Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019

  • GBD 2019 Chronic Respiratory Diseases Collaborators:

Sara Momtazmanesh 1, Sahar Saeedi Moghaddam 2, Seyyed-Hadi Ghamari 3, Elaheh Malakan Rad 4, Negar Rezaei 5, Parnian Shobeiri 6, Amirali Aali 7, Mohsen Abbasi-Kangevari 2, Zeinab Abbasi-Kangevari 3, Michael Abdelmasseh 8, Meriem Abdoun 9, Deldar Morad Abdulah 10, Abu Yousuf Md Abdullah 11, Aidin Abedi 12, Hassan Abolhassani 13, Zahra Abrehdari-Tafreshi 14, Basavaprabhu Achappa 15, Denberu Eshetie Adane Adane 16, Tigist Demssew Adane 17, Isaac Yeboah Addo 18, Mohammad Adnan 19, Qor-Inah Estiningtyas Sakilah Adnani 20, Sajjad Ahmad 21, Ali Ahmadi 22, Keivan Ahmadi 23, Ali Ahmed 24, Ayman Ahmed 25, Tarik Ahmed Rashid 26, Hanadi Al Hamad 27, Fares Alahdab 28, Astawus Alemayehu 29, Sheikh Mohammad Alif 30, Syed Mohamed Aljunid 31, Sami Almustanyir 32, Khalid A Altirkawi 33, Nelson Alvis-Guzman 34, Javad Aminian Dehkordi 35, Mehrdad Amir-Behghadami 36, Robert Ancuceanu 37, Catalina Liliana Andrei 38, Tudorel Andrei 39, Catherine M Antony 40, Anayochukwu Edward Anyasodor 41, Jalal Arabloo 42, Judie Aru-Lappan 43, Tahira Ashraf 44, Seyyed Shamsadin Athari 45, Engi F Attia 46, Meshe-Sha Tsegazeab Ayele 47, Sina Azadnajafabad 2, Abraham Samuel Babu 48, Sara Bagherieh 49, Ovidiu Constantin Baltatu 50, Maciej Banach 51, Mainak Bardhan 52, Francesco Barone-Adesi 53, Amadou Barrow 54, Saurav Basu 55, Nebiyou Simegnew Bayileyegn 56, Isabela M Bensenor 57, Nikha Bhardwaj 58, Pankaj Bhardwaj 59, Ajay Nagesh Bhat 60, Krittika Bhattacharyya 61, Souad Bouaoud 62, Dejana Braithwaite 63, Michael Brauer 64, Muhammad Hammad Butt 65, Zahid A Butt 66, Daniela Calina 67, Luis Alberto Cámera 68, Gashaw Sisay Chanie 69, Periklis Charalampous 70, Vijay Kumar Chattu 71, Odgerel Chimed-Ochir 72, Dinh-Toi Chu 73, Aaron J Cohen 74, Natália Cruz-Martins 75, Omid Dadras 76, Aso Mohammad Darwesh 77, Saswati Das 78, Sisay Abebe Debela 79, Laura Delgado-Ortiz 80, Diriba Dereje 81, Mostafa Dianatinasab 82, Nancy Diao 83, Daniel Diaz 84, Lankamo Ena Digesa 85, Gebisa Dirirsa 86, Paul Narh Doku 87, Deepa Dongarwar 88, Abdel Douiri 89, Haneil Larson Dsouza 90, Ebrahim Eini 91, Michael Ekholuenetale 92, Temitope Cyrus Ekundayo 93, Ahmed Elabbas Mustafa Elagali 94, Muhammed Elhadi 95, Daniel Berhanie Enyew 96, Ryen-Chindorj Erkhembayar 97, Farshid Etaee 98, Adeniyi Francis Fagbamigbe 99, Andre Faro 100, Ali Fatehizadeh 101, Ginenus Fekadu 102, Irina Filip 103, Florian Fischer 104, Masoud Foroutan 105, Richard Charles Franklin 106, Peter Andras Gaal 107, Santosh Gaihre 108, Abduzhappar Gaipov 109, Mesfin Gebrehiwot 110, Urge Gerema 111, Motuma Erena Getachew 112, Tamiru Getachew 113, Mansour Gha-Fourifard 114, Reza Ghanbari 115, Ahmad Ghashghaee 116, Ali Gholami 117, Artyom Urievich Gil 118, Mahaveer Golechha 119, Pouya Goleij 120, Davide Golinelli 121, Habtamu Alganeh Guadie 122, Bhawna Gupta 123, Sapna Gupta 124, Veer Bala Gupta 125, Vivek Kumar Gupta 126, Mostafa Hadei 127, Rabih Halwani 128, Asif Hanif 129, Arief Hargono 130, Mehdi Harorani 131, Risky Kusuma Hartono 132, Hamidreza Hasani 133, Abdiwahab Hashi 134, Simon I Hay 135, Mohammad Heidari 136, Merel E Hellemons 137, Claudiu Herteliu 138, Ramesh Holla 139, Nobuyuki Horita 140, Mohammad Hoseini 141, Mehdi Hosseinzadeh 142, Junjie Huang 143, Salman Hussain 144, Bing-Fang Hwang 145, Ivo Iavicoli 146, Segun Emmanuel Ibitoye 147, Sufyan Ibrahim 148, Olayinka Stephen Ilesanmi 149, Irena M Ilic 150, Milena D Ilic 151, Mustapha Immurana 152, Nahlah Elkudssiah Ismail 153, Linda Merin J, Mihajlo Jakovljevic 154, Elham Jamshidi 155, Manthan Dilipkumar Janodia 156, Tahereh Javaheri 157, Sathish Kumar Jayapal 158, Shubha Jayaram 159, Ravi Prakash Jha 160, Olatunji Johnson 161, Tamas Joo 162, Nitin Joseph 163, Jacek Jerzy Jozwiak 164, Vaishali K, Billingsley Kaambwa 165, Zubair Kabir 166, Laleh R Kalankesh 167, Rohollah Kalhor 168, Himal Kandel 169, Shama D Karanth 170, Ibraheem M Karaye 171, Bekalu Getnet Kassa 172, Gizat M Kassie 173, Leila Keikavoosi-Arani 174, Mohammad Keykhaei 175, Himanshu Khajuria 176, Imteyaz A Khan 177, Moien Ab Khan 178, Yusra H Khan 179, Haneen Khreis 180, Min Seo Kim 181, Adnan Kisa 182, Sezer Kisa 183, Luke D Knibbs 184, Pavel Kolkhir 185, Somayeh Komaki 186, Farzad Kompani 187, Hamid Reza Koohestani 188, Ali Koolivand 189, Oleksii Korzh 190, Ai Koyanagi 191, Kewal Krishan 192, Kris J Krohn 40, Naveen Kumar 193, Nithin Kumar 163, Om P Kurmi 194, Ambily Kuttikkattu 195, Carlo La Vecchia 196, Judit Lám 197, Qing Lan 198, Savita Lasrado 199, Kamaluddin Latief 200, Paolo Lauriola 201, Sang-Woong Lee 