn, Thurston, George D., Tran, Jimmy H., Van Dingenen, Rita, van Donkelaar, Aaron, Veerman, J. Lennert, Vijayakumar, Lakshmi, Weintraub, Robert, Weissman, Myrna M., White, Richard A., Whiteford, Harvey, Wiersma, Steven T., Wilkinson, James D., Williams, Hywel C., Williams, Warwick, Wilson, Nicholas, Woolf, Anthony D., Yip, Paul, Zielinski, Jan M., Lopez, Alan D., Murray, Christopher J. L. and Ezzati, Majid (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380 9859: 2224-2260. doi:10.1016/S0140-6736(12)61766-8


Author Lim, Stephen S.
Vos, Theo
Flaxman, Abraham D.
Danaei, Goodarz
Shibuya, Kenji
Adair-Rohani, Heather
Amann, Markus
Anderson, H. Ross
Andrews, Kathryn G.
Aryee, Martin
Atkinson, Charles
Bacchus, Loraine J.
Bahalim, Adil N.
Balakrishnan, Kalpana
Balmes, John
Barker-Collo, Suzanne
Baxter, Amanda
Bell, Michelle L.
Blore, Jed D.
Blyth, Fiona
Bonner, Carissa
Borges, Guilherme
Bourne, Rupert
Boussinesq, Michel
Brauer, Michael
Brooks, Peter
Bruce, Nigel G.
Brunekreef, Bert
Bryan-Hancock, Claire
Bucello, Chiara
Buchbinder, Rachelle
Bull, Fiona
Burnett, Richard T.
Byers, Tim E.
Calabria, Bianca
Carapetis, Jonathan
Carnahan, Emily
Chafe, Zoe
Charlson, Fiona
Chen, Honglei
Chen, Jian Shen
Cheng, Andrew Tai-Ann
Child, Jennifer Christine
Cohen, Aaron
Colson, K. Ellicott
Cowie, Benjamin C.
Darby, Sarah
Darling, Susan
Davis, Adrian
Degenhardt, Louisa
Dentener, Frank
Des Jarlais, Don C.
Devries, Karen
Dherani, Mukesh
Ding, Eric L.
Dorsey, E. Ray
Driscoll, Tim
Edmond, Karen
Ali, Suad Eltahir
Engell, Rebecca E.
Erwin, Patricia J.
Fahimi, Saman
Falder, Gail
Farzadfar, Farshad
Ferrari, Alize
Finucane, Mariel M.
Flaxman, Seth
Fowkes, Francis Gerry R.
Freedman, Greg
Freeman, Michael K.
Gakidou, Emmanuela
Ghosh, Santu
Giovannucci, Edward
Gmel, Gerhard
Graham, Kathryn
Grainger, Rebecca
Grant, Bridget
Gunnell, David
Gutierrez, Hialy R.
Hall, Wayne
Hoek, Hans W.
Hogan, Anthony
Hosgood, H. Dean, III
Hoy, Damian
Hu, Howard
Hubbell, Bryan J.
Hutchings, Sally J.
Ibeanusi, Sydney E.
Jacklyn, Gemma L.
Jasrasaria, Rashmi
Jonas, Jost B.
Kan, Haidong
Kanis, John A.
Kassebaum, Nicholas
Kawakami, Norito
Khang, Young-Ho
Khatibzadeh, Shahab
Khoo, Jon-Paul
Kok, Cindy
Laden, Francine
Lalloo, Ratilal
Lan, Qing
Lathlean, Tim
Leasher, Janet L.
Leigh, James
Li, Yang
Lin, John Kent
Lipshultz, Steven E.
London, Stephanie
Lozano, Rafael
Lu, Yuan
Mak, Joelle
Malekzadeh, Reza
Mallinger, Leslie
Marcenes, Wagner
March, Lyn
Marks, Robin
Martin, Randall
McGale, Paul
McGrath, John
Mehta, Sumi
Mensah, George A.
Merriman, Tony R.
Micha, Renata
Michaud, Catherine
Mishra, Vinod
Hanafiah, Khayriyyah Mohd
Mokdad, Ali A.
Morawska, Lidia
Mozaffarian, Dariush
Murphy, Tasha
Naghavi, Mohsen
Neal, Bruce
Nelson, Paul K.
Miquel Nolla, Joan
Norman, Rosana
Olives, Casey
Omer, Saad B.
Orchard, Jessica
Osborne, Richard
Ostro, Bart
Page, Andrew
Pandey, Kiran D.
Parry, Charles D. H.
Passmore, Erin
Patra, Jayadeep
Pearce, Neil
Pelizzari, Pamela M.
Petzold, Max
Phillips, Michael R.
Pope, Dan
Pope, C. Arden, III
Powles, John
Rao, Mayuree
Razavi, Homie
Rehfuess, Eva A.
Rehm, Juergen T.
Ritz, Beate
Rivara, Frederick P.
Roberts, Thomas
Robinson, Carolyn
Rodriguez-Portales, Jose A.
Romieu, Isabelle
Room, Robin
Rosenfeld, Lisa C.
Roy, Ananya
Rushton, Lesley
Salomon, Joshua A.
Sampson, Uchechukwu
Sanchez-Riera, Lidia
Sanman, Ella
Sapkota, Amir
Seedat, Soraya
Shi, Peilin
Shield, Kevin
Shivakoti, Rupak
Singh, Gitanjali M.
Sleet, David A.
Smith, Emma
Smith, Kirk R.
Stapelberg, Nicolas J. C.
Steenland, Kyle
Stoeckl, Heidi
Stovner, Lars Jacob
Straif, Kurt
Straney, Lahn
Thurston, George D.
Tran, Jimmy H.
Van Dingenen, Rita
van Donkelaar, Aaron
Veerman, J. Lennert
Vijayakumar, Lakshmi
Weintraub, Robert
Weissman, Myrna M.
White, Richard A.
Whiteford, Harvey
Wiersma, Steven T.
Wilkinson, James D.
Williams, Hywel C.
Williams, Warwick
Wilson, Nicholas
Woolf, Anthony D.
Yip, Paul
Zielinski, Jan M.
Lopez, Alan D.
Murray, Christopher J. L.
Ezzati, Majid
Total Author Count Override 207
Title A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
1474-547X
Publication date 2012-12
Sub-type Article (original research)
DOI 10.1016/S0140-6736(12)61766-8
Volume 380
Issue 9859
Start page 2224
End page 2260
Total pages 37
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Collection year 2013
Language eng
Formatted abstract
Background Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time.
Methods We estimated deaths and disability-adjusted life years; DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden.
Findings In 2010, the three leading risk factors for global disease burden were high blood pressure (7 0% [95% uncertainty interval 6 2-7 7] of global DALYs); tobacco smoking including second-hand smoke (6 3% [5 5-7 0]), and alcohol use (5 5% [5 0-5 9]). In 1990, the leading risks were childhood underweight (7 9% [6 8-9 4]), household air pollution from solid fuels; (HAP; 7 0% [5 6-8 3]), and tobacco smoking including second-hand smoke (6 1% [5 4-6 8]). Dietary risk factors and physical inactivity collectively accounted for 10 0% (95% UI 9 2-10 8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water ' and sanitation accounting for 0 9% (0 4-1 6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania.
Interpretation Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children
Keyword Coronary heart disease
Lung cancer risk
Fine particulate matter
Asia Pacific region
Cardiovascular disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Queensland Brain Institute Publications
Official 2013 Collection
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School of Medicine Publications
 
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