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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•
A New Algorithm for the Diagnosis of Hypertension in Canada

[...]

Lyne Cloutier1, Stella S. Daskalopoulou2, Raj Padwal3, Maxime Lamarre-Cliche4, Peter Bolli, Donna McLean3, Alain Milot5, Sheldon W. Tobe6, Guy Tremblay, Donald W. McKay7, Raymond R. Townsend8, Norm R.C. Campbell9, Mark Gelfer10 •
Université du Québec à Trois-Rivières1, McGill University2, University of Alberta3, Université de Montréal4, Laval University5, University of Toronto6, Memorial University of Newfoundland7, University of Pennsylvania8, University of Calgary9, University of British Columbia10
01 May 2015-Canadian Journal of Cardiology
TL;DR: Evidence for a revised algorithm to diagnose hypertension is presented and recommends that out-of-office blood pressure measurements, ambulatory blood pressure monitoring (preferred), or home blood pressure measurement, should be performed to confirm the diagnosis of hypertension.

98 citations

Journal Article•DOI•
Diesel exhaust augments allergen-induced lower airway inflammation in allergic individuals: a controlled human exposure study

[...]

Christopher Carlsten1, Anders Blomberg2, Mandy Pui1, Thomas Sandström2, Sze Wing Wong1, Neil E. Alexis3, Jeremy A. Hirota1 •
University of British Columbia1, Umeå University2, University of North Carolina at Chapel Hill3
01 Jan 2016-Thorax
TL;DR: Inhalation of diesel exhaust at environmentally relevant concentrations augments allergen-induced allergic inflammation in the lower airways of atopic individuals and the GSTT1 genotype enhances this response.
Abstract: Rationale Traffic-related air pollution has been shown to augment allergy and airway disease. However, the enhancement of allergenic effects by diesel exhaust in particular is unproven in vivo in the human lung, and underlying details of this apparent synergy are poorly understood. Objective To test the hypothesis that a 2 h inhalation of diesel exhaust augments lower airway inflammation and immune cell activation following segmental allergen challenge in atopic subjects. Methods 18 blinded atopic volunteers were exposed to filtered air or 300 mg PM2.5/m(3) of diesel exhaust in random fashion. 1 h post-exposure, diluent-controlled segmental allergen challenge was performed; 2 days later, samples from the challenged segments were obtained by bronchoscopic lavage. Samples were analysed for markers and modifiers of allergic inflammation (eosinophils, Th2 cytokines) and adaptive immune cell activation. Mixed effects models with ordinal contrasts compared effects of single and combined exposures on these end points. Results Diesel exhaust augmented the allergen-induced increase in airway eosinophils, interleukin 5 (IL-5) and eosinophil cationic protein (ECP) and the GSTT1 null genotype was significantly associated with the augmented IL-5 response. Diesel exhaust alone also augmented markers of non-allergic inflammation and monocyte chemotactic protein (MCP)-1 and suppressed activity of macrophages and myeloid dendritic cells. Conclusion Inhalation of diesel exhaust at environmentally relevant concentrations augments allergen-induced allergic inflammation in the lower airways of atopic individuals and the GSTT1 genotype enhances this response. Allergic individuals are a susceptible population to the deleterious airway effects of diesel exhaust.

98 citations

Journal Article•DOI•
Urban Form, Air Pollution, and Health

[...]

Steve Hankey1, Julian D. Marshall2•
Virginia Tech1, University of Washington2
01 Dec 2017-Current Environmental Health Reports
TL;DR: Urban form can support efforts to design clean, health-promoting cities and there is evidence that these factors may modify the relationship between air pollution and health.
Abstract: Urban form can impact air pollution and public health. We reviewed health-related articles that assessed (1) the relationships among urban form, air pollution, and health as well as (2) aspects of the urban environment (i.e., green space, noise, physical activity) that may modify those relationships. Simulation and empirical studies demonstrate an association between compact growth, improved regional air quality, and health. Most studies are cross-sectional and focus on connections between transportation emissions and land use. The physical and mental health impacts of green space, public spaces that promote physical activity, and noise are well-studied aspects of the urban environment and there is evidence that these factors may modify the relationship between air pollution and health. Urban form can support efforts to design clean, health-promoting cities. More work is needed to operationalize specific strategies and to elucidate the causal pathways connecting various aspects of health.

98 citations

Journal Article•DOI•
Smokers' and drinkers' choice of smartphone applications and expectations of engagement: a think aloud and interview study.

[...]

