1990-2021年全球、中国及高负担地区归因于室内空气污染的白内障疾病负担及趋势预测分析OA

Objective:To analyze the sex-and age-specific distribution of cataract attributable to household air pollution(HAP)globally,in China,and in high-burden regions(South Asia,Southeast Asia,Oceania,and sub-Saharan Africa)from 1990 to 2021,and to project trends through 2035.This study aims to provide epidemiological evidence to optimize clean fuel control strategies and inform targeted cataract prevention.Methods:Using data from the Global Burden of Disease(GBD)2021,we analyzed disability-adjusted life years(DALYs)for cataract attributable to HAP from 1990 to 2021 globally,in China,and across South Asia,Southeast Asia,Oceania,and sub-Saharan Africa.Joinpoint regression was used to calculate annual percentage change(APC)and average annual percentage change(AAPC).Autoregressive integrated moving average(ARIMA)and linear models were employed to project disease burden trends from 2022 to 2035.Results:In 2021,the highest age-standardized DALY rates(ASDRs)for HAP-attributable cataract were observed in South Asia,Oceania,sub-Saharan Africa,and Southeast Asia.Between 1990 and 2021,the global ASDR decreased by 38.42%.South Asia bore the highest absolute burden(1.03 million DALYs),followed by Southeast Asia(480,200 DALYs).Across all regions,DALY rates were consistently higher in females than in males.Globally,the ASDR exhibited a significant downward trend(AAPC:-1.51%,95%CI:-1.65%to-1.37%).Older adults(aged≥60 years)constituted the primary demographic bearing this burden across all regions.ARIMA projections indicate that the ASDR will continue to decline globally,as well as in China,South Asia and Oceania through 2035,whereas Southeast Asia and sub-Saharan Africa are projected to experience a U-shaped rebound.Conclusions:The global age-standardized burden of cataract attributable to HAP declined steadily from 1990 to 2021,a trend projected to continue.However,the anticipated rebound in Southeast Asia and sub-Saharan Africa warrants close attention.Prevention efforts should prioritize high-burden regions,namely Southeast Asia,South Asia,and sub-Saharan Africa,and target older adults,particularly female.Furthermore,integrating HAP exposure into cataract risk assessments for older patients has important clinical implications.