Lung cancer is a public health dilemma / Монголын Анагаах Ухаан

@#Lung cancer has the highest mortality rate in the world and is the most common cancer type in Asiancountries. In developed countries, new cases and lung cancer among women tend to increase, while in less developed countries, the death rate of this cancer is high and its prevalence is higher among males. </br>Moreover, in many studies conducted in recent years worldwide, a sample of the studies containing early detection, diagnosis, and treatment that can be implemented at the national level was translated and compiled. </br>Improvement of public health education, availability of health care services, an increase of human resource capacity, implementation of early detection programs among the public, and early detection with a reduced dose of KTG among the target group are expectations of the public health sector. </br>Special attention should be paid to issues such as reducing smoking among the people of Mongolia, immediately solving the problem of air pollution in central areas, assessing and reducing the risk factors of occupational diseases of mining workers, and introducing modern methods of treatment and diagnosis in health care services. The time has come to take multifaceted measures to prevent lung cancer, which has a high global disease burden and economic burden, with public participation.

The status and trend of child growth failure (CGF) burden in children aged < 5 years in China / 公共卫生与预防医学

Objective To analyze the status and trend for the mortality and DALY rates of child growth failure (CGF) in children aged < 5 years in China from 1990 to 2019, so as to provide a scientific basis for CGF prevention and control. Methods The mortality and DALY rates of CGF in children aged < 5 years from 1990 to 2019 were obtained from GBD 2019. The changes of these indicators with the years in China , the United States, Japan, Russia, India and the global were compared and analyzed. Results In 2019, the mortality of child wasting, child stunting and child underweight in children aged < 5 years in China were 9.62/100 000, 1.23/100 000, and 1.29/100 000 respectively, the mortality rates were 867.50/100 000 , 129.23/100 000 , and 112.87/100 000 rescpectively, higher than those of the United States, Japan, and Russia, and far lower than those of India and the global. The disease burden of three types of CGF were all higher in males than females, and higher in children aged < 1 years than children aged 1-4 years. From 1990 to 2019, the mortality and DALY rates of CGF in children aged < 5 years in China decreased from 300.41/100 000 and 26 445.38/100 000 to 10.49/100 000 and 943.57/100 000, respectively. China had the largest drop rate compared with all analyzed countries. As for children aged < 5 years in China, the DALY rate of lower respiratory infection ranked first in all the diseases caused by CGF. Conclusion From 1990 to 2019, the disease burden of CGF in children aged < 5 years has shown a significant decrease in China , but it is still far behind the developed countries. In the future, more attention should be paid to the problems of child growth in hope of reducing the mortality and DALY rates of CGF.

Analysis of disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020 / 中华劳动卫生职业病杂志

Objective: Through comparative analysis of the disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020, the main influencing factors are screened, and scientific basis is provided for rational allocation of limited health resources, precise management and policy implementation. Methods: In August 2021, survey and collect information on surviving occupational pneumoconiosis patients and dead occupational pneumoconiosis patients diagnosed in Gansu Province from 2010 to 2020, and analyze and calculate indicators such as morbidity, mortality, and disability adjusted of life years (DALY). Analyzing the influencing factors of disease burden usirrg multiple linear regression. Results: From 2010 to 2020, the average annual incidence of occupational pneumoconiosis in Gansu Province was 0.9992/100000, the average annual mortality was 0.897/100000, the cumulative case fatality rate was 25.75%, and the cumulative DALY was 28932.96 person-years. The first stage of occupational pneumoconiosis was the highest among DALY loss (19920.14 person-years), and the DALY loss was positively correlated with the stage of occupational pneumoconiosis. Among occupational pneumoconiosis in Gansu Province, silicosis (13753.66 person-years) and coal worker's pneumoconiosis (13414.73 person-years) caused the highest disease burden, followed by cement pneumoconiosis and asbestos lung. Period, length of service, type of disease, and region are all influencing factors of DALY loss (P<0.05). Conclusion: From 2010 to 2020, the DALY losses caused by occupational pneumoconiosis in Gansu Province showed a fluctuating decrease, with the composition of DALY mainly changing from the loss of life years due to premature death to the loss of years due to injury and disability.

