Environmental Burden of Disease in Europe: Assessing Nine Risk Factors in Six Countries

Background: Environmental factors determine children’s health. Quantifying the health impacts related to environmental hazards for children is essential to prioritize interventions to improve health in Europe. Objective: This study aimed to assess the burden of childhood disease due to environmental risks across the European Union. Methods: We conducted an environmental burden of childhood disease assessment in the 28 countries of the EU (EU28) for seven environmental risk factors (particulate matter less than 10 micrometer of diameter (PM10) and less than 2.5 micrometer of diameter (PM2.5), ozone, secondhand smoke, dampness, lead, and formaldehyde). The primary outcome was disability-adjusted life years (DALYs), assessed from exposure data provided by the World Health Organization, Global Burden of Disease project, scientific literature, and epidemiological risk estimates. Results: The seven studied environmental risk factors for children in the EU28 were responsible for around 211,000 DALYs annually. Particulate matter (PM10 and PM2.5) was the main environmental risk factor, producing 59% of total DALYs (125,000 DALYs), followed by secondhand smoke with 20% of all DALYs (42,500 DALYs), ozone 11% (24,000 DALYs), dampness 6% (13,000 DALYs), lead 3% (6200 DALYs), and formaldehyde 0.2% (423 DALYs). Conclusions: Environmental exposures included in this study were estimated to produce 211,000 DALYs each year in children in the EU28, representing 2.6% of all DALYs in children. Among the included environmental risk factors, air pollution (particulate matter and ozone) was estimated to produce the highest burden of disease in children in Europe, half of which was due to the effects of PM10 on infant mortality. Effective policies to reduce environmental pollutants across Europe are needed.

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Introduction to the Environmental Burden of Disease concept – history, methods and selected results

European Journal of Public Health ◽

10.1093/eurpub/ckz185.655 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

D Plass ◽

M Tobollik ◽

D Wintermeyer

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Population Health ◽

Environmental Risk ◽

Burden Of Disease ◽

Disease Burden ◽

Environmental Risk Factors ◽

Attributable Fraction ◽

Environmental Risk Factor ◽

Environmental Burden

Abstract Background The Environmental Burden of Disease (EBD)-concept was introduced by the World Health Organization to quantify the impacts of environmental risk factors on population health in a comprehensive and comparable way. Since the first Global Burden of Disease (GBD)-study the EBD-methodology was used in numerous global, regional and national assessments. Methods In the EBD-concept data from different sources are joined using a standardized framework. To calculate the EBD several steps need to be taken into account. First, the exposure of the selected population towards an environmental risk factor is estimated. In a second step, exposure data and information from an exposure-response-function are combined by using the population attributable fraction formula. In a last step, the attributable fraction (percentage) is multiplied by the disease burden resulting from a selected health outcome to estimate the share of disease burden attributable to the environmental risk factor. Results Since the first GBD-study several stakeholders have used the EBD-concept to estimate the disease burden attributable to environmental risk factors. This lead to an increased number of available data sets, which - due to the varying assumptions used in the models - are not ad hoc comparable among each other. Generally, the results of EBD-assessments are presented using disability-adjusted life years (DALY) as the core measure of burden of disease assessments. However, e. g. due to lack of data, assessments also focus on the number of attributable deaths, illnesses or single components of the DALY such as the years of life lost due to premature mortality (YLL). Conclusions The EBD-concept allows to compare the impact of environmental risk factors on population health. Though the general concept is widely standardized, assumptions on model parameters can lead to varying results. Therefore, when communicating EBD-results it is necessary to be very transparent about data and model inputs.

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Skills building seminar: Environmental Burden of Disease: methods and applications

European Journal of Public Health ◽

10.1093/eurpub/ckz185.654 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Keyword(s):