202, Yo Han Lee 203, Samson Mideksa Legesse 204, Jacopo Lenzi 121, Ming-Chieh Li 205, Ro-Ting Lin 206, Gang Liu 207, Wei Liu 208, Chun-Han Lo 209, László Lorenzovici 210, Yifei Lu 211, Soun-Darya Mahalingam 212, Elham Mahmoudi 213, Narayan B Mahotra 214, Mohammad-Reza Malekpour 2, Ahmad Azam Malik 215, Tauqeer Hussain Mallhi 216, Deborah Carvalho Malta 217, Borhan Mansouri 218, Elezebeth Mathews 219, Sazan Qadir Maulud 220, Enkeleint A Mechili 221, Entezar Mehrabi Nasab 222, Ritesh G Menezes 223, Dechasa Adare Mengistu 224, Alexios-Fotios A Mentis 225, Mahboo-Beh Meshkat 226, Tomislav Mestrovic 227, Ana Carolina Micheletti Gomide Nogueira de Sá 217, Erkin M Mirrakhimov 228, Awoke Misganaw 229, Prasanna Mithra 163, Javad Moghadasi 230, Esmaeil Mohammadi 2, Mokhtar Mohammadi 231, Marita Mohammadshahi 232, Shafiu Mohammed 233, Syam Mohan 234, Nagab-Hishek Moka 235, Lorenzo Monasta 236, Mohammad Ali Moni 237, Md Monir-Uzzaman 238, Fateme Montazeri 239, Maryam Moradi 240, Ebrahim Mostafavi 241, Christine Mpundu-Kaambwa 242, Efrén Murillo-Zamora 243, Christopher J L Murray 135, Tapas Sadasivan Nair 244, Vinay Nangia 245, Sreenivas Narasimha Swamy 246, Aparna Ichalangod Narayana 247, Zuhair S Natto 248, Biswa Prakash Nayak 176, Wogene Wogene Negash 249, Evangelia Nena 250, Sandhya Neupane Kandel 251, Robina Khan Niazi 252, Antonio Tolentino Nogueira de Sá 253, Ali Nowroozi 254, Chimezie Igwegbe Nzoputam 255, Ogochukwu Janet Nzoputam 256, Bogdan Oancea 257, Rahman Md Obaidur 258, Oluwakemi Ololade Odukoya 259, Hassan Okati-Aliabad 260, Akinkunmi Paul Okekunle 261, Osaretin Christabel Okonji 262, Andrew T Olagunju 263, Ahmed Omar Bali 264, Sergej M Ostojic 265, P A Mahesh 266, Alicia Padron-Monedero 267, Jagadish Rao Padubidri 268, Mohammad Taha Pahlevan Fallahy 269, Tamás Palicz 162, Adrian Pana 270, Eun-Kee Park 271, Jay Patel 272, Rajan Paudel 273, Uttam Paudel 274, Paolo Pedersini 275, Marcos Pereira 276, Renato B Pereira 277, Ionela-Roxana Petcu 39, Majid Pirestani 278, Maarten J Postma 279, Akila Prashant 280, Mohammad Rabiee 281, Amir Radfar 282, Sima Rafiei 283, Fakher Rahim 284, Mohammad Hifz Ur Rahman 285, Mosiur Rahman 286, Muhammad Aziz Rahman 287, Amir Masoud Rahmani 288, Shayan Rahmani 2, Vahid Rahmanian 289, Prashant Rajput 290, Juwel Rana 291, Chythra R Rao 292, Sowmya J Rao 293, Sina Rashedi 294, Mohammad-Mahdi Rashidi 3, Zubair Ahmed Ratan 295, David Laith Rawaf 296, Salman Rawaf 297, Lal Rawal 298, Reza Rawassizadeh 299, Mohammad Sadegh Razeghinia 300, Elrashdy Moustafa Mohamed Redwan 301, Maryam Rezaei 302, Nazila Rezaei 303, Nima Rezaei, Mohsen Rezaeian 304, Mónica Rodrigues 305, Jefferson Antonio Buendia Rodriguez 306, Leonardo Roever 307, David Rojas-Rueda 308, Kristina E Rudd 309, Aly M A Saad 310, Siamak Sabour 311, Basema Saddik 312, Erfan Sadeghi 313, Masoumeh Sadeghi 314, Umar Saeed 315, Maryam Sahebazzamani 316, Amirhossein Sahebkar 317, Harihar Sahoo 318, Mirza Rizwan Sajid 319, Sateesh Sakhamuri 320, Sana Salehi 321, Abdallah M Samy 322, Milena M Santric-Milicevic 323, Bruno Piassi Sao Jose 324, Brijesh Sathian 325, Maheswar Satpathy 326, Ganesh Kumar Saya 327, Subramanian Senthilkumaran 328, Allen Seylani 329, Saeed Shahabi 330, Masood Ali Shaikh 331, Mohd Shanawaz 332, Mohammed Shannawaz 333, Rahim Ali Sheikhi 334, Sha-Shank Shekhar 335, Migbar Mekonnen Sibhat 336, Colin R Simpson 337, Jasvinder A Singh 338, Paramdeep Singh 339, Surjit Singh 340, Valentin Yurievich Skryabin 341, Anna Aleksandrovna Skryabina 342, Mohammad Sadegh Soltani-Zangbar 343, Suhang Song 344, Ireneous N Soyiri 345, Paschalis Steiropoulos 250, Leo Stockfelt 346, Jing Sun 347, Ken Takahashi 348, Iman M Talaat 349, Ker-Kan Tan 350, Nathan Y Tat 351, Vivian Y Tat 352, Birhan Tsegaw Taye 353, Pugazhenthan Thangaraju 354, Rekha Thapar 163, Friedrich Thienemann 355, Amir Tiyuri 356, Mai Thi Ngoc Tran 357, Jaya Prasad Tripathy 358, Lorainne Tudor Car 359, Biruk Shalmeno Tusa 360, Irfan Ullah 361, Sana Ullah 362, Marco Vacante 363, Pascual R Valdez 364, Rohollah Valiza-Deh 365, Job F M van Boven 366, Tommi Juhani Vasankari 367, Siavash Vaziri 368, Francesco S Violante 369, Bay Vo 370, Ning Wang 371, Melissa Y Wei 372, Ronny Westerman 373, Nuwan Darshana Wickramasinghe 374, Suowen Xu 375, Xiaoyue Xu 376, Lalit Yadav 377, Yazachew Yismaw 378, Dong Keon Yon 379, Naohiro Yone-Moto 380, Chuanhua Yu 381, Yong Yu 382, Ismaeel Yunusa 383, Mazyar Zahir 384, Moein Zangiabadian 385, Zahra Zareshahrabadi 386, Armin Zarrintan 387, Mikhail Sergeevich Zastrozhin 388, Zelalem Banjaw Zegeye 389, Yunquan Zhang 390, Mohsen Naghavi 135, Bagher Larijani 391, Farshad Farzadfar 5

