Global, regional, and national burden of tracheal, bronchus, and lung cancer attributable to polycyclic aromatic hydrocarbons occupational expose from 1990 to 2021: worsening or improving?

1990 年至 2021 年,全球、区域和国家层面因职业接触多环芳烃而导致的气管癌、支气管癌和肺癌负担:恶化还是改善?

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Abstract

BACKGROUND: Occupational exposure to polycyclic aromatic hydrocarbons (PAH) directly contributes to tracheal, bronchus, and lung cancer. However, it remains a challenge to accurately determine the epidemiological relationship between PAH and lung cancer. METHODS: The incidence, deaths, disability-adjusted life-years (DALYs), years lost due to disability (YLDs), years of life lost (YLLs), and corresponding estimated annual percentage changes (EAPC) were used from the Global Burden of Disease 2021. Trends were stratified by region/country, age, sex, and sociodemographic index (SDI). Joinpoint regression, decomposition analysis, and frontier analysis were conducted to explore potential characteristics of the disease burden. RESULTS: The burden of occupational PAH exposure is globally rising. The lung cancer's age-standardized mortality rate (ASMR) and DALYs rate (ASDR) attributable to occupational PAH exposure were 0.07 (95%UI: 0.06, 0.08) and 1.98 (95%UI: 1.63,2.40) per 100,000 population, with EAPC of 1.14 (95%CI: 1.10, 1.39) and 0.61 (95%CI: 0.58, 0.72), correspondingly. The highest disease burden was observed among individuals aged 65-69 years. The disease burden increased in high-middle, middle, low-middle, and low SDI levels, with the most pronounced rise observed in high-middle SDI countries during thirty years. Joinpoint regression analyses showed that ASMR generally increased for both males and females. The population contributed to the fluctuations in DALYs and deaths in the decomposition analysis. The frontier analyses suggested the greatest potential between burden reduction and high-SDI countries. We demonstrated that the burden of occupational PAH exposure is escalating globally, and the burden of lung cancer attributable to occupational PAH exposure is also increasing, with significant variations in age, sex, and socioeconomic development. CONCLUSIONS: This study underscores the urgent need for public health interventions, especially in high-medium SDI regions. With economies developing, it is imperative to consider additional measures to mitigate occupational exposure to PAH, with the aim of alleviating both the societal and economic burdens, as well as the associated health risks.

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