Global, regional, and national trends in the incidence of pneumoconiosis among populations aged 20 and above from 1990 to 2021

Our plain-English summary of Global, regional, and national trends in the incidence of pneumoconiosis among populations aged 20 and above from 1990 to 2021, by Q. Cheng, S. He, Y. Hu, et al (Frontiers in Public Health, 2025).

The study

• Authors: Q. Cheng, S. He, Y. Hu, P. Pan, X. Hu, S. Liao, S. Wang, H. Li
• Journal: Frontiers in Public Health
• Published: 2025;13:1608109
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Pneumoconiosis remains one of the most critical occupational health hazards globally. Utilizing data from the Global Burden of Disease (GBD) 2021, we have updated the epidemiological trends of pneumoconiosis.

Methods: We conducted and analyzed pneumoconiosis-related data from the GBD 2021 study for individuals aged ≥20 years. Our analysis described the incident cases and age-standardized incidence rates (ASIRs) across various global regions and age groups. Temporal trends were evaluated using Estimated Annual Percentage Change (EAPC) for ASIRs between 1990 and 2021.

Results: The ASIR of pneumoconiosis among individuals aged ≥20 years declined globally at an annual average of 0.48% between 1990 and 2021. Except for high socio-demographic index (SDI) regions, the ASIR of pneumoconiosis declined across all other SDI categories. Males had significantly higher incidence rates than females, especially in older adults. Silicosis emerged as the predominant type of pneumoconiosis, constituting ~56.7% of cases. While the ASIRs for silicosis, coal workers' pneumoconiosis, and other pneumoconiosis decreased, the ASIRs for asbestosis exhibited a notable upward trend, with an EAPC of 1.21%. A strong negative correlation was observed between the EAPC of pneumoconiosis incidence and the 1990 ASIRs values. Notably, the EAPC showed a statistically significant but very weak positive correlation with the 2021 Human Development Index (HDI) values.

Conclusion: Despite a gradual global decline in the ASIR of pneumoconiosis, the disease burden remains substantial in certain regions. Our findings could inform governments and policymakers in developing targeted prevention strategies to mitigate this burden. Future strategies should integrate technological innovation with regulatory frameworks, prioritizing male-dominated high-risk sectors through strengthened global asbestos bans and lifetime health surveillance for workers in pneumoconiosis-prone occupations worldwide.

Copyright © 2025 Cheng, He, Hu, Pan, Hu, Liao, Wang and Li.

In plain English

This study reanalyzed existing Global Burden of Disease (GBD) 2021 estimates rather than collecting new data. It covered new cases of pneumoconiosis in people aged 20 and over in 204 countries from 1990 to 2021, split into silicosis, asbestosis, coal workers' pneumoconiosis and other pneumoconiosis. Globally, estimated new cases rose from 41,479 (95% uncertainty interval 35,116 to 47,972) in 1990 to 62,184 (53,682 to 70,514) in 2021. The age-standardized rate fell from 1.35 (1.14 to 1.56) to 1.18 (1.02 to 1.34) per 100,000, an estimated annual change of minus 0.48% (95% interval minus 0.57% to minus 0.40%). Rates were higher in males than in females. In 2021, silicosis made up 56.7% of cases and asbestosis 16.7%. The global asbestosis rate rose (annual change 1.21%), while rates for the other three types fell. Asbestosis's share of cases rose from 36.6% to 85.2% in Australasia and 12% to 45.3% in Western Europe. The authors concluded that the global rate declined but high burdens persist in Australasia and East Asia. They noted possible selection bias and misclassification in GBD data, and underreporting where surveillance is weak.

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: Secondary analysis of modeled Global Burden of Disease (GBD) 2021 estimates of incidence and trends (age-standardized incidence rates and estimated annual percentage change)
• Who was studied: People aged 20 and over in 204 countries and territories (21 GBD regions), 1990 to 2021, analyzed at global, regional and national levels
• Exposure: No exposures were measured directly. The study examined four types of pneumoconiosis as recorded in GBD: silicosis, asbestosis, coal workers' pneumoconiosis (CWP) and other pneumoconiosis.
• Main results:
  • Global age-standardized incidence rate of all pneumoconiosis, ages 20 and over, fell from 1.35 per 100,000 (95% UI 1.14 to 1.56) in 1990 to 1.18 (95% UI 1.02 to 1.34) in 2021; EAPC minus 0.48% (95% UI minus 0.57% to minus 0.40%)
  • Global incident cases, ages 20 and over: 41,479 (95% UI 35,116 to 47,972) in 1990 and 62,184 (95% UI 53,682 to 70,514) in 2021
  • Males: 36,249 cases and a rate of 2.37 per 100,000 in 1990; 53,063 cases and 2.04 per 100,000 in 2021. Females: 5,230 cases and 0.34 per 100,000 in 1990; 9,121 cases and 0.34 per 100,000 in 2021.
  • In 2021, silicosis accounted for 56.7% of pneumoconiosis cases among people aged 20 and over
  • In 2021, asbestosis accounted for 16.7% of pneumoconiosis cases among people aged 20 and over
  • Global incidence rates for silicosis, coal workers' pneumoconiosis and other pneumoconiosis decreased from 1990 to 2021, while the asbestosis rate rose (EAPC 1.21%)
  • Asbestosis's share of pneumoconiosis cases rose from 36.6% to 85.2% in Australasia and from 12% to 45.3% in Western Europe between 1990 and 2021
  • The highest asbestosis incidence rate was in Finland, followed by the United Kingdom and Australia
  • Australasia had the largest regional increase in the all-pneumoconiosis rate (EAPC 2.72)
  • High SDI countries: rate 1.63 per 100,000 in 1990 and 1.65 in 2021, EAPC 0.01 (95% CI minus 0.06 to 0.08). The authors described this as the only SDI group with an increasing trend.
  • Across countries, the trend (EAPC) was negatively correlated with the 1990 incidence rate (r = minus 0.35, 95% CI minus 0.46 to minus 0.22)
  • The trend showed a statistically significant but very weak positive correlation with the 2021 Human Development Index (r = 0.16, 95% CI 0.01 to 0.30)
• The authors' conclusion: The authors concluded that the global incidence rate of pneumoconiosis among people aged 20 and over declined from 1990 to 2021, which they attributed to progress in prevention, but that high burdens persist in Australasia and East Asia.
• Limitations the authors state:
  • GBD data come from diverse sources and carry selection bias and misclassification. This may underestimate silicosis, asbestosis and CWP and overestimate other subtypes.
  • Data gaps, especially in low- and middle-income countries with weak occupational health surveillance, result in underreported cases
  • The authors said the rise in high-SDI regions likely reflects better diagnosis rather than a genuine change in disease occurrence

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Incidence, Silicosis.

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