A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Stephen S Lim, Eric Theo Vos, Abraham D Flaxman, Goodarz Danaei, Kenji Shibuya, Heather Adair-Rohani, Mohammed Abdulaziz Al Mazroa, Marcus Armann, Hugh Ross Anderson, Kathryn G Andrews, Martin Aryee, Charles Atkinson, Loraine J Bacchus, Adil N Bahalim, Kalpana Balakrishnan, John Balmes, Suzanne Barker-Collo, Amanda Baxter, Michelle L Bell, Jed D BloreFiona Blyth, Carissa Bonner, Guilherme Borges, Rupert Bourne, Michel Boussinesq, Michael Brauer, Peter Brooks, Nigel G Bruce, Bert Brunekreef, Claire Bryan-Hancock, Chiara Bucello, Rachelle Buchbinder, Fiona Bull, Richard T Burnett, Tim E Byers, Bianca Calabria, Jonathan Carapetis, Emily Carnahan, Zoe Chafe, Fiona Charlson, Honglei Chen, Jian Shen Chen, Andrew Tai-Ann Cheng, Jennifer Christine Child, Aaron Cohen, K Ellicott Colsen, Benjamin Cowie, Sarah Darby, Susan Darling, Adrian Davis, Louisa Degenhardt, Frank Dentener, Don C Des Jarlais, Karen Devries, Mukash Dherani, Eric L Ding, E Ray Darsey, Timothy Driscoll, Karen Edmond, Suad Eltahir Ali, Rebecca E Engell, Patricia J Erwin, Saman Fahimi, Gail Falder, Farshad Farzadfar, Alize Ferrari, Mariel M Finucane, Seth Flaxman, Francis Gerry R Fowkes, Greg Freedman, Michael K Freeman, Emmanuela Gakidou, Santu Ghosh, Edward Giovannucci, Gerhard Gmel, Kathryn Graham, Rebecca Grainger, Bridget Grant, David Gunnell, Hialy R Gutierrez, Wayne Hall, Hans W Hoek, Anthoony Hogan, H Dean Hosgood, Damian Hoy, Howard Hu, Bryan J Hubbell, Sally J Hutchings, Sydney E Ibeanusi, Gemma L Jacklyn, Rashmi Jasrasaria, Jost B Jonas, Haidong Kan, John A Kanis, Nicholas Kassebaum, Norito Kawakami, Yong-Ho Khang, Shahab Khatibzadeh, Jon-Paul Khoo, Cindy Kok, Francine Laden, Ratilah Lalloo, Qing Lan, Tim Lathlean, Janet L Leasher, James Leigh, Yang Li, John Kent Lin, Steven E Lipshultz, Stephanie London, Rafael Lozano, Yuan Lu, Joelle Mak, Reza Malekzadeh, Leslie Mallinger, Wagner Marcenes, Lyn March, Robin Marks, Randall Martin, Paul McGale, John McGrath, Sumi Mehta, Ziad A Memish, George A Mensah, Tony R Merriman, Renata Micha, Catherine Michaud, Vinod Mishra, Khayriyyah Mohd Hanafiah, Ali A Mokdad, Lidia Morawska, Dariush Mozaffarian, Tasha Murphy, Mohsen Naghavi, Bruce Neal, Paul K Nelson, Joan Miquel Nolla, Rosana Norman, Casey Olives, Saad B Omer, Jessica Orchard, Richard Harry Osborne, Bart Ostro, Andrew Page, Kiran D Pandey, Charles D H Parry, Erin Passmore, Jayadeep Patra, Neil Pearce, Pamela M Pelizzari, Max Petzold, Michael R Philips, Dan Pope, C Arden Pope, John Powles, Mayuree Rao, Homie Razavi, Eva A Rehfuess, Jurgen T Rehm, Beate Ritz, Frederick P Rivara, Thomas Roberts, Carlyn Robinson, Jose A Rodriguez-Portales, Isabelle Romieu, Robin Room, Lisa C Rosenfeld, Ananya Roy, Lesley Rushton, Joshua Salomon, Uchechukwu Sampson, Lidia Sanchez-Riera, Ella Sanman, Amir Sapkota, Soraya Seedat, Peilin Shi, Kevin Shield, Rupak Shivakoti, Gitanjali M Singh, David A Sleet, Emma Smith, Kirk R Smith, Nicolas J C Stapelberg, Kyle Steenland, Heidi Stockl, Lars Jacob Stovner, Kurt Straif, Lahn Straney, George D Thurston, Jimmy H Tran, Rita Van Dingenen, Aaron von Donkelaar, J Lennert Veerman, Lakshmi Vijayakumar, Robert Weintraub, Myrna Weissman, Richard A White, Harvey Whiteford, Steven T Wiersma, James D Wilkinson, Hywel C Williams, Warwick Williams, Nicholas Wilson, Anthony Woolf, Paul Yip, Jan M Zielinski, Alan D Lopez, Christopher J L Murray, Majid Ezzati

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Abstract

In 2010, the three leading risk factors for global disease burden were high blood pressure (7?0 [95 uncertainty interval 6?2?7?7] of global DALYs), tobacco smoking including second-hand smoke (6?3 [5?5?7?0]), and alcohol use (5?5 [5?0?5?9]). In 1990, the leading risks were childhood underweight (7?9 [6?8?9?4]), household air pollution from solid fuels (HAP; 7?0 [5?6?8?3]), and tobacco smoking including second-hand smoke (6?1 [5?4?6?8]). Dietary risk factors and physical inactivity collectively accounted for 10?0 (95 UI 9?2?10?8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0?9 (0?4?1?6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania.
Original languageEnglish
Pages (from-to)2224 - 2260
Number of pages37
JournalThe Lancet
Volume380
Issue number9859
DOIs
Publication statusPublished - 2012

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