Burden of chronic respiratory disease in Fujian province, 1990-2021

Chronic respiratory diseases (CRDs) are major public health problems with significant risk factors. This study aimed to analyze the disease burden and attributable risk factors of CRDs in Fujian, Southeast China, between 1990 and 2021 and provide a scientific basis for developing public health policies for Fujian government.

Data on incidence, prevalence, deaths, disability-adjusted life years (DALYs), and attributable risk factors for CRDs among Fujian residents were estimated as part of the Global Burden of Disease 2021 (GBD 2021) study at the provincial level. Joinpoint regression was used to assess the long-term temporal trends of the disease burden and identify the main risk factors of CRD between 1990 and 2021.

In 1990, there were 0.22 million (95% CI: 0.20-0.28) new CRD cases and 1.56 million (95% CI: 1.38-1.78) patients with CRDs, increasing up to 0.24 million (95% CI: 0.21-0.28) new cases and 2.00 million (95% CI: 1.80-2.24) patients with CRDs in 2021. However, the age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized DALY rate decreased by 29.63%, 29.26%, 75.92%, and 73.62% in Fujian (all P < 0.01) in these 32 years. The DALYs for CRDs were higher in males, patients older than 50 years, and patients with COPD. Smoking, ambient particulate matter pollution, and occupational exposure were the top three attributable risk factors of DALYs for CRDs in Fujian in 2021. Moreover, the proportion attributed to household air pollution from solid fuels significantly decreased.

The total CRD burden in Fujian province decreased, but the number of new cases and patients continuously increased. The ranking of risk factors of CRDs has changed between 1990 and 2021. Older men, smokers, and people with occupational exposure were the key groups that relieved the CRD burden. Efforts should focus on quitting smoking and reducing air pollution.