Abstract
BACKGROUND: Low temperatures are an important risk factor for chronic obstructive pulmonary disease (COPD). However, trends and projections of the global burden of COPD at low temperatures are unclear. METHODS: Based on data from the 2021 Global Burden of Disease Study (GBD), this study assessed trends in the global and regional burden of death and disability-adjusted life years (DALYs) due to COPD from 1990 to 2021, and identified patterns of change in different regions. A Bayesian Age-Period-cohort (BAPC) model was used to predict the burden of COPD over the next 20 years. RESULTS: Although the number of COPD deaths worldwide in 2021 increased from 242,170 in 1990 to 300,849, and the number of DALYs increased from 4,749,734 to 4,981,981, the age-standardized deaths rate decreased from 7.04 to 3.69 per 100,000, and the DALYs rate decreased from 126.69 to 59.22 per 100,000. Up to 2021, men consistently bore a higher burden than women, though their age-standardized deaths rate declined more sharply (54.2% vs. 39.2%). COPD burden increased notably after age 45, with those aged 65 and older contributing most to the total and showing the steepest rise. By SDI level, middle and middle-high SDI regions had the highest burden but saw the fastest declines, while low and low-middle SDI areas carried heavier burdens with slower reductions. High SDI regions maintained low and stable burden levels. BAPC projections suggest a continued but slower decline in COPD mortality linked to low temperature by 2041, with a projected drop of 1.39 per 100,000, less than the 3.35 per 100,000 reduction observed from 1990 to 2021. CONCLUSION: Global age-standardized mortality and DALYs for COPD at risk of low temperatures have declined over the past 30 years, with absolute burden numbers, BAPC predicting a slower rate of decline in the future, and persistent cross-country health inequalities. More precise interventions should be developed to target the resistance to low-temperature risk in older age groups and areas with low SDI.