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Journal Article•DOI•

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

Stephen S Lim1, Theo Vos, Abraham D. Flaxman1, Goodarz Danaei2  +207 more•Institutions (92)
15 Dec 2012-The Lancet (Elsevier)-Vol. 380, Iss: 9859, pp 2224-2260
TL;DR: In this paper, the authors 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.
About: This article is published in The Lancet.The article was published on 2012-12-15 and is currently open access. It has received 9324 citations till now. The article focuses on the topics: Disease burden & Risk factor.

Summary (1 min read)

Jump to: [Convincing evidence] – [Probable evidence] – [Possible evidence] and [Insufficient evidence]

Convincing evidence

  • Evidence based on epidemiological studies showing consistent associations between exposure and disease, with little or no evidence to the contrary.
  • The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects.

Probable evidence

  • Evidence based on epidemiological studies showing fairly consistent associations between exposure and disease, but for which there are perceived shortcomings in the available evidence or some evidence to the contrary, which precludes a more definite judgment.
  • Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up.

Possible evidence

  • Evidence based mainly on findings from case-control and cross-sectional studies.
  • Insufficient randomised controlled trials, observational studies, or non-randomised controlled trials are available.
  • Evidence based on non-epidemiological studies, such as clinical and laboratory investigations, is supportive.
  • More trials are needed to support the tentative associations, which should be biologically plausible.

Insufficient evidence

  • Evidence based on findings of a few studies which are suggestive, but insufficient to establish an association between exposure and disease.
  • Burden of disease attributable to individual risk factors are shown sequentially for ease of presentation.

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Citations
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Journal Article•DOI•
Environmental Pollution: An Under-recognized Threat to Children’s Health, Especially in Low- and Middle-Income Countries

[...]

William A. Suk1, Hamid Ahanchian2, Kwadwo Ansong Asante3, David O. Carpenter4, Fernando Díaz-Barriga5, Eun Hee Ha, Xia Huo6, Malcolm King7, Mathuros Ruchirawat8, Emerson Rodrigues da Silva9, Leith Sly10, Peter D. Sly10, Renato T. Stein11, Martin van den Berg12, Heather J. Zar13, Philip J. Landrigan14 •
National Institutes of Health1, Mashhad University of Medical Sciences2, Council for Scientific and Industrial Research3, University at Albany, SUNY4, Universidad Autónoma de San Luis Potosí5, Shantou University6, Simon Fraser University7, Chulabhorn Research Institute8, University of Caxias do Sul9, University of Queensland10, Pontifícia Universidade Católica do Rio Grande do Sul11, Utrecht University12, University of Cape Town13, Icahn School of Medicine at Mount Sinai14
01 Mar 2016-Environmental Health Perspectives
TL;DR: A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease.
Abstract: Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children's health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease.

100 citations

Journal Article•DOI•
Can population levels of physical activity be increased? Global evidence and experience.

[...]

Michael Pratt1, Michael Pratt2, Lilian G. Perez3, Shifalika Goenka4, Ross C. Brownson5, Adrian Bauman6, Olga L. Sarmiento1, Pedro C. Hallal7 •
University of Los Andes1, Emory University2, University of California, San Diego3, Public Health Foundation of India4, Washington University in St. Louis5, University of Sydney6, Universidade Federal de Pelotas7
01 Jan 2015-Progress in Cardiovascular Diseases
TL;DR: Using the socio-ecological framework to conceptualize PA interventions, it is shown that PA can be targeted at multiple levels of influence and by multiple sectors outside the health system.

100 citations

Journal Article•DOI•
Screening for atrial fibrillation in 13 122 Hong Kong citizens with smartphone electrocardiogram

[...]

Ngai-Yin Chan, Chi-Chung Choy
01 Jan 2017-Heart
TL;DR: Community screening for AF with SL-ECG was feasible and it identified a significant proportion of citizens with newly diagnosed AF and the prevalence of AF in a Chinese population in Hong Kong was comparable with that of contemporary Western counterparts.
Abstract: Objective The purpose of this study was to assess the feasibility of community screening for atrial fibrillation (AF) using a smartphone-based wireless single-lead ECG (SL-ECG) and to generate epidemiological data on the prevalence and risk factors of AF in Hong Kong. Methods In the period between 1 May 2014 to 30 April 2015, 13 122 Hong Kong citizens consented and voluntarily participated in a territory-wide community-based AF screening programme. Results 56 (0.4%) out of 13 122 SL-ECG were uninterpretable. 101 (0.8%) participants had newly diagnosed AF, with 66 (65.3%) being asymptomatic. The congestive heart failure, hypertension, age>75(doubled), diabetes, stroke(doubled), vascular disease, age 65–74, sex(female) score (CHA2DS2VASc score) of participants with newly diagnosed AF was 3.1±1.3. The prevalence rates for AF detected by SL-ECG was 1.8% and for AF detected by SL-ECG or self-reported by participants was 8.5%. Using multivariable logistic regression analysis, independent predictors of AF include age, sex, height, weight, body mass index, history of heart failure, valvular heart disease, stroke, hyperlipidaemia, coronary artery disease, peripheral artery disease and cardiothoracic surgery. Conclusion Community screening for AF with SL-ECG was feasible and it identified a significant proportion of citizens with newly diagnosed AF. The prevalence of AF in a Chinese population in Hong Kong was comparable with that of contemporary Western counterparts. Apart from age and sex, different anthropometric parameters and cardiovascular comorbid conditions were identified as independent predictors of AF.