Affiliations

05 January 2023

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doi: 10.1016/j.eclinm.2023.101936

Abstract

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019.

Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input.

Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6-4.3) with a prevalence of 454.6 million cases (417.4-499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4-225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9-3.6) deaths. With 262.4 million (224.1-309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively.

Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries.

Keywords: Asthma; Chronic obstructive pulmonary disease; Epidemiology; Interstitial lung disease; Lung disease; Morbidity; Mortality; Pneumoconiosis; Pulmonary emphysema.

Conflict of interest statement

Declaration of interests R Ancuceanu reports consulting fees from Abbvie; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Abbvie, B. Braun, Sandoz, and Laropharm all outside the submitted work. NS Bayileyegn reports participation on a Data Safety Monitoring Board or Advisory Board with Jimma University; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Jimma University as part of the disaster response team all outside the submitted work. S Das reports grants or contracts from the Department of Science and Technology, government of India all outside the submitted work. TC Ekundayo other support from the African-German Network of Excellence in Science, the Federal Ministry of Education and Research, and the Alexander von Humboldt Foundation all outside the submitted work. R Erkhembayar reports grants or contracts from World Health Organization, Country Office in Mongolia for disease burden estimates and utilizations, training and capacity building at CHD, MoH, Mongolia all outside the submitted work. A Faro reports support for the present manuscript from CNPq - National Council for Scientific and Technological Development, Brazil all outside the submitted work. I Filip reports other support from Avicenna Medical and Research Institute all outside the submitted work. R Franklin reports grants or contracts for Heatwaves in Queensland Arc Flash, Human Factors from Queensland Government; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from World Safety Conference 2022; support for attending meetings and/or travel from ACTM - Tropical Medicine and Travel Medicine Conference 2022; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Kidsafe as a Director, with Auschem as a Director, with ISASH as part of the Governance Committee, with Farmsafe as a Director, and with PHAA Injury Prevention SIG Convenor all outside the submitted work. C Herteliu reports grants or contracts from Romanian Ministry of Research Innovation and Digitalization, MCID for project number ID-585-CTR-42-PFE-2021 research grant (Jan 2022-Jun 2023) “Enhancing institutional performance through development of infrastructure and transdisciplinary research ecosystem within socio-economic domain - PERFECTIS ” all outside the submitted work. NE Ismail reports leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Malaysian Academy of Pharmacy as a Council Member. J Jozwiak reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis and Adamed all outside the submitted work. K Krishan reports other support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India all outside the submitted work. AFA Mentis reports grants or contracts from `MilkSafe: A novel pipeline to enrich formula milk using omics technologies,’ a research co financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH - CREATE - INNOVATE (project code: T2EDK-02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860); payment for expert testimony having served as external peer-reviewer for Fondazione Car-iplo, Italy; participation on a Data Safety Monitoring Board or Advisory Board serving as Editorial Board Member for “Systematic Reviews” journal, for “Annals of Epidemiology” journal, and as Associate Editor for “Translational Psychiatry;” stock or stock options in a family winery; and other support from BGI Group as a scientific officer all outside the submitted work. N Moka reports leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Kentucky Society of Clinical Oncology as Treasurer. MJ Postma reports leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with JCVI (UK) as an unpaid Member; stock or stock options in HealthEcore (Zeist, NL) and PAG BV (Groningen, NL) all outside the submitted work. A Radfar reports other support from Avicenna Medical and Research Institute all outside the submitted work. J Singh reports consulting fees Crealta/Horizon, Medisys, Fidia, PK Med, Two labs Inc., Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point communications; and the National Institutes of Health and the American College of Rheumatology; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Simply Speaking on the speaker’s bureau; support for attending meetings and/or travel from the steering committee of OMERACT; participation on a Data Safety Monitoring Board or Advisory Board with FDA Arthritis Advisory Committee; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with OMERACT as a steering committee member, Veterans Affairs Rheumatology Field Advisory Committee as Chair, and UAB Cochrane Muskuloskelatal Group Satellite Center on Network Meta-analysis as editor and Director; stock or stock options in TPT Global Tech, Vaxart pharmaceuticals, Atyu biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics Inc., Seres Therapeutics, Tonix Pharmaceuticals and Charlotte’s Web Holdings, Inc all outside the submitted work. E Upadhyay reports patents planned, issued or pending for “A system and method of reusable filters for anti-pollution mask” (published), “A system and method for electricity generation through crop stubble by using microbial fuel cells” (published), “A system for disposed personal protection equipment (PPE) into biofuel through pyrolysis and method” (published), and “A novel herbal pharmaceutical aid for formulation of gel and method thereof” (filed) all outside the submitted work. M Wei reports support for the present manuscript from NIH National Institute on Aging K23 career development award; grants or contract from NIH National Institute on Aging K23 career development award; support for attending meetings and/or travel from NIH National Institute on Aging K23 career development award to attend national meetings (SGIM, AGS) to present results; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Society of General Internal Medicine (SGIM) as Chair of the Research Committee all outside the submitted work.

