The burden of disease and injury in Serbia

BACKGROUND: In the last decade of the 20th century, a considerable effort has been put into the development of summary measures of population health that combine information on mortality and non-fatal health outcomes. We used the DALYs (Disability adjusted life years) method to assess the burden of disease and injury in the population of Serbia. METHODS: Our study, largely based on the methods developed for the Global burden of disease study, was conducted between October 2002 and September 2003. DALYs, stratified by gender and age, were calculated for 18 selected health conditions for the population of Serbia, Serbia and Montenegro for 2000. Years of life lost (YLL) were calculated using country mortality statistics, while years lived with disability (YLD) were calculated using different sources of information. Also, the YLD/YYL ratio and age-adjusted rates of DALYs were calculated. RESULTS: Ischaemic heart disease, cerebrovascular diseases, lung cancer, unipolar depressive disorders, and diabetes mellitus were responsible for almost two-thirds (70%) of the total burden of 18 selected disorders in Serbia 2000. The leading five causes for males were ischaemic heart disease (26.1 DALY per 1000), stroke (17.9), lung cancer (12.7), road traffic accidents (6.5), and self-inflicted injuries (5.5). For females, the leading five causes were stroke (18.1 DALY per 1000), ischaemic heart disease (14.1), depression (8.7), breast cancer (6.1), and diabetes mellitus (5.2). CONCLUSIONS: The final results of the study have shown that the national health priority areas should cover cardiovascular diseases, cancers, and mental health.     

某市居民主要恶性肿瘤疾病负担分析

摘要:目的　分析2014年某市居民主要恶性瘤疾病负担情况,为卫生行政部门制定肿瘤防治措施提供参考依据。方法　对2014年某市居民主要恶性肿瘤发病和死亡病例资料进行统计分析,利用全球疾病负担研究中使用的专门公式计算恶性肿瘤的死亡损失生命年（YLL）、伤残损失年（YLD）和伤残调整寿命年（DALY）评价该地居民主要恶性肿瘤的疾病负担。结果　该地居民由恶性肿瘤导致的疾病负担为每千人22.7251个DALYs,其中YLLs为17.2218,占75.78%,YLDs为5.5033,占24.22%。DALY前5位的恶性肿瘤为肝癌（26.59%）、肺癌（14.50%）、胃癌（7.91%）、宫颈癌（7.47%）、鼻咽癌（4.00%）,占到该市居民全部恶性肿瘤疾病负担的60.47%。男性居民由恶性肿瘤导致的疾病负担为女性的1.70倍,肝癌、肺癌、胃癌、肠癌、白血病的DALYs男性高于女性,而鼻咽癌、胰腺癌、淋巴癌的DALYs女性高于男性,男性与女性DALY顺位有所不同。结论　该市居民恶性肿瘤疾病负担主要由早死所致,肝癌、肺癌、胃癌、宫颈癌和鼻咽癌是恶性肿瘤防治的重点。     

2007-2009年湖北省十堰市恶性肿瘤早死所致生命损失分析

目的研究湖北省十堰市恶性肿瘤的疾病负担,为制定干预措施提供科学依据。方法以早死引起的生命损失（YLL）为十堰市恶性肿瘤疾病负担的测量单位。结果性别统计,男性多数年龄段恶性肿瘤YLL高于女性,且总男性恶性肿瘤每千人口的YLL 2007-2009年均高于女性,2007年相差10.8,2008年相差9.9,2009年相差8.8;年龄组统计,2007-2009年,十堰市恶性肿瘤YLL以65岁以上组较高,而较小年龄段的恶性肿瘤YLL较低。结论十堰市恶性肿瘤对男性的寿命影响比女性大;且对老年人群危害严重,应对老年人群积极采取有效干预措施。     

The burden of cancer in New Zealand: a comparison of incidence and DALY metrics and its relevance for ethnic disparities

Aim : Cancer burden measured in disability adjusted life years (DALYs) captures survival and disability impacts of incident cancers. In this paper, we estimate the prospective burden of disease arising from 27 cancer sites diagnosed in 2006, by sex and ethnicity; and determine how its distribution differs from that for incidence rates alone. Methods : Using a prospective approach, Markov and cancer disease models were used to estimate DALYs with inputs of population counts, incidence and excess mortality rates, disability weights, and background mortality. DALYs were discounted at 3.5% per year. Results : The age standardised Māori:non‐Māori incidence rate ratios were 1.00 for males and 1.19 for females, whereas for DALYs they were greater at 1.42 for males and 1.68 for females. The total burden of cancer for 2006 incident cases (i.e. not age standardised) was estimated to be approximately 127,000 DALYs. Breast (27%), lung (14%) and colorectal (13%) cancers for females and lung (16%), colorectal (14%), and prostate (16%) cancers for males were the top contributors. By ethnicity, Māori experienced a substantially higher burden from lung cancer (around 25% for both sexes). Conclusions: Due to Māori both having higher rates of cancers with a worse survival (e.g. lung cancer), and tending to have worse survival for each cancer site, ethnic disparities in the age‐standardised DALY burden were greater than those for incidence (rate ratios of 1.52 and 1.07 respectively, sexes pooled).     