Research progress on the disease burden of pneumoconiosis in China / 中华劳动卫生职业病杂志

Pneumoconiosis is the largest and most serious disease among the legal occupational diseases in China, which causes long-term heavy disease burden to individuals, enterprises and society. How to scientifically and reasonably measure and reduce the health impact and economic loss caused by pneumoconiosis has become a key and difficult research topic. In recent years, with the development of global burden of disease (GBD) research, some scholars have adopted disease burden index to evaluate the disease burden of pneumoconiosis, but the research results and data are relatively independent, and there is a lack of systematic evaluation system and framework. This paper summarized the application of disease burden assessment index for pneumoconiosis, epidemiological and economic burden of pneumoconiosis, and the cost-effectiveness of reducing the burden. This paper aims to understand the present situation of pneumoconiosis disease burden in our country, discover the problems and challenges of pneumoconiosis disease burden research in our country now. It provides scientific basis for the research and application of pneumoconiosis and other occupational disease burden in China, as well as the formulation of comprehensive intervention measures, optimization of health resources allocation and reduction of disease burden.

Changes in the disease burden of liver cancer caused by nonalcoholic steatohepatitis in China 1990-2019 / 公共卫生与预防医学

Objective To describe and analyze the disease burden and its changing trend of liver cancer caused by nonalcoholic steatohepatitis (NASH) in China from 1990 to 2019, and to provide reference for reducing the morbidity and mortality of liver cancer in China. Methods Based on data from the Global Burden of Disease (GBD2019) study, different gender and age groups were selected. The morbidity, mortality, and disability adjusted life year (DALY) rate were used to analyze the disease burden of liver cancer caused by NASH in China from 1990 to 2019. The time trend was analyzed by using the Joinpoint regression model, and the annual percent of change (APC) and annual average percentage change (AAPC) of morbidity, mortality and DALY rate were calculated. Results Compared with 1990, the incidence rate, mortality rate and DALY rate of liver cancer caused by NASH in 2019 decreased by 4.05%, 12% and 25.79%, respectively. Age-standardized morbidity, standardized mortality and standardized DALY rates decreased by 49.50%, 54.72% and 58.45%, respectively. In 2019, the incidence rate, mortality data and DALY rate of liver cancer caused by NASH increased with age, and the highest mortality rate was among people over 85 years old. The average annual change percentage (AAPC) of age-standardized incidence rate, standardized mortality rate and standardized DALY rate of liver cancer caused by NASH from 1990 to 2019 were -2.65% ［95% CI（-3.09%，-2.21 %），P<0.001］, -2.86%［95% CI（-3.34%，-2.38 %），P<0.001］, and -2.91%［95% CI（-3.23%，-2.58%），P<0.001］，respectively. The AAPC of all indexes in males was higher than that in females. Conclusion From 1990 to 2019, the disease burden of liver cancer caused by NASH in China showed an overall downward trend. The AAPC of all indexes in males is higher than that in females, and the elderly population is a high-risk group.

Years of life lost due to premature deaths associated with air pollution: an ecological time-series study

ABSTRACT BACKGROUND: Exposure to air pollutants is associated with hospital admissions due to cardiovascular diseases and premature deaths. OBJECTIVE: To estimate years of life lost (YLL) due to premature deaths and their financial costs. DESIGN AND SETTING: Ecological time-series study carried out in São José dos Campos, Brazil, in 2016. METHODS: Data on deaths among residents of this city in 2016 were assessed to estimate the financial cost of premature deaths associated with air pollution. The diagnoses studied were ischemic heart disease, congestive heart failure and cerebrovascular disease, according to YLL. The fractions attributable to deaths associated with air pollutant exposure and to each potential year of life lost were calculated using negative binomial regression with lags of 0-7 days between exposure and outcome. Nitrogen dioxide, particulate matter (PM10) and ozone concentrations were included in the model and adjusted for temperature, humidity and seasonality. RESULTS: Exposure to particulate matter was significant at lag 3 days. There were 2177 hospitalizations over the study period, with 201 deaths (9.2%). Premature deaths led to 2035.69 years of life lost. A 10 μg/m3 increase in PM10 concentrations was correlated with 8.0% of the hospitalizations, which corresponded to 152.67 YLL (81.67 for males and 71.00 for females). The cost generated was approximately US$ 9.1 million in 2016. CONCLUSION: In this first study conducted in a medium-sized Brazilian city, using the YLL methodology, we identified an excess expense attributable to air pollution.

