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| Disease burden of chronic obstructive pulmonary disease in Zhejiang Province from 1990 to 2021 |
| ZHOU Xiaoyan, GONG Weiwei, PAN Jin, DAI Pinyuan, GUAN Yunqi, WANG Hao, LI Na, LU Feng, ZHONG Jieming
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| Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China |
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Abstract Objective To analyze the disease burden of chronic obstructive pulmonary disease (COPD) and changes in its risk factors among residents in Zhejiang Province from 1990 to 2021, so as to identify key priorities for COPD prevention and control. Methods Data on COPD mortality and disability-adjusted life years (DALY) for residents in Zhejiang Province from 1990 to 2021 were collected from the Global Burden of Disease (GBD) 2021 database. Standardized mortality and standardized DALY rate were calculated using the GBD 2021 world population standard structure. Premature mortality was computed via the life table method. The average annual percent change (AAPC) was applied to analyze trends in COPD mortality, DALY rate, and premature mortality. Changes in deaths of COPD risk factors were evaluated using population attributable fraction (PAF). Results From 1990 to 2021, the standardized COPD mortality in Zhejiang Province decreased from 272.40/105 to 70.56/105 (AAPC=-4.395%), and the standardized DALY rate declined from 4 167.37/105 to 1 071.89/105 (AAPC=-4.396%). Similar downward trends were observed in both males (AAPC=-3.933%, -4.173%) and females (AAPC=-4.785%, -4.480%), all P<0.05. Crude mortality and DALY rates increased with age, and the crude mortality and DALY rates of various age groups in Zhejiang Province showed decreasing trends from 1990 to 2021 (all P<0.05). The premature mortality declined from 4.37% to 0.60% from 1990 to 2021 (AAPC=-6.206%), with consistent trends across males and females (AAPC=-6.144%, -6.379%, all P<0.05). From 1990 to 2021, particulate matter pollution showed the largest reduction in PAF (-56.76%), while ambient ozone pollution had the largest increase (103.07%) in Zhejiang Province. By 2021, smoking became the leading risk factor for deaths of COPD (PAF=43.32%). Conclusions The standardized mortality, standardized DALY rate, and premature mortality for COPD show consistent declining trends in Zhejiang Province from 1990 to 2021. However, risk factors such as smoking and ambient ozone pollution require intensified focus to further reduce disease burden of COPD.
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Received: 13 March 2025
Revised: 15 July 2025
Published: 20 August 2025
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