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What drives the transition to modern energy cooking services? A systematic review of the evidence. Batchelor S., Brown E., Scott N., Leary J. Two birds, one stone—reframing cooking energy policies in Africa and Asia. Energies. 2019;12(9) Rosenthal J., Quinn A., Grieshop A.P., Pillarisetti A., Glass R.I. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain Dev. 2018;42:152–159. - PMC - PubMed Wong G.W., Brunekreef B., Ellwood P., et al. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) Lancet Respir Med. 2013;1(5):386–394. - PubMed Shaddick G., Thomas M.L., Mudu P., Ruggeri G., Gumy S. Half the world's population are exposed to increasing air pollution. NPJ Climate Atmos Sci. 2020;3(1):23. Fayiga A.O., Ipinmoroti M.O., Chirenje T. Environmental pollution in Africa. Environ Dev Sustain. 2018;20(1):41–73. Wu Y., Song P., Lin S., et al. Global burden of respiratory diseases attributable to ambient particulate matter pollution: findings from the global burden of disease study 2019. Front Public Health. 2021;9:740800. - PMC - PubMed Hystad P., Larkin A., Rangarajan S., et al. Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet Planet Health. 2020;4(6):e235–e245. - PMC - PubMed Communication from the Commission to the European Parliament, the European Council, the Council, the European Economic and Social Committee and the Committee of the Regions . 2019. The European green deal, COM; p. 640. [final] GBD, 2016 Occupational Chronic Respiratory Risk Factors Collaborators Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med. 2020;77(3):142. - PMC - PubMed The Lancet. Improving occupational health in China. Lancet. 2019;394(10197):443. - PubMed Wang D., Liang R., Yang M., et al. Incidence and disease burden of coal workers' pneumoconiosis worldwide, 1990–2019: evidence from the Global Burden of Disease Study 2019. Eur Respir J. 2021;58(5):2101669. - PubMed Meghji J., Mortimer K., Agusti A., et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021;397(10277):928–940. - PubMed World Health Organization WHO package of essential noncommunicable (PEN) disease interventions for primary health care. 2020. https://www.who.int/publications/i/item/9789240009226 World Health Organization Practical approach to lung health: manual on initiating pal implementation. 2008. https://www.who.int/publications/i/item/WHO-HTM-TB-2008.410 - PubMed Bousquet J., Dahl R., Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J. 2007;29(2):233. - PubMed Beltramo G., Cottenet J., Mariet A.-S., et al. Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. 2021:2004474. - PMC - PubMed Aveyard P., Gao M., Lindson N., et al. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. Lancet Respir Med. 2021;9(8):909–923. - PMC - PubMed Wu X., Liu X., Zhou Y., et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021;9(7):747–754. - PMC - PubMed Han X., Fan Y., Alwalid O., et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177–E186. - PMC - PubMed Safiri S., Carson-Chahhoud K., Noori M., et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022:378. e069679. - PMC - PubMed Hall R., Hall I.P., Sayers I. Genetic risk factors for the development of pulmonary disease identified by genome-wide association. Respirology. 2019;24(3):204–214. - PubMed Benjafield A.V., Ayas N.T., Eastwood P.R., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687–698. - PMC - PubMed Blaiss M.S., Hammerby E., Robinson S., Kennedy-Martin T., Buchs S. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol. 2018;121(1):43–52.e3. - PubMed Park Y., Ahn C., Kim T.-H. Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses. Sci Rep. 2021;11(1):4318. - PMC - PubMed The novel virus was first identified in an outbreak in the Chinese city of Wuhan in December 2019. https://www.thelancet.com/journals/lancet/issue/vol396no10258/PIIS0140-6... Accessed October 17, 2020.