Transição da morbimortalidade no Brasil: um desafio aos 30 anos de SUS / Transition of morbidity and mortality in Brazil: a challenge on the thirtieth anniversary of the SUS

Resumo Em 2020, completamos 30 anos desde a publicação das Leis Orgânicas do Sistema Único de Saúde. Desde então, a mudança no perfil de morbimortalidade tem desafiado a gestão, para que o serviço de saúde consiga atender à grande heterogeneidade dos quase seis mil municípios. Para isso, é necessário monitorar os principais indicadores do país. O objetivo do presente estudo foi apresentar uma visão geral das tendências de mortalidade e morbidade no Brasil entre 1990 e 2019. Utilizamos os dados do Estudo de Carga Global de Doenças para descrever a morbimortalidade pelos grandes grupos (doenças infecciosas, doenças crônicas e causas externas), segundo sexo e grupos etários. Há redução da morbimortalidade no período, independente do grupo de causa ou faixa etária, com variada diferença entre sexo de acordo com o grupo de causas. A contribuição das doenças crônicas é crescente com a progressão da idade, com diferença substancial segundo o sexo. As curvas de mortalidade e de anos perdidos por incapacidade possuem padrão típico, com destaque ao padrão diferenciado para curvas de homens por causas externas, com marcada sobremortalidade em idades jovens. A tendência ratifica o declínio dos indicadores de forma linear no período.

Abstract In 2020, the 30th anniversary of the publication of the Organic Laws of the Unified Health System was celebrated. Since then, the change in the profile of morbidity and mortality has been a challenge to management to ensure that the health services can attend the significant heterogeneity of approximately 6,000 municipalities. To achieve this, it is necessary to monitor the leading indicators of the country. The scope of this study was to present an overview of trends in mortality and morbidity in Brazil between 1990 and 2019. Data from the Study on the Global Burden of Disease was used to describe morbidity and mortality by major groupings (infectious diseases, chronic diseases, and external causes), according to gender and age groups. There was a reduction in morbidity and mortality in the period, irrespective of the cause or age group, albeit with a varied difference between the sexes depending on the cause. The contribution of chronic diseases increases with age, with a marked difference according to gender. The curves for mortality and years lost due to disability have a typical profile, with a different pattern of curves for men due to external causes, with marked excess mortality at young ages. The trend confirms the decline of indicators in a linear manner over the period.

Status and trend of cardiovascular disease burden in China from a global perspective / 公共卫生与预防医学

Objective To analyze the epidemic trends and risk factors of cardiovascular disease (CVD) burden in China from 1990 to 2019, based on the Global Burden of Disease (GBD) study 2019, by comparing with the world, the USA, Japan and India. Methods Data were obtained from the Global Health Data Exchange (GHDx) database, and the prevalence, incidence, mortality, disability adjusted life years (DALY) rate and main risk factors of CVD in China in 2019 were analyzed by gender and age. Age-standardized rates were used to compare the trends of CVD burden in the world and other four countries. Results In 2019, the number of CVD patients, incidences and deaths in China was 120.33 million, 12.34 million, and 4.58 million, respectively. The prevalence, morbidity, mortality and DALY rate increased from 4 235.43/100 000, 447.81/100 000, 204.75/100 000 and 5 091.03/100 000 in 1990 to 8 460.08/100 000, 867.65/100 000, 322.30/100 000, and 6 463.47/100 000 in 2019, respectively, all of which were increasing with age. The burden of CVD in males was higher than that in females. After eliminating the influence of population aging, the age-standardized mortality rate of CVD in China decreased from 381.21/100 000 in 1990 to 276.93/100 000 in 2019, and the age-standardized DALY rate decreased from 7 412.81/100 000 to 4 938.38/100 000. However, they were still slightly higher than those in the world and significantly higher than those in the USA and Japan. In addition, the leading four risk factors of CVD in China in 2019 were hypertension, dietary risks, air pollution and tobacco. A higher burden of CVD caused by all these factors in China were above the global average level. Conclusion Due to hypertension, dietary factors, air pollution, tobacco and other reasons, coupled with the rapid aging of the population, the burden of CVD in China is still very serious, and relevant departments need to pay more attention to it.

