Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017

GBD 2017 Risk Factor Collaborators

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177 Citations (Scopus)

Abstract

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.

Original languageEnglish
Pages (from-to)1923-1994
Number of pages72
JournalThe Lancet
Volume392
Issue number10159
DOIs
StatePublished - 10 Nov 2018

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Quality-Adjusted Life Years
Global Burden of Disease
Demography
Information Storage and Retrieval
Population Growth
Environmental Exposure
Statistical Models
Censuses
Occupational Exposure
Causality
Cohort Studies
Randomized Controlled Trials
Age Groups
Wounds and Injuries
Population

Cite this

@article{8eeb7d422276440097e985a64fb3d8b4,
title = "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017",
abstract = "Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.",
author = "{GBD 2017 Risk Factor Collaborators} and Stanaway, {Jeffrey D.} and Ashkan Afshin and Emmanuela Gakidou and Lim, {Stephen S.} and Degu Abate and Abate, {Kalkidan Hassen} and Cristiana Abbafati and Nooshin Abbasi and Hedayat Abbastabar and Foad Abd-Allah and Jemal Abdela and Ahmed Abdelalim and Ibrahim Abdollahpour and Abdulkader, {Rizwan Suliankatchi} and Molla Abebe and Zegeye Abebe and Abera, {Semaw F.} and Abil, {Olifan Zewdie} and Abraha, {Haftom Niguse} and Abrham, {Aklilu Roba} and Abu-Raddad, {Laith Jamal} and Abu-Rmeileh, {Niveen M.E.} and Accrombessi, {Manfred Mario Kokou} and Dilaram Acharya and Pawan Acharya and Adamu, {Abdu A.} and Adane, {Akilew Awoke} and Adebayo, {Oladimeji M.} and Adedoyin, {Rufus Adesoji} and Victor Adekanmbi and Zanfina Ademi and Adetokunboh, {Olatunji O.} and Adib, {Mina G.} and Amha Admasie and Adsuar, {Jose C.} and Afanvi, {Kossivi Agbelenko} and Mohsen Afarideh and Gina Agarwal and Anju Aggarwal and Aghayan, {Sargis Aghasi} and Anurag Agrawal and Sutapa Agrawal and Alireza Ahmadi and Mehdi Ahmadi and Hamid Ahmadieh and Ahmed, {Muktar Beshir} and Aichour, {Amani Nidhal} and Ibtihel Aichour and Aichour, {Miloud Taki Eddine} and Anil Kaul",
year = "2018",
month = "11",
day = "10",
doi = "10.1016/S0140-6736(18)32225-6",
language = "English",
volume = "392",
pages = "1923--1994",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Ltd",
number = "10159",

}

TY - JOUR

T1 - Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017

T2 - A systematic analysis for the Global Burden of Disease Study 2017

AU - GBD 2017 Risk Factor Collaborators

AU - Stanaway, Jeffrey D.

AU - Afshin, Ashkan

AU - Gakidou, Emmanuela

AU - Lim, Stephen S.

AU - Abate, Degu

AU - Abate, Kalkidan Hassen

AU - Abbafati, Cristiana

AU - Abbasi, Nooshin

AU - Abbastabar, Hedayat

AU - Abd-Allah, Foad

AU - Abdela, Jemal

AU - Abdelalim, Ahmed

AU - Abdollahpour, Ibrahim

AU - Abdulkader, Rizwan Suliankatchi

AU - Abebe, Molla

AU - Abebe, Zegeye

AU - Abera, Semaw F.

AU - Abil, Olifan Zewdie

AU - Abraha, Haftom Niguse

AU - Abrham, Aklilu Roba

AU - Abu-Raddad, Laith Jamal

AU - Abu-Rmeileh, Niveen M.E.

AU - Accrombessi, Manfred Mario Kokou

AU - Acharya, Dilaram

AU - Acharya, Pawan

AU - Adamu, Abdu A.

AU - Adane, Akilew Awoke

AU - Adebayo, Oladimeji M.

AU - Adedoyin, Rufus Adesoji

AU - Adekanmbi, Victor

AU - Ademi, Zanfina

AU - Adetokunboh, Olatunji O.

AU - Adib, Mina G.

AU - Admasie, Amha

AU - Adsuar, Jose C.

AU - Afanvi, Kossivi Agbelenko

AU - Afarideh, Mohsen

AU - Agarwal, Gina

AU - Aggarwal, Anju

AU - Aghayan, Sargis Aghasi

AU - Agrawal, Anurag

AU - Agrawal, Sutapa

AU - Ahmadi, Alireza

AU - Ahmadi, Mehdi

AU - Ahmadieh, Hamid

AU - Ahmed, Muktar Beshir

AU - Aichour, Amani Nidhal

AU - Aichour, Ibtihel

AU - Aichour, Miloud Taki Eddine

AU - Kaul, Anil

PY - 2018/11/10

Y1 - 2018/11/10

N2 - Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.

AB - Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.

UR - http://www.scopus.com/inward/record.url?scp=85056201749&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(18)32225-6

DO - 10.1016/S0140-6736(18)32225-6

M3 - Article

C2 - 30496105

AN - SCOPUS:85056201749

VL - 392

SP - 1923

EP - 1994

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10159

ER -