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–1222. - PMC - PubMed Syamlal G.B.A., Dodd K.E. Medical expenditures attributed to asthma and chronic obstructive pulmonary disease among workers — United States, 2011–2015. MMWR Morb Mortal Wkly Rep. 2020;69:809–814. - PMC - PubMed European Respiratory Society . World Health Organization; Brussels: 2013. The economic burden of lung disease. European lung white book: respiratory health and disease in Europe. UN General Assembly Transforming our world : the 2030 agenda for sustainable development. 2015. https://sdgs.un.org/2030agenda World Health Organization Thirteenth general programme of work 2019–2023. 2019. https://www.who.int/about/what-we-do/thirteenth-general-programme-of-wor... World health statistics 2022: monitoring health for the SDGs, sustainable development goals. World Health Organization; Geneva: 2022. Licence: CC BY-NC-SA 3.0 IGO. World Health Organization Towards a global action plan for healthy lives and well-being for all. Uniting to accelerate progress towards the health-related SDGs. 2018. https://apps.who.int/iris/bitstream/handle/10665/311667/WHO-DCO-2018.3-e... World Health Organization Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. 2007. https://www.who.int/gard/publications/GARD_Manual/en/ Pauwels R. Global initiative for chronic obstructive lung diseases (GOLD): time to act. Eur Respir J. 2001;18(6):901. - PubMed Reddel H.K., FitzGerald J.M., Bateman E.D., et al. GINA 2019: a fundamental change in asthma management. Eur Respir J. 2019;53(6):1901046. - PubMed GBD 2017 Chronic Respiratory Disease Collaborators Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020;8(6):585–596. - PMC - PubMed GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706. - PMC - PubMed Foreman K.J., Lozano R., Lopez A.D., Murray C.J.L. Modeling causes of death: an integrated approach using CODEm. Popul Health Metrics. 2012;10(1):1. - PMC - PubMed Murray C.J.L., Lopez A.D. Global mortality, disability, and the contribution of risk factors: global Burden of Disease Study. Lancet. 1997;349(9063):1436–1442. - PubMed GBD 2019 Risk Factors Collaborators Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–1249. - PMC - PubMed Global Burden of Disease Cancer Collaboration Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524–548. - PMC - PubMed Wang H., Abbas K.M., Abbasifard M., et al. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1160–1203. - PMC - PubMed D'Amato G., Cecchi L., D'Amato M., Annesi-Maesano I. Climate change and respiratory diseases. Eur Respir Rev. 2014;23(132):161. - PMC - PubMed D'Amato G., Chong-Neto H.J., Monge Ortega O.P., et al. The effects of climate change on respiratory allergy and asthma induced by pollen and mold allergens. Allergy. 2020;75(9):2219–2228. - PubMed Stenius-Aarniala B., Poussa T., Kvarnström J., Grönlund E.-L., Ylikahri M., Mustajoki P. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ. 2000;320(7238):827. - PMC - PubMed World Health Organization Global health observatory data repository. 2017. https://apps.who.int/gho/data/view.main.BMI30CWBv World Health Organization . World Health Organization; Geneva: 2009. WHO report on the global tobacco epidemic 2008: the MPOWER package. Chung-Hall J., Craig L., Gravely S., Sansone N., Fong G.T. Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group. Tobac Control. 2019;28(Suppl 2):s119. - PMC - PubMed Goodchild M., Zheng R. Tobacco control and healthy China 2030. Tobac Control. 2019;28(4):409. - PMC - PubMed Flor L.S., Reitsma M.B., Gupta V., Ng M., Gakidou E. The effects of tobacco control policies on global smoking prevalence. Nat Med. 2021;27(2):239–243. - PMC - PubMed Thomson B., Rojas N.A., Lacey B., et al. Association of childhood smoking and adult mortality: prospective study of 120 000 Cuban adults. Lancet Global Health. 2020;8(6):e850–e857. - PMC - PubMed World Health Organization . 2nd ed. World Health Organization; Geneva: 2018. WHO global report on trends in prevalence of tobacco smoking 2000-2025. Wills T.A., Soneji S.S., Choi K., Jaspers I., Tam E.K. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J. 2021;57(1):1901815. - PMC - PubMed Energy Sector Management Assistance Program (ESMAP) World Bank; Washington, DC: 2021. What drives the transition to modern energy cooking services? A systematic review of the evidence. Batchelor S., Brown E., Scott N., Leary J. Two birds, one stone—reframing cooking energy policies in Africa and Asia. Energies. 2019;12(9) Rosenthal J., Quinn A., Grieshop A.P., Pillarisetti A., Glass R.I. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain Dev. 2018;42:152–159. - PMC - PubMed Wong G.W., Brunekreef B., Ellwood P., et al. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) Lancet Respir Med. 2013;1(5):386–394. - PubMed Shaddick G., Thomas M.L., Mudu P., Ruggeri G., Gumy S. Half the world's population are exposed to increasing air pollution. NPJ Climate Atmos Sci. 2020;3(1):23. Fayiga A.O., Ipinmoroti M.O., Chirenje T. Environmental pollution in Africa. Environ Dev Sustain. 2018;20(1):41–73. Wu Y., Song P., Lin S., et al. Global burden of respiratory diseases attributable to ambient particulate matter pollution: findings from the global burden of disease study 2019. Front Public Health. 2021;9:740800. - PMC - PubMed Hystad P., Larkin A., Rangarajan S., et al. Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet Planet Health. 2020;4(6):e235–e245. - PMC - PubMed Communication from the Commission to the European Parliament, the European Council, the Council, the European Economic and Social Committee and the Committee of the Regions . 2019. The European green deal, COM; p. 640. [final] GBD, 2016 Occupational Chronic Respiratory Risk Factors Collaborators Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med. 2020;77(3):142. - PMC - PubMed The Lancet. Improving occupational health in China. Lancet. 2019;394(10197):443. - PubMed Wang D., Liang R., Yang M., et al. Incidence and disease burden of coal workers' pneumoconiosis worldwide, 1990–2019: evidence from the Global Burden of Disease Study 2019. Eur Respir J. 2021;58(5):2101669. - PubMed Meghji J., Mortimer K., Agusti A., et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021;397(10277):928–940. - PubMed World Health Organization WHO package of essential noncommunicable (PEN) disease interventions for primary health care. 2020. https://www.who.int/publications/i/item/9789240009226 World Health Organization Practical approach to lung health: manual on initiating pal implementation. 2008. https://www.who.int/publications/i/item/WHO-HTM-TB-2008.410 - PubMed Bousquet J., Dahl R., Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J. 2007;29(2):233. - PubMed Beltramo G., Cottenet J., Mariet A.-S., et al. Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. 2021:2004474. - PMC - PubMed Aveyard P., Gao M., Lindson N., et al. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. Lancet Respir Med. 2021;9(8):909–923. - PMC - PubMed Wu X., Liu X., Zhou Y., et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021;9(7):747–754. - PMC - PubMed Han X., Fan Y., Alwalid O., et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177–E186. - PMC - PubMed Safiri S., Carson-Chahhoud K., Noori M., et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022:378. e069679. - PMC - PubMed Hall R., Hall I.P., Sayers I. Genetic risk factors for the development of pulmonary disease identified by genome-wide association. Respirology. 2019;24(3):204–214. - PubMed Benjafield A.V., Ayas N.T., Eastwood P.R., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687–698. - PMC - PubMed Blaiss M.S., Hammerby E., Robinson S., Kennedy-Martin T., Buchs S. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol. 2018;121(1):43–52.e3. - PubMed Park Y., Ahn C., Kim T.-H. Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses. Sci Rep. 2021;11(1):4318. - PMC - PubMed The novel virus was first identified in an outbreak in the Chinese city of Wuhan in December 2019. https://www.thelancet.com/journals/lancet/issue/vol396no10258/PIIS0140-6... Accessed October 17, 2020.