The current status and trends of chronic kidney disease (CKD) burden in China based on GBD Data / 公共卫生与预防医学

Objective To analyze the current status and trends of chronic kidney disease (CKD) burden in China from the global perspective, and to provide reference for the prevention and control of CKD in China. Methods The incidence, prevalence, mortality and disability adjusted life year (DALY) rate of China and other regions were retrieved from GBD 2019. Comparative analyses were carried out to reflect the burden of CKD. Results In 2019, the incidence and the prevalence in females were higher than those in males, while the mortality and the DALY rates in females were lower than those in males. There were obvious distinctions in different age groups and people over 65 years old had a higher CKD burden. The burden of CKD mainly came from hypertensive nephropathy and type 2 diabetic nephropathy. From 1990 to 2019, the DALY rate of CKD in China showed an overall upward trend. After eliminating the differences in age composition, the standardized DALY rate of CKD in China was higher than that in Japan, Korea and Ukraine although lower than the global. The main influencing factors of the burden of CKD were metabolic factors. Conclusion The burden of CKD in China is continuously rising. It is still necessary to pay attention to the three-level prevention and control, and focus on the key people groups and high-risk factors to further reduce the burden of CKD in China.

Current situation and trend analysis of AIDS burden in China, the United States and Japan / 公共卫生与预防医学

Objective By analyzing the incidence, prevalence, mortality, Disability Adjusted of Life Years (DALY) situations and trends of AIDS in China from 1990 to 2019, this paper provides scientific basis for the preventions and controls of AIDS in China. Methods The incidence, prevalence, mortality and DALY rate of AIDS from 1990 to 2019 are obtained from GBD 2019 data. The standardardized rate of four indicators are used to compare and analyze the AIDS changes in China, the United States, Japan and the global with the development of years. Results The four indicators of AIDS in China present increasing trends, with male higher than female. The incidence rate increased from 0.82/100 000 in 1990 to 2.24/100 000 in 2019, the prevalence increased from 5.63/100 000 to 38.77/100 000, and the mortality increased from 0.23/100 000 to 2.23/100 000. The DALY rate increased from 13.18/100 000 to 98.15/100 000. Compared with the global and the United States, the standardized rate of four indicators of AIDS in China in 2019 showed a trend of low level, but it was higher than that in Japan. Conclusion In recent years, some progress has been made in AIDS preventions and controls in China, but the disease burden of AIDS is still on the rise. The situation of AIDS preventions and controls is still serious and unremitting efforts should be made to reduce the burden of AIDS.

Analysis on the status and trend of TB burden in China from the global views / 中华疾病控制杂志

@#Objective To analyze the status and trends for the prevalence，morbidity，mortality， and DALY of tuberculosis ( TB) in China from 1990 to 2017，so as to provide scientific basis for TB pre- vention and control． Methods From 1990 to 2017 in China，the United States，India，Japan，and the global，the TB ( standardized) prevalence，( standardized) morbidity，( standardized) mortality，and ( standardized) DALY rates were obtained from Institute for Health Metrics and Evaluation ( IHME) web- site，and comparative analysis of changes in these indicators with years were carried out． Ｒesults In 2017， the prevalence，morbidity，mortality，and DALY rate of TB in China were higher in the high-age group than in the low-age group． The prevalence，morbidity，mortality，and DALY rates were all higher for males than females． The prevalence was 29 641. 59/100 000 and 28 803. 26/100 000 for male and female，respectively． The male and female mortality rates were 72. 23/100 000 and 44. 85/100 000． The male and female mortali- ty rates were 3. 85/100 000 and 1. 67/100 000，and the DALY rate of male and female were 156. 95/100 000 and 84. 73/100 000． From 1990 to 2017，the prevalence of TB decreased from 32 178. 39/100 000 in 1990 to 29 231. 80/100 000 in 2017，the morbidity rate of TB decreased from 141. 83/100 000 in 1990 to 58. 83/100 000 in 2017，the mortality rate of TB decreased from 13. 82/100 000 in1990 to 2. 78/100 000 in 2017，and the DALY rate of TB decreased from 582. 87/100 000 in 1990 to 121. 60/100 000 in 2017． Conclusions The burden of TB in China declined markedly from 1990 to 2017． Although some progress has been made in the prevention and treatment of TB in China，but there is still a certain gap compared with de- veloped countries． It is still necessary to further reduce the morbidity rate and mortality rate of TB．