Risk Factors ◽

Environmental Risk ◽

Burden Of Disease ◽

Premature Death ◽

Environmental Risk Factors ◽

World Health ◽

Mitigation Measures ◽

Environmental Burden ◽

State Of Research ◽

Health Organization

Abstract There is an increasing body of evidence showing that environmental risk factors can cause illness and death. For example, particulate matter triggers lung cancer and noise increases the risk of heart attack. Consequently, governments worldwide should aim to mitigate the negative health effects of environmental exposures. The concept of Environmental Burden of Disease (EBD) aims to quantify the number of illnesses and deaths associated with various environmental risk factors, as well as the health benefits of potential prevention and mitigation measures. Current EBD studies commonly use the Disability-Adjusted Life Year (DALY) metric as a common currency for integrating the effects of ill health and premature death, thereby facilitating the comparison of the burden of various environmental risk factors amongst each other and with other risk factors. The EBD approach has been used since the 1990s, spearheaded by the World Health Organization. However, even today, the approach is not yet commonly adopted across Europe, mainly because of a lack of capacity. At the same time, the EBD approach remains in full development, trying to adapt to the current state of research. The overall aim of this skills building seminar is therefore to a) create awareness of the EBD approach, and b) to present and discuss current methodologies and future developments. The skills building seminar consists of four presentations. In the first presentation, the history and general methodological framework of the EBD approach will be outlined. Next, three presentations will present EBD case studies. These presentations will explain in a didactic, step-by-step way how the estimates were produced, and how technical challenges were addressed. Finally, ample time will be foreseen to discuss methodologies, challenges, possible solutions, and future collaborations to increase EBD capacity within Europe. Key messages Participants will gain insights in the use, strengths and weaknesses of the Environmental Burden of Disease approach. Participants will develop an understanding of current Environmental Burden of Disease methodology.

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Trends and Risk Factors of Mortality and Disability-Adjusted Life Years for Cardiovascular Diseases from 1990 to 2017: Systematic Analysis for the Global Burden of Disease Study 2017

SSRN Electronic Journal ◽

10.2139/ssrn.3724861 ◽

2020 ◽

Author(s):

Zhenkun Wang ◽

Zhishui Chen ◽

Congyi Wang ◽

Aihua Du ◽

Hong Liu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Burden Of Disease ◽

Global Burden Of Disease ◽

Global Burden ◽

Disability Adjusted Life Years ◽

Systematic Analysis ◽

Disability Adjusted Life ◽

Life Years ◽

Disease Study

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Unscattering the burden of disease landscape: supporting interaction between existing burden of disease efforts

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1378 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Haagsma ◽

M Majdan ◽

S M Pires ◽

R Assunção

Keyword(s):

Risk Factors ◽

Infectious Diseases ◽

Burden Of Disease ◽

Methodological Approach ◽

Data Sources ◽

Global Burden ◽

Disease Network ◽

Non Communicable Diseases ◽

Cost Action ◽

The Eu

Abstract The burden of disease landscape in Europe is currently scattered with experts from diverse professional backgrounds, ranging from experts in infectious diseases, non-communicable diseases, injuries and risk factors, to experts in more comprehensive national, regional and global burden of disease studies. Currently there is little interaction between these experts and existing burden of disease efforts. The European burden of disease network (burden-eu) COST Action aims to bring together expertise across different domains and professional backgrounds. During the course of the burden-eu COST Action, several steps will be taken to facilitate interaction between existing burden of disease efforts. First, a survey has been sent around to all members of the EU burden of disease network to map burden of disease studies that have been carried out in their country. Apart from general details about the year of the study and cause of disease categories, items of the survey included data sources, methodological approach and collaborations with institutes of other countries. In the first month, the survey has been completed for over 70 studies that have been carried out in twelve countries. Second, comparison of existing burden of disease initiatives allows for the identification of the various domains for which burden of disease has been assessed, highlight methodological differences as well as similarities, and facilitate improvements and harmonization of methods and approaches. Furthermore, the data collected from the survey will be included in a continuously updated burden of disease database that lists all past and current burden of disease activities. Lastly, burden-eu will facilitate regular meetings and workshops. Each of these steps will make it possible to move beyond the currently scattered burden of disease landscape and increase interaction between professionals and burden of disease efforts.

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Examination of incidence, mortality and disability-adjusted life years and risk factors of breast cancer in 49 Asian countries, 1990–2019: estimates from Global Burden of Disease Study 2019

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyab004 ◽

2021 ◽

Author(s):

Rajesh Sharma

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Mortality Rate ◽

Burden Of Disease ◽

Global Burden ◽

Disability Adjusted Life Years ◽

Asian Countries ◽

Disability Adjusted Life ◽

Life Years ◽

Standardized Mortality Rate

Abstract Background This study presents an up-to-date, comprehensive and comparative examination of breast cancer’s temporal patterns in females in Asia in last three decades. Methods The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. Results In Asia, female breast cancer incidence grew from 245 045[226 259–265 260] in 1990 to 914 878[815 789–1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6–22.9] to 35.9/100 000[32.0–40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094–148 380] to 337 822[301 454–375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0–13.1]; 2019: 13.4[12.0–14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95–21.4] in Mongolia to 122.5[92.1–160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2–8.8] in South Korea to 51.9[39.0–69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. Conclusion With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.

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