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–1222. - PMC - PubMed Syamlal G.B.A., Dodd K.E. Medical expenditures attributed to asthma and chronic obstructive pulmonary disease among workers — United States, 2011–2015. MMWR Morb Mortal Wkly Rep. 2020;69:809–814. - PMC - PubMed European Respiratory Society . World Health Organization; Brussels: 2013. The economic burden of lung disease. European lung white book: respiratory health and disease in Europe. UN General Assembly Transforming our world : the 2030 agenda for sustainable development. 2015. https://sdgs.un.org/2030agenda World Health Organization Thirteenth general programme of work 2019–2023. 2019. https://www.who.int/about/what-we-do/thirteenth-general-programme-of-wor... World health statistics 2022: monitoring health for the SDGs, sustainable development goals. World Health Organization; Geneva: 2022. Licence: CC BY-NC-SA 3.0 IGO. World Health Organization Towards a global action plan for healthy lives and well-being for all. Uniting to accelerate progress towards the health-related SDGs. 2018. https://apps.who.int/iris/bitstream/handle/10665/311667/WHO-DCO-2018.3-e... World Health Organization Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. 2007. https://www.who.int/gard/publications/GARD_Manual/en/ Pauwels R. Global initiative for chronic obstructive lung diseases (GOLD): time to act. Eur Respir J. 2001;18(6):901. - PubMed Reddel H.K., FitzGerald J.M., Bateman E.D., et al. GINA 2019: a fundamental change in asthma management. Eur Respir J. 2019;53(6):1901046. - PubMed GBD 2017 Chronic Respiratory Disease Collaborators Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020;8(6):585–596. - PMC - PubMed GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706. - PMC - PubMed Foreman K.J., Lozano R., Lopez A.D., Murray C.J.L. Modeling causes of death: an integrated approach using CODEm. Popul Health Metrics. 2012;10(1):1. - PMC - PubMed Murray C.J.L., Lopez A.D. Global mortality, disability, and the contribution of risk factors: global Burden of Disease Study. Lancet. 1997;349(9063):1436–1442. - PubMed GBD 2019 Risk Factors Collaborators Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–1249. - PMC - PubMed Global Burden of Disease Cancer Collaboration Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524–548. - PMC - PubMed Wang H., Abbas K.M., Abbasifard M., et al. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1160–1203. - PMC - PubMed D'Amato G., Cecchi L., D'Amato M., Annesi-Maesano I. Climate change and respiratory diseases. Eur Respir Rev. 2014;23(132):161. - PMC - PubMed D'Amato G., Chong-Neto H.J., Monge Ortega O.P., et al. The effects of climate change on respiratory allergy and asthma induced by pollen and mold allergens. Allergy. 2020;75(9):2219–2228. - PubMed Stenius-Aarniala B., Poussa T., Kvarnström J., Grönlund E.-L., Ylikahri M., Mustajoki P. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ. 2000;320(7238):827. - PMC - PubMed World Health Organization Global health observatory data repository. 2017. https://apps.who.int/gho/data/view.main.BMI30CWBv World Health Organization . World Health Organization; Geneva: 2009. WHO report on the global tobacco epidemic 2008: the MPOWER package. Chung-Hall J., Craig L., Gravely S., Sansone N., Fong G.T. Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group. Tobac Control. 2019;28(Suppl 2):s119. - PMC - PubMed Goodchild M., Zheng R. Tobacco control and healthy China 2030. Tobac Control. 2019;28(4):409. - PMC - PubMed Flor L.S., Reitsma M.B., Gupta V., Ng M., Gakidou E. The effects of tobacco control policies on global smoking prevalence. Nat Med. 2021;27(2):239–243. - PMC - PubMed Thomson B., Rojas N.A., Lacey B., et al. Association of childhood smoking and adult mortality: prospective study of 120 000 Cuban adults. Lancet Global Health. 2020;8(6):e850–e857. - PMC - PubMed World Health Organization . 2nd ed. World Health Organization; Geneva: 2018. WHO global report on trends in prevalence of tobacco smoking 2000-2025. Wills T.A., Soneji S.S., Choi K., Jaspers I., Tam E.K. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J. 2021;57(1):1901815. - PMC - PubMed Energy Sector Management Assistance Program (ESMAP) World Bank; Washington, DC: 2021. What drives the transition to modern energy cooking services? A systematic review of the evidence. Batchelor S., Brown E., Scott N., Leary J. Two birds, one stone—reframing cooking energy policies in Africa and Asia. Energies. 2019;12(9) Rosenthal J., Quinn A., Grieshop A.P., Pillarisetti A., Glass R.I. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain Dev. 2018;42:152–159. - PMC - PubMed Wong G.W., Brunekreef B., Ellwood P., et al. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) Lancet Respir Med. 2013;1(5):386–394. - PubMed Shaddick G., Thomas M.L., Mudu P., Ruggeri G., Gumy S. Half the world's population are exposed to increasing air pollution. NPJ Climate Atmos Sci. 2020;3(1):23. Fayiga A.O., Ipinmoroti M.O., Chirenje T. Environmental pollution in Africa. Environ Dev Sustain. 2018;20(1):41–73. Wu Y., Song P., Lin S., et al. Global burden of respiratory diseases attributable to ambient particulate matter pollution: findings from the global burden of disease study 2019. Front Public Health. 2021;9:740800. - PMC - PubMed Hystad P., Larkin A., Rangarajan S., et al. Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet Planet Health. 2020;4(6):e235–e245. - PMC - PubMed Communication from the Commission to the European Parliament, the European Council, the Council, the European Economic and Social Committee and the Committee of the Regions . 2019. The European green deal, COM; p. 640. [final] GBD, 2016 Occupational Chronic Respiratory Risk Factors Collaborators Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med. 2020;77(3):142. - PMC - PubMed The Lancet. Improving occupational health in China. Lancet. 2019;394(10197):443. - PubMed Wang D., Liang R., Yang M., et al. Incidence and disease burden of coal workers' pneumoconiosis worldwide, 1990–2019: evidence from the Global Burden of Disease Study 2019. Eur Respir J. 2021;58(5):2101669. - PubMed Meghji J., Mortimer K., Agusti A., et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021;397(10277):928–940. - PubMed World Health Organization WHO package of essential noncommunicable (PEN) disease interventions for primary health care. 2020. https://www.who.int/publications/i/item/9789240009226 World Health Organization Practical approach to lung health: manual on initiating pal implementation. 2008. https://www.who.int/publications/i/item/WHO-HTM-TB-2008.410 - PubMed Bousquet J., Dahl R., Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J. 2007;29(2):233. - PubMed Beltramo G., Cottenet J., Mariet A.-S., et al. Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. 2021:2004474. - PMC - PubMed Aveyard P., Gao M., Lindson N., et al. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. Lancet Respir Med. 2021;9(8):909–923. - PMC - PubMed Wu X., Liu X., Zhou Y., et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021;9(7):747–754. - PMC - PubMed Han X., Fan Y., Alwalid O., et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177–E186. - PMC - PubMed Safiri S., Carson-Chahhoud K., Noori M., et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022:378. e069679. - PMC - PubMed Hall R., Hall I.P., Sayers I. Genetic risk factors for the development of pulmonary disease identified by genome-wide association. Respirology. 2019;24(3):204–214. - PubMed Benjafield A.V., Ayas N.T., Eastwood P.R., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687–698. - PMC - PubMed Blaiss M.S., Hammerby E., Robinson S., Kennedy-Martin T., Buchs S. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol. 2018;121(1):43–52.e3. - PubMed Park Y., Ahn C., Kim T.-H. Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses. Sci Rep. 2021;11(1):4318. - PMC - PubMed The novel virus was first identified in an outbreak in the Chinese city of Wuhan in December 2019. https://www.thelancet.com/journals/lancet/issue/vol396no10258/PIIS0140-6... Accessed October 17, 2020.