Years of life lost by CNCD attributed to occupational hazards in Brazil: GBD 2016 study / Anos de vida perdidos por DCNT atribuídos aos riscos ocupacionais no Brasil: estudo GBD 2016

ABSTRACT OBJECTIVE To assess the years of life lost due to premature death and disability-adjusted life years (DALY) as a result of chronic noncommunicable diseases attributable to occupational hazard factors, and to compare their position according to the risk ranking for chronic noncommunicable diseases in 1990 and 2016. METHODS Data for the DALY indicator, estimated from the Global Burden of Disease 2016 (GBD 2016) study, were analyzed for noncommunicable chronic diseases attributable to occupational, and other risk factors, selected in Brazil. A descriptive analysis was performed comparing the proportion of DALY by sex and age group (15 to 49 and 50 to 69 years old), as well as the ranking of occupational hazard factors in 1990 and 2016. RESULTS In 2016, ergonomic risk factors, carcinogenic agents, and noise in the workplace were among the 25 largest contributors to DALY for chronic noncommunicable diseases affecting the age group between 15 and 49 years. The contribution of all occupational hazard factors increased in 2016, except for occupational aerodispersoids affecting men. Concerning the age group between 50 and 69, occupational carcinogens stand out, with an increase of 26.0% for men, and 17.1% for women in 2016. Risk factors evaluated according to their 1990 and 2016 ranking show that occupational hazards have all scored higher on the second evaluation (2016), especially when compared with other risks. CONCLUSIONS The global burden of chronic noncommunicable diseases attributed to occupational hazard factors has become increasingly important. We suggest the strengthening of the approach of occupational hazard factors in the agendas for tackling these diseases in Brazil.

RESUMO OBJETIVO Avaliar anos de vida perdidos por morte prematura e por incapacidade ( disability-adjusted life years - DALY) em decorrência de doenças crônicas não transmissíveis atribuíveis a fatores de risco ocupacionais e comparar a posição desses fatores no ranking dos riscos para doenças crônicas não transmissíveis em 1990 e 2016. MÉTODOS Os dados referentes ao indicador DALY, estimado no estudo de Carga Global de Doenças de 2016 (GBD 2016), foram analisados para doenças crônicas não transmissíveis atribuíveis a fatores de risco ocupacionais e outros selecionados no Brasil. Realizou-se análise descritiva comparando a proporção de DALY por sexo e faixa etária (15 a 49 e 50 a 69 anos), além do ranqueamento de atribuição dos fatores de risco ocupacionais em 1990 e 2016. RESULTADOS Em 2016, fatores de risco ergonômicos, agentes carcinogênicos e ruído no ambiente laboral estiveram entre os 25 que mais contribuíram para os DALY por doenças crônicas não transmissíveis na faixa etária de 15 a 49 anos. A contribuição de todos fatores de risco ocupacionais aumentou em 2016, exceto os aerodispersoides ocupacionais para os homens. Para a faixa etária de 50 a 69 anos, sobressaem os agentes carcinogênicos ocupacionais, com aumento de 26.0% para homens e 17.1% para mulheres em 2016. Comparando o ranqueamento de 1990 e 2016 dos fatores de risco avaliados, os ocupacionais ascenderam de posição, com destaque em relação aos demais. CONCLUSÕES A carga global de doenças crônicas não transmissíveis atribuídas aos fatores de risco ocupacionais têm adquirido importância crescente. Sugere-se reforçar a abordagem dos fatores de risco ocupacionais nas agendas para enfrentamento dessas doenças no Brasil.

