Global, regional, and national burden of DALYs attributable to occupational risks, 1990-2021: Trends and projections...

Occupational risks remain an important yet underrecognized contributor to the global burden of disease. Understanding long-term trends and regional disparities in occupational health risks is essential for effective prevention.

We used data from the Global Burden of Disease Study (GBD) 2021 to estimate Disability-Adjusted Life Years (DALYs) attributable to six major occupational risk factors (occupational carcinogens, asthmagens, noise, ergonomic factors, injuries, and occupational particulate matter, gases, and fumes) across 204 countries and territories from 1990 to 2021. We used joinpoint regression to identify significant trend shifts and average annual trends. Furthermore, we conducted decomposition analyses to identify drivers of change and applied Bayesian age-period-cohort models to project DALYs to 2030. Results were disaggregated by sex, region, and Socio-demographic Index (SDI).

Between 1990 and 2021, total DALYs attributable to six selected occupational risk factors increased from 73.0 million to 77.2 million, while the global age-standardized DALYs rate declined significantly (-1.72 % per year; 95 % CI: -1.78 to -1.66). The burden was consistently higher in males and low-SDI regions. Population growth and ageing were the primary drivers of increasing DALYs, while reductions in exposure levels had limited or counterbalancing effects. Occupational injuries and ergonomic factors were the leading contributors in low-SDI settings, whereas carcinogen-related DALYs predominated in high-SDI countries. Notably, the burden from occupational noise continued to rise globally. Inequality analyses revealed persistent disparities, including in high-income regions.

Although substantial progress has been made in reducing age-standardized rates, occupational risks still contribute meaningfully to global health loss. Region-specific and equity-oriented strategies remain essential to address preventable occupational disease burden, particularly in low-resource settings.