Global and regional burden of disease and injury in 2016 arising from occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016

Our plain-English summary of Global and regional burden of disease and injury in 2016 arising from occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016, by GBD 2016 Occupational Risk Factors Collaborators (Occupational and Environmental Medicine, 2020).

The study

• Author: GBD 2016 Occupational Risk Factors Collaborators
• Journal: Occupational and Environmental Medicine
• Published: 2020;77(3):133-141
• Cited by: 80 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objectives: This study provides an overview of the influence of occupational risk factors on the global burden of disease as estimated by the occupational component of the Global Burden of Disease (GBD) 2016 study.

Methods: The GBD 2016 study estimated the burden in terms of deaths and disability-adjusted life years (DALYs) arising from the effects of occupational risk factors (carcinogens; asthmagens; particulate matter, gases and fumes (PMGF); secondhand smoke (SHS); noise; ergonomic risk factors for low back pain; risk factors for injury). A population attributable fraction (PAF) approach was used for most risk factors.

Results: In 2016, globally, an estimated 1.53 (95% uncertainty interval 1.39-1.68) million deaths and 76.1 (66.3-86.3) million DALYs were attributable to the included occupational risk factors, accounting for 2.8% of deaths and 3.2% of DALYs from all causes. Most deaths were attributable to PMGF, carcinogens (particularly asbestos), injury risk factors and SHS. Most DALYs were attributable to injury risk factors and ergonomic exposures. Men and persons 55 years or older were most affected. PAFs ranged from 26.8% for low back pain from ergonomic risk factors and 19.6% for hearing loss from noise to 3.4% for carcinogens. DALYs per capita were highest in Oceania, Southeast Asia and Central sub-Saharan Africa. On a per capita basis, between 1990 and 2016 there was an overall decrease of about 31% in deaths and 25% in DALYs.

Conclusions: Occupational exposures continue to cause an important health burden worldwide, justifying the need for ongoing prevention and control initiatives.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

In plain English

This part of the Global Burden of Disease (GBD) 2016 study estimated how many deaths and disability-adjusted life years (DALYs) worldwide in 2016 could be attributed to work-related exposures. These were carcinogens, asthmagens, particulate matter, gases and fumes, secondhand smoke, noise, ergonomic factors for low back pain, and injury risk factors. Most estimates used population attributable fractions and counted only people aged 15 years and above. The authors estimated 1.53 million deaths (95% uncertainty interval 1.39 to 1.68 million), or 2.7% of all deaths, and 76.1 million DALYs (95% uncertainty interval 66.3 to 86.3 million). Carcinogens accounted for 23% of these deaths. In high-income regions, carcinogens caused the most work-related deaths, and asbestos-related cancers made up about 80% of carcinogen deaths there. Per person, work-related deaths fell by about 31% between 1990 and 2016. The authors stated that leaving out informal workers and excluded exposures probably led to underestimates. They also said risk estimates came mainly from cohorts of male workers in high-income countries. The authors concluded that occupational exposures are an important cause of largely preventable disease and injury burden in all regions.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Global burden of disease estimation study (part of the Global Burden of Disease Study 2016) using population attributable fractions
• Who was studied: Populations of all countries and GBD regions worldwide, persons aged 15 years and above, with 2016 the focus year and results calculated for 1990 to 2016
• Exposure: Occupational carcinogens (asbestos is named among them; fiber types are not specified), asthmagens, particulate matter, gases and fumes (PMGF), secondhand smoke (SHS), noise, ergonomic risk factors for low back pain, risk factors for occupational injury, and pneumoconiotic dusts
• Main results:
  • Globally in 2016, an estimated 1.53 million deaths (95% UI 1.39 to 1.68 million) were attributable to the included work-related risk factors
  • These deaths represented 2.7% of all deaths in 2016 (3.1% of deaths among those aged 15 years or more)
  • Globally, 76.1 million DALYs (95% UI 66.3 to 86.3 million) were attributable to occupational risk factors, 3.2% of total DALYs in 2016
  • Of occupation-attributable deaths, 30% were from PMGF and SHS causing COPD, 23% from carcinogens, 22% from injury risk factors and 22% from SHS causing other diseases
  • In all high-income regions, carcinogens caused the largest number of occupation-attributable deaths, and asbestos-related cancers made up about 80% of carcinogen deaths in these regions
  • Population attributable fractions based on deaths ranged from 3.9% for carcinogens to 15.7% for PMGF and SHS causing COPD
  • 77% of occupation-attributable deaths occurred in males
  • 76% of occupation-attributable deaths but only 39% of DALYs occurred in persons aged 55 years and older
  • Between 1990 and 2016, age and sex standardised rates fell by about 31% for deaths and 25% for DALYs
• The authors' conclusion: The authors concluded that occupational exposures are an important cause of largely preventable disease and injury burden in all regions of the world
• Limitations the authors state:
  • Relative risk estimates came mainly from cohorts of male workers in high-income countries
  • Carcinogen exposure data (CAREX) covered only high-income countries and gave only exposure prevalence, not exposure levels or cumulative exposures
  • Information on the latency of specific cancers is generally lacking, and worldwide variation in workforce turnover is uncertain
  • Incomplete coverage of informal and guest workers may considerably underestimate the population at risk and the burden
  • Many probably harmful occupational exposures were excluded, which was expected to considerably underestimate the total burden

Topics

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Population Attributable Fraction (PAF).

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