A study on knowledge, attitude and practice about rabies among pharmacy students in a tertiary care hospital

Background: Rabies, a disease of antiquity, continues to be a major public health problem in India and itis 100% fatal. Objective: To assess the knowledge, attitude and practice about rabies among pharmacy students of Assam Medical College and Hospital, to assess whether there is any difference of knowledge, attitude and practice among male and female students and study the socio-demographic profile of the students. Materials &Methods: A cross sectional study was conducted among 156 pharmacy students by purposive sampling using pre designed structured close ended questionnaire. Knowledge and attitude was assessed by a scoring system. Statistical analysis was done by percentage and chi square test. Results: The mean age of the students was 20.64 ± 1.42 years. Most (63.5%) of the students were males and most (46.7%) of them belong to the Hindu religion. Almost all (97.4%) the students had heard the word rabies. Conclusion: Most (61.2%) of the students had average knowledge, 38.8 % had good knowledge, 48.7 % had negative attitude and 51.3 % had positive attitude about rabies.

DALY of diseases caused by air pollution in Ulaanbaatar city 2008-2017 / Монголын Анагаах Ухаан

Background@#Air pollution has been increasing intensively during last decade in big cities of Mongolia especially in Ulaanbaatar due to urbanization, poor urban plan, migration from rural areas to urban areas, poverty, unemployment, economic crises, exercise with unclean technology mainly coal for heating and cooking, raise of number of motor vehicle and other air pollution sources; as result of this phenomena population health has been worsening. The Global burden of disease concept, first published in 1996, constituted the most comprehensive and consistent set of estimates of mortality and morbidity and WHO now regularly develops GBD estimates at regional and global level. The goal of this study is to define DALY of air pollution related diseases in Ulaanbaatar. @*Materials and Methods@#This is retrospective study which used air pollution and mortality secondary data 2008-2017. The DALY extends the concept of potential years of life lost due to premature death (YLL) to include equivalent years of ‘healthy’ life lost by virtue of being in states other than good health. DALYs for a disease or health condition are calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the equivalent ‘healthy’ years lost due to disability (YLD) for incident cases of the health condition. We used WHO recommended estimation methodology and selected 2 disease category of mortality of each RSD (pneumonia, COPD) and CVD (ischemic heart disease, cerebrovascular disease).@*Results@#According to the age group, most of children 0-4 due to RSD and most of adults were died due to CVD. In general, hospitalization is increasing year by year and differing by season. Significant associations were found for all air pollutants such as PM10, PM2.5, CO, SO₂, and O₃ had a statistically significant association with cold season’s mortality of RSD and CVD. The most common mortality cases were ischemic heart disease, cerebrovascular disease, pneumonia and COPD. In Ulaanbaatar in 2008-2017, 2205 people were died due to RSD and CVD. Hospital admission and mortality has an increasing trend. @*Conclusion@#Residents of Ulaanbaatar were lost in total 249854 years due to pneumonia, COPD, ischemic heart disease, and cerebrovascular disease during 2008-2017. The most vulnerable group of people on air pollution was children and elders of Ulaanbaatar city.

Disability weight determination for road traffic injuries in the Philippines: Metro Manila scenario

@#<p style="text-align: justify;"><strong>Objective:</strong> To determine the Disability Adjusted Life Year (DALY) weights of road traffic injuries and use the DALY weights in determining the total DALYs lost in Metro Manila using available data.</p><p style="text-align: justify;"><strong>Methods:</strong> Consensus on DALY weights for each of the 31 International Classification of Diseases (ICD)10 codes related to road traffic injuries was done using Delphi Process. Experts from different fields were invited to participate in 2 rounds of discussion-and-scoring were done to obtain consensus were obtained for each DALY weight. Philippine Health Insurance Corporation (PHIC) data on the counts of the 31 ICD 10 coded claims for the years 2011, 2012, and 2013 were obtained and used to calculate the total DALY lost due to vehicular injuries for Metro-Manila.</p><p style="text-align: justify;"><strong>Results:</strong> Road traffic related injuries affected mostly young people (mean 34 yo + 15) and affected mostly men (81%). There were a total of 3,199 injuries seen in 2,573 patients. 98.1% of the patients had a < 1 year type of injury with an average disability weight of 0.34154 and a total DALYs lost of 300.4. 0.5% of the patients had a ? 1 year type of injury with an average disability weight of 0.2726 and a total DALYs lost of 218.08.1.4% of the patients most likely died from their injuries earning a total DALYs lost of 1,440.The sum of DALYs lost is equivalent to a total of 1,958.12.</p><p style="text-align: justify;"><strong>Conclusion:</strong> The Metro Manila loses roughly Php 76.6 Million per year due to road traffic injuries and accidents. These events are highly preventable. Without proper interventions, road traffic injuries may lead to impoverishment of the young families who pick up the pieces, or are left behind.</p>

