Abstract
BACKGROUND: With the frequent occurrence of extreme weather worldwide, non-optimal temperature increased the risk of death from respiratory diseases. The burden of non-optimal temperature on chronic obstructive pulmonary disease (COPD) was quantitatively assessed, and its influencing factors were discussed to provide a basis for the prevention and treatment of COPD. METHODS: Based on GBD 2019, we characterized the age-standardized mortality rate (ASMR) and years of life lost rate (ASYR) of COPD attributable to non-optimal temperature in three groups of countries at different isotherms (China and USA, South Africa and Australia, Iraq and Portugal) between 1990 and 2019. We constructed the age-period-cohort model to analyze age, period and cohort effects on mortality and the Bayesian age-period-cohort model to predict ASMR in six countries. We analyzed the relationship of socio-demographic index (SDI) with ASMR and ASYR by restricted cubic spline and quantile regression using data from 21 GBD regions. RESULTS: ASMR of COPD attributable to non-optimal temperature in 2019 was 11.03/100,000 (China), 5.62/100,000 (USA), 2/100,000 (Australia), 0.93/100,000 (Iraq), 3.74/100,000 (Portugal), 4.13/100,000 (South Africa). Low temperature had a greater impact on COPD. The mortality showed an increasing trend with age, the period effect only showed a decreasing trend in China, and cohort effect showed a decreasing trend. The higher COPD burden was concentrated in areas with SDI values of 0.39-0.78. Implied quantile regression of mortality to SDI fit was meaningful at P(5) and P(75), and ASYR was at P(5), P(25), P(75), and P(95). We predicted an upward trend in COPD ASMR over the next 25 years only in the USA. CONCLUSIONS: In COPD burden caused by non-optimal temperature, low temperature played a more important role, and it was affected by sex, age, period, cohort and SDI. Over the next 25 years, ASMR in COPD was predicted to decline in all countries except the USA.