The effect of air pollution on deaths, disease burden, and life expectancy across China and its provinces, 1990-2017: an analysis for the Global Burden of Disease Study 2017.

Background: Air pollution is an important public health concern in China, with high levels of exposure to both ambient and household air pollution. To inform action at provincial levels in China, we estimated the exposure to air pollution and its effect on deaths, disease burden, and loss of life expectancy across all provinces in China from 1990 to 2017.

Methods: In all 33 provinces, autonomous regions, municipalities, and special administrative regions in China, we estimated exposure to air pollution, including ambient particulate matter pollution (defined as the annual gridded concentration of PM), household air pollution (defined as the percentage of households using solid cooking fuels and the corresponding exposure to PM), and ozone pollution (defined as average gridded ozone concentrations).

Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors.

Background: The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals.

Objectives: We review key aspects of the GBD for the EH community and introduce the Global Burden of Disease-Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden-both current and projected.

Identifying residual hotspots and mapping lower respiratory infection morbidity and mortality in African children from 2000 to 2017.

Lower respiratory infections (LRIs) are the leading cause of death in children under the age of 5, despite the existence of vaccines against many of their aetiologies. Furthermore, more than half of these deaths occur in Africa. Geospatial models can provide highly detailed estimates of trends subnationally, at the level where implementation of health policies has the greatest impact.

Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter.

Exposure to ambient fine particulate matter (PM) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM-mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range.

Impact of air pollution control policies on future PM concentrations and their source contributions in China.

To investigate the impact of air pollutant control policies on future PM concentrations and their source contributions in China, we developed four future scenarios for 2030 based on a 2013 emission inventory, and conducted air quality simulations for each scenario using the chemical transport model GEOS-Chem (version 9.1.3).

Global estimation of exposure to fine particulate matter (PM) from household air pollution.

Background: Exposure to household air pollution (HAP) from cooking with dirty fuels is a leading health risk factor within Asia, Africa and Central/South America. The concentration of particulate matter of diameter ≤ 2.5 μm (PM) is an important metric to evaluate HAP risk, however epidemiological studies have demonstrated significant variation in HAP-PM concentrations at household, community and country levels.

Data Integration for the Assessment of Population Exposure to Ambient Air Pollution for Global Burden of Disease Assessment.

Air pollution is a leading global disease risk factor. Tracking progress (e.g.

Source influence on emission pathways and ambient PM pollution over India (2015-2050).

India is currently experiencing degraded air quality, and future economic development will lead to challenges for air quality management. Scenarios of sectoral emissions of fine particulate matter and its precursors were developed and evaluated for 2015-2050, under specific pathways of diffusion of cleaner and more energy-efficient technologies. The impacts of individual source sectors on PM concentrations were assessed through systematic simulations of spatially and temporally resolved particulate matter concentrations, using the GEOS-Chem model, followed by population-weighted aggregation to national and state levels.

The Burden of Cardiovascular Diseases Among US States, 1990-2016.

Importance: Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously.

Objective: To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes.

Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015.

Background: Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels.

Methods: We estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements.

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger.

The Global Burden of Lead Toxicity Attributable to Informal Used Lead-Acid Battery Sites.

Background: Prior calculations of the burden of disease from environmental lead exposure in low- and middle-income countries (LMICs) have not included estimates of the burden from lead-contaminated sites because of a lack of exposure data, resulting in an underestimation of a serious public health problem.

Objective: We used publicly available statistics and detailed site assessment data to model the number of informal used lead-acid battery (ULAB) recyclers and the resulting exposures in 90 LMICs. We estimated blood lead levels (BLLs) using the US Environment Protection Agency's Integrated Exposure Uptake Biokinetic Model for Lead in Children and Adult Lead Model.

The Regional Impacts of Cooking and Heating Emissions on Ambient Air Quality and Disease Burden in China.

Exposure to air pollution is a major risk factor globally and particularly in Asia. A large portion of air pollutants result from residential combustion of solid biomass and coal fuel for cooking and heating. This study presents a regional modeling sensitivity analysis to estimate the impact of residential emissions from cooking and heating activities on the burden of disease at a provincial level in China.

Ambient Air Pollution Exposure Estimation for the Global Burden of Disease 2013.

Exposure to ambient air pollution is a major risk factor for global disease. Assessment of the impacts of air pollution on population health and evaluation of trends relative to other major risk factors requires regularly updated, accurate, spatially resolved exposure estimates. We combined satellite-based estimates, chemical transport model simulations, and ground measurements from 79 different countries to produce global estimates of annual average fine particle (PM2.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.