The Disease Burden of Lung Cancer Attributable to Residential Radon Exposure in Korean Homes

BACKGROUND: Residential radon exposure is known to be an important risk factor for the development of lung cancer. The objective of this study was to calculate the disease burden of lung cancer attributable to residential radon exposure in Korea. METHODS: We calculated the national exposure level using Korean national radon survey data from 2011 to 2014, and house structure distribution data from each administrative region. Using the exposure-risk function, the population attributable fraction (PAF) was calculated and applied to calculate the disease burden for lung cancer attributable to residential radon exposure. RESULTS: Residential radon exposure levels were the highest, at 116.4 ± 50.4 Bq/m3 (annual mean radon concentration ± standard deviation) in detached houses, followed by 74.1 ± 30.0 Bq/m3 in the multi-family dwellings, and 55.9 ± 21.1 Bq/m3 in apartments. The PAF for lung cancer, due to long-term radon exposure in Korean homes, was 6.6% and 4.7% in men and women, respectively. The total disease burden of lung cancer attributable to residential radon exposure was 14,866 years of life lost (YLL) and 1,586 years lost due to disability (YLD) in 2013. Overall, 1,039 deaths occurred due to residential radon exposure, of which 828 were in men and 211 in women. CONCLUSION: The smoking rate of men in Korea exceeded 70% in the 1990s, and is still near 40%. Although the size of the effect varies depending on the estimation method, it is a critical aspect as a risk factor of lung cancer because of the synergistic relationship between smoking and radon exposure. Because the Korean society is rapidly aging, population who were formerly heavy-smokers are entering a high-risk age of lung cancer. Therefore, it is necessary to inform the public about the health benefits of reduced radon exposure and to strengthen the risk communication.

Burden Of Disease Attributable To Overweight And Obesity In Malaysia

@#The overweight and obese population may affect the population health which can lead to economic stability and development of the countries to be compromised. Thus, this study estimates the burden of disease attributable to overweight and obesity in Malaysia for adults aged 20-59 years old. Population attribution fraction (PAF) and disability-adjusted life year (DALY) have been used to quantify years of life lost from premature death and number of years lost due to disability resulting from obesity and overweight. The burden of disease attributable to overweight was 1582 and 1146 PYs per 1000 persons for male and female, respectively. Meanwhile, the burden of disease attributable to obesity was 2951 PYs per 1000 persons with women in the lead at 1657 PYs per 1000 persons. The burden of overweight and obesity among Malaysian adults is substantial. The outcome of this study is crucial as it gives a comprehensive information on the burden of overweight and obesity in Malaysia. The information from this study also enables the authorities to develop activities and programs to combat obesity and tomaintain healthy lifestyle among Malaysian.

Job Stress-attributable Burden of Disease in Korea

BACKGROUND: As job stress is associated with various diseases and psychiatric conditions, we aimed to estimate the job stress-attributable burden of disease in Korea based on the concept of disability-adjusted life years (DALY). METHODS: We selected ischemic heart disease (IHD), stroke, major depressive disorder (MDD), and suicide as health outcomes from job stress, because of the ease of access to data estimating burdens and of important meaning of them in Korean occupational background. RESULTS: Our findings demonstrated that approximately 21% of Korean workers were exposed to high job strain, which was attributable for approximately 6.7% of IHDs, 6.9% of strokes, 13.6% of MDDs, and 4% of suicides. In terms of job stress-attributable DALY, the burdens of disease per 100,000 people were 38 for IHD, 72 for stroke, 168 for MDDs, and 44 for suicides. CONCLUSION: The present findings suggested that one-fifth of Korean workers were suffering from high job strain. Although the figures may not be accurate due to several assumptions, job stress is an important risk factor for health in working environment in Korea.