Olga Perski1, Ann Blandford1, Harveen Kaur Ubhi1, Robert West1, Susan Michie1 •
University College London1
28 Feb 2017-BMC Medical Informatics and Decision Making
TL;DR: Choice of a smoking cessation or alcohol reduction app may be influenced by its immediate look and feel, ‘social proof’ and titles that appear realistic, which may enhance motivation, autonomy, personal relevance and credibility.
Abstract: Public health organisations such as the National Health Service in the United Kingdom and the National Institutes of Health in the United States provide access to online libraries of publicly endorsed smartphone applications (apps); however, there is little evidence that users rely on this guidance. Rather, one of the most common methods of finding new apps is to search an online store. As hundreds of smoking cessation and alcohol-related apps are currently available on the market, smokers and drinkers must actively choose which app to download prior to engaging with it. The influences on this choice are yet to be identified. This study aimed to investigate 1) design features that shape users’ choice of smoking cessation or alcohol reduction apps, and 2) design features judged to be important for engagement. Adult smokers (n = 10) and drinkers (n = 10) interested in using an app to quit/cut down were asked to search an online store to identify and explore a smoking cessation or alcohol reduction app of their choice whilst thinking aloud. Semi-structured interview techniques were used to allow participants to elaborate on their statements. An interpretivist theoretical framework informed the analysis. Verbal reports were audio recorded, transcribed verbatim and analysed using inductive thematic analysis. Participants chose apps based on their immediate look and feel, quality as judged by others’ ratings and brand recognition (‘social proof’), and titles judged to be realistic and relevant. Monitoring and feedback, goal setting, rewards and prompts were identified as important for engagement, fostering motivation and autonomy. Tailoring of content, a non-judgmental communication style, privacy and accuracy were viewed as important for engagement, fostering a sense of personal relevance and trust. Sharing progress on social media and the use of craving management techniques in social settings were judged not to be engaging because of concerns about others’ negative reactions. Choice of a smoking cessation or alcohol reduction app may be influenced by its immediate look and feel, ‘social proof’ and titles that appear realistic. Design features that enhance motivation, autonomy, personal relevance and credibility may be important for engagement.

98 citations

Journal Article•DOI•
Pollutant Emissions and Energy Efficiency of Chinese Gasifier Cooking Stoves and Implications for Future Intervention Studies

[...]

Ellison Carter1, Ming Shan2, Xudong Yang2, Jiarong Li2, Jill Baumgartner3, Jill Baumgartner4 •
University of Texas at Austin1, Tsinghua University2, University of Minnesota3, McGill University4
20 May 2014-Environmental Science & Technology
TL;DR: Four Chinese gasifier cookstoves evaluated for their pollutant emissions and efficiency using the internationally recognized water boiling test (WBT), version 4.1.2, had lower PM2.5 emissions and higher CO emissions compared with several widely disseminated "improved" cookstove selected from the literature.
Abstract: Household air pollution from solid fuel combustion is the leading environmental health risk factor globally. In China, almost half of all homes use solid fuel to meet their household energy demands. Gasifier cookstoves offer a potentially affordable, efficient, and low-polluting alternative to current solid fuel combustion technology, but pollutant emissions and energy efficiency performance of this class of stoves are poorly characterized. In this study, four Chinese gasifier cookstoves were evaluated for their pollutant emissions and efficiency using the internationally recognized water boiling test (WBT), version 4.1.2. WBT performance indicators included PM2.5, CO, and CO2 emissions and overall thermal efficiency. Laboratory investigation also included evaluation of pollutant emissions (PM2.5 and CO) under stove operating conditions designed to simulate common Chinese cooking practices. High power average overall thermal efficiencies ranged from 22 to 33%. High power average PM2.5 emissions ranged from 120 to 430 mg/MJ of useful energy, and CO emissions ranged from 1 to 30 g/MJ of useful energy. Compared with several widely disseminated "improved" cookstoves selected from the literature, on average, the four Chinese gasifier cookstoves had lower PM2.5 emissions and higher CO emissions. The recent International Organization for Standardization (ISO) International Workshop Agreement on tiered cookstove ranking was developed to help classify stove performance and identify the best-performing stoves. The results from this study highlight potential ways to further improve this approach. Medium power stove operation emitted nearly twice as much PM2.5 as was emitted during high power stove operation, and the lighting phase of a cooking event contributed 45% and 34% of total PM2.5 emissions (combined lighting and cooking). Future approaches to laboratory-based testing of advanced cookstoves could improve to include greater differentiation between different modes of stove operation, beyond those evaluated with the WBT.

98 citations

References
More filters
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

Related Papers (5)
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

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15 Dec 2012-The Lancet
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Global burden of hypertension: analysis of worldwide data

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Patricia M. Kearney, Patricia M. Kearney, Megan Whelton, Kristi Reynolds, Paul Muntner, Paul K. Whelton, Jiang He 
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.

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21 May 2003-JAMA
Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green, Joseph L. Izzo, Daniel W. Jones, Barry J. Materson, Suzanne Oparil, Jackson T. Wright, Edward J. Roccella 
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21 Jul 2013-European Heart Journal
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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.