100 citations

Journal Article•DOI•
Urban cross-sector actions for carbon mitigation with local health co-benefits in China

[...]

Anu Ramaswami1, Kangkang Tong1, Andrew Fang1, Raj M. Lal2, Ajay Singh Nagpure1, Yang Li3, Huajun Yu3, Daqian Jiang4, Armistead G. Russell2, Lei Shi3, Marian Chertow4, Yangjun Wang5, Shuxiao Wang3 •
University of Minnesota1, Georgia Institute of Technology2, Tsinghua University3, Yale University4, Shanghai University5
18 Sep 2017-Nature Climate Change
TL;DR: In this article, the authors quantified the large-scale impact of cross-sectoral strategies to reduce fossil fuel use through the exchange of energy and materials across homes, businesses, infrastructure and industries co-located in urban areas.
Abstract: Cities offer unique strategies to reduce fossil fuel use through the exchange of energy and materials across homes, businesses, infrastructure and industries co-located in urban areas. However, the large-scale impact of such strategies has not been quantified. Using new models and data sets representing 637 Chinese cities, we find that such cross-sectoral strategies—enabled by compact urban design and circular economy policies—contribute an additional 15%–36% to national CO2 mitigation, compared to conventional single-sector strategies. As a co-benefit, ∼25,500 to ∼57,500 deaths annually are avoided from air pollution reduction. The benefits are highly variable across cities, ranging from <1%–37% for CO2 emission reduction and <1%–47% for avoided premature deaths. These results, using multi-scale, multi-sector physical systems modelling, identify cities with high carbon and health co-benefit potential and show that urban–industrial symbiosis is a significant carbon mitigation strategy, achievable with a combination of existing and advanced technologies in diverse city types. The use of cross-sectoral strategies, such as the exchange of waste energy through co-location of industry, business and residential areas, is shown to be effective for greenhouse gas and particulate mitigation in this study of 637 Chinese cities.

100 citations

Journal Article•DOI•
Health impact and related cost of ambient air pollution in Tehran.

[...]

Reza Bayat1, Khosro Ashrafi1, Majid Shafiepour Motlagh1, Mohammad Sadegh Hassanvand2, Rajabali Daroudi2, Günther Fink3, Nino Künzli3 •
University of Tehran1, Tehran University of Medical Sciences2, Swiss Tropical and Public Health Institute3
01 Sep 2019-Environmental Research
TL;DR: The estimated total annual economic benefit (2017) of reducing PM2.5 concentration levels to 2.4 μg/m3 was USD 0.591 (95% CI: 0.447-0.624) billion per year, using the value of a life year (VOLY) approach, and USD 2.894 ( 95%CI: 2.671-3.043) billions per year using thevalue of a statistical life approach.

99 citations

References
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Journal Article•DOI•
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

[...]

William C. Knowler1, Elizabeth Barrett-Connor1, Sarah E. Fowler1, Richard F. Hamman1, John M. Lachin1, Elizabeth A. Walker, David M. Nathan1 •
George Washington University1
07 Feb 2002-The New England Journal of Medicine
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Abstract: Background Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors — elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle — are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. Methods We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. Results The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Conclusions Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

17,333 citations

Journal Article•DOI•
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Rafael Lozano1, Mohsen Naghavi1, Kyle J Foreman2, Stephen S Lim1  +192 more•Institutions (95)
15 Dec 2012-The Lancet
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.

11,809 citations

Journal Article•DOI•
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.

[...]

Sarah Lewington, Robert Clarke, Nawab Qizilbash, Richard Peto, Rory Collins 
14 Dec 2002-The Lancet
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.

9,101 citations

Book•
The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020.

[...]

Christopher J L Murray, Alan D. Lopez
01 Jan 1996
TL;DR: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors" and use historical trends in main determinants to project mortality and disease burden forward to 2020.
Abstract: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors;...generate assessments of numbers of deaths by cause that are consistent with the total numbers of deaths by age sex and region provided by demographers;...provide methodologies for and assessments of aggregate disease burden that combine--into the Disability-Adjusted Life Year or DALY measure--burden from premature mortality with that from living with disability; and...use historical trends in main determinants to project mortality and disease burden forward to 2020." This first volume includes chapters summarizing results from the project as a whole. (EXCERPT)

7,154 citations

Journal Article•DOI•
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Theo Vos, Abraham D. Flaxman1, Mohsen Naghavi1, Rafael Lozano1  +360 more•Institutions (143)
15 Dec 2012-The Lancet
TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.

7,021 citations

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Frequently Asked Questions (4)
Q1. What are the contributions mentioned in the paper "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 author" ?

Lim, Stephen S, Vos, Umer, Shibuya, Shibaya, Kenji, AdairRohani, Heather, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anne-Charlson, H Dean, this paper, Nolla, Nissim, Nelson, Paul K 

Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up. 

The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects. 

In reality, the burden attributable to different risks overlaps because of multicausality and because the effects of some risk factors are partly mediated throughLim et al.