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–1222. - PMC - PubMed Syamlal G.B.A., Dodd K.E. Medical expenditures attributed to asthma and chronic obstructive pulmonary disease among workers — United States, 2011–2015. MMWR Morb Mortal Wkly Rep. 2020;69:809–814. - PMC - PubMed European Respiratory Society . World Health Organization; Brussels: 2013. The economic burden of lung disease. European lung white book: respiratory health and disease in Europe. UN General Assembly Transforming our world : the 2030 agenda for sustainable development. 2015. https://sdgs.un.org/2030agenda World Health Organization Thirteenth general programme of work 2019–2023. 2019. https://www.who.int/about/what-we-do/thirteenth-general-programme-of-wor... World health statistics 2022: monitoring health for the SDGs, sustainable development goals. World Health Organization; Geneva: 2022. Licence: CC BY-NC-SA 3.0 IGO. World Health Organization Towards a global action plan for healthy lives and well-being for all. Uniting to accelerate progress towards the health-related SDGs. 2018. https://apps.who.int/iris/bitstream/handle/10665/311667/WHO-DCO-2018.3-e... World Health Organization Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. 2007. https://www.who.int/gard/publications/GARD_Manual/en/ Pauwels R. Global initiative for chronic obstructive lung diseases (GOLD): time to act. Eur Respir J. 2001;18(6):901. - PubMed Reddel H.K., FitzGerald J.M., Bateman E.D., et al. GINA 2019: a fundamental change in asthma management. 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Lancet. 1997;349(9063):1436–1442. - PubMed GBD 2019 Risk Factors Collaborators Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–1249. - PMC - PubMed Global Burden of Disease Cancer Collaboration Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524–548. - PMC - PubMed Wang H., Abbas K.M., Abbasifard M., et al. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1160–1203. - PMC - PubMed D'Amato G., Cecchi L., D'Amato M., Annesi-Maesano I. Climate change and respiratory diseases. Eur Respir Rev. 2014;23(132):161. - PMC - PubMed D'Amato G., Chong-Neto H.J., Monge Ortega O.P., et al. The effects of climate change on respiratory allergy and asthma induced by pollen and mold allergens. Allergy. 2020;75(9):2219–2228. - PubMed Stenius-Aarniala B., Poussa T., Kvarnström J., Grönlund E.-L., Ylikahri M., Mustajoki P. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ. 2000;320(7238):827. - PMC - PubMed World Health Organization Global health observatory data repository. 2017. https://apps.who.int/gho/data/view.main.BMI30CWBv World Health Organization . World Health Organization; Geneva: 2009. WHO report on the global tobacco epidemic 2008: the MPOWER package. Chung-Hall J., Craig L., Gravely S., Sansone N., Fong G.T. Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group. 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What drives the transition to modern energy cooking services? A systematic review of the evidence. Batchelor S., Brown E., Scott N., Leary J. Two birds, one stone—reframing cooking energy policies in Africa and Asia. Energies. 2019;12(9) Rosenthal J., Quinn A., Grieshop A.P., Pillarisetti A., Glass R.I. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain Dev. 2018;42:152–159. - PMC - PubMed Wong G.W., Brunekreef B., Ellwood P., et al. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) Lancet Respir Med. 2013;1(5):386–394. - PubMed Shaddick G., Thomas M.L., Mudu P., Ruggeri G., Gumy S. Half the world's population are exposed to increasing air pollution. NPJ Climate Atmos Sci. 2020;3(1):23. Fayiga A.O., Ipinmoroti M.O., Chirenje T. Environmental pollution in Africa. Environ Dev Sustain. 2018;20(1):41–73. 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[final] GBD, 2016 Occupational Chronic Respiratory Risk Factors Collaborators Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med. 2020;77(3):142. - PMC - PubMed The Lancet. Improving occupational health in China. Lancet. 2019;394(10197):443. - PubMed Wang D., Liang R., Yang M., et al. Incidence and disease burden of coal workers' pneumoconiosis worldwide, 1990–2019: evidence from the Global Burden of Disease Study 2019. Eur Respir J. 2021;58(5):2101669. - PubMed Meghji J., Mortimer K., Agusti A., et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021;397(10277):928–940. - PubMed World Health Organization WHO package of essential noncommunicable (PEN) disease interventions for primary health care. 2020. https://www.who.int/publications/i/item/9789240009226 World Health Organization Practical approach to lung health: manual on initiating pal implementation. 2008. https://www.who.int/publications/i/item/WHO-HTM-TB-2008.410 - PubMed Bousquet J., Dahl R., Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J. 2007;29(2):233. - PubMed Beltramo G., Cottenet J., Mariet A.-S., et al. Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. 2021:2004474. - PMC - PubMed Aveyard P., Gao M., Lindson N., et al. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. 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Fig. 2 Global age-standardised rates of incidence, prevalence, deaths, and DALYs of chronic respiratory diseases in both sexes combined in each SDI quintile. DALYs = Disability-Adjusted Life Years, SDI = Socio-demographic Index.

