# Global, regional, and national disease burden of pneumoconiosis, chronic obstructive pulmonary disease, tracheal-bronchus-and-lung cancer, and asthma attributable to occupational risks, 1990–2021: a systematic analysis for the global burden of disease study 2021

## TL;DR

This study analyzes how occupational risks contribute to respiratory diseases globally from 1990 to 2021, showing significant health burdens and disparities.

## Contribution

The paper provides updated global, regional, and national estimates of disease burden attributable to occupational risks for four respiratory diseases.

## Key findings

- Occupational risks caused over 900,000 deaths in 2021 from pneumoconiosis, COPD, TBL cancer, and asthma.
- Middle SDI regions had the highest burden for pneumoconiosis and COPD, while high-SDI regions for TBL cancer.
- Population growth and aging increased absolute disease burdens despite declining age-standardized rates.

## Abstract

Occupational risks contribute substantially to the global burden of pneumoconiosis, chronic obstructive pulmonary disease (COPD), tracheal-bronchus-and-lung (TBL) cancer, and asthma; however, comprehensive, up-to-date global, regional, and national estimates remain limited.

Data from the Global Burden of Disease Study (GBD) 2021 were analyzed to quantify the burden of these diseases attributable to occupational exposure across 204 countries between 1990 and 2021, stratified by sex, age, socio-demographic index (SDI), and geographic region.

In 2021, occupational risks led to 30,546 deaths due to pneumoconiosis, 285,628 deaths due to COPD, 585,451 deaths due to TBL (the highest among the four diseases), and 18,315 deaths due to asthma, with disability-adjusted life years (DALYs) of 1.8, 6.1, 12.6, and 0.4 million, respectively. Male patients exhibited higher burdens of all diseases, reflecting greater exposure to male-dominated industries. Geographically, middle SDI regions had the highest absolute cases for pneumoconiosis and COPD, high-SDI regions for TBL cancer, and low-middle SDI regions for asthma. While age-standardized rates declined for most outcomes over time, the absolute burdens increased owing to population growth and aging, with demographic factors driving up to 80% of the increase in total cases. Health inequities persisted, with lower SDI regions bearing a disproportionate burden, despite modest improvements in absolute inequalities.

These findings highlight the need for strengthened occupational health regulations, targeted interventions in high-risk regions, and policies addressing population dynamics to mitigate the impact of workplace exposure on respiratory health.