Fig. 2 Global age-standardised rates of incidence, prevalence, deaths, and DALYs of chronic respiratory diseases in both sexes combined in each SDI quintile. DALYs = Disability-Adjusted Life Years, SDI = Socio-demographic Index.

Fig. 3 Global age-standardised rate of deaths and DALYs from chronic respiratory diseases in 2019 and their percent change from 1990 in both sexes combined. DALYs = Disability-Adjusted Life Years.

Fig. 3 Global age-standardised rate of deaths and DALYs from chronic respiratory diseases in 2019 and their percent change from 1990 in both sexes combined. DALYs = Disability-Adjusted Life Years.

Fig. 4 Ranked contribution of risk factors to the age-standardised rate of DALYs from chronic respiratory diseases by region, 2019, for both sexes combined, females, and males. Risk factors are ranked from 1 (the leading risk factor for age-standardised Disability-Adjusted Life Years (DALYs); dark red) to 11 (the lowest risk factor for age-standardised DALYs; dark green). The numbers inside each box indicate the ranking.

Fig. 4 Ranked contribution of risk factors to the age-standardised rate of DALYs from chronic respiratory diseases by region, 2019, for both sexes combined, females, and males. Risk factors are ranked from 1 (the leading risk factor for age-standardised Disability-Adjusted Life Years (DALYs); dark red) to 11 (the lowest risk factor for age-standardised DALYs; dark green). The numbers inside each box indicate the ranking.

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