Health impact assessment of increasing public transport and cycling use in Barcelona: A morbidity and burden of disease approach

Objective

Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips.

Methods

A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution < 2.5 μm (PM_2.5) and traffic incidents in travelers was estimated. We also estimate PM_2.5 exposure and cases of disease in the general population.

Results

A 40% reduction in long-duration car trips substituted by public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM_2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection.

Conclusions

Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation.     

乙型病毒性肝炎的健康生命年损失研究

目的研究中国乙型病毒性肝炎的健康寿命损失。方法采用DALY指标2005年全国乙型病毒性肝炎损失的健康寿命。结果乙型病毒性肝炎的DALY值是26919.38人年,其中死亡与残疾的疾病负担之比为1∶3.76;DALY值男性均高于女性,20岁出现高峰,15~55年龄组为乙型病毒性肝炎的高危人群;中国八大分区中除西北地区稍偏高,居首位达0.042人年/千人,华南地区和黄河中游地区次之,其余地区差别不明显,高低地区之比为3.5∶1。结论乙型病毒性肝炎不仅因死亡导致健康寿命年的损失,而且由于疾病造成的残疾而导致的损失更大,给人群和社会带来沉重的负担。     

云南省石林县早死所致生命损失(YLL)分析

目的研究石林县的疾病负担。方法以早死引起的生命损失年YLL为疾病负担的测量单位。结果伤害、循环系病、肿瘤、呼吸系病是导致石林县人群生命损失的前四位死因,肿瘤对汉族造成的YLL损失比彝族严重,慢性非传染病的YLL所占比重最大。结论慢性非传染病和意外伤害应作为防治重点。     

Association between ambient temperature and chronic obstructive pulmonary disease: a population-based study of the years of life lost

Limited evidence on the burden of chronic obstructive pulmonary disease (COPD) attributable to ambient temperature. We aim to explore the association between ambient temperature and years of life lost (YLL), and to get a more intuitive understanding of the dangers of COPD in China. Death and meteorological data of 31 Chinese provincial capital cities during 2008–2013 was analyzed in this study. Distributed Lag Non-linear Model (DLNM) was used to estimate the association between ambient temperature and mortality. The attributable fraction (AF) to cold effect ranged from 8.19 (95%CI: -8.52,19.38) to 28.98 (95%CI: -64.78,67.59), while the AF to heat effect varied from 0.02 (95%CI: -0.13,0.05) to 5.73 (95%CI: 0.31,10.22). Cold effect was higher than heat effect on COPD in women and elderly, heat effect was higher in men and younger. Low temperature can cause more serious disease burden of COPD than high temperature.     

Burden of diabetes mellitus attributable to demographic levels in Qatar: An emerging public health problem

BackgroundDiabetes is one of the main contributors to ill health and premature mortality worldwide and its prevalence has been rising during the last decades.AimThe aim of the present study was to quantify the burden of disease in terms of deaths and loss of healthy life years (DALYs) attributed to diabetes by its demographic levels in the State of Qatar.Materials and methodsThe methods were largely based on the established Global Burden of Disease methodology and use the burden of disease in terms of disability adjusted life years (DALYs) and the years lost due to disability (YLD) as the outcome measure. We calculated years lost due to disability (YLD) and years life lost (YLL) attributable to diabetes. The study was conducted during the period from June 2013 to January 2014.ResultsThe study findings revealed that disability adjusted life years (DALYs) has been increasing across the years and reached to 4.35 in 2011 from 2.58 in 2007. DALYs for men was remarkably higher than women during the period (2007–2011). Diabetes mellitus was the 6th leading cause of disease burden in Qatar (3.8%). The YLD showed a sharp increase in men (2.52 in 2011 from 1.34 in 2007) and women (1.05 in 2011 from 0.33 in 2007) during the year 2011. YLL portion of women enlarged considerably in 2011 (0.10) compared to 2010 (0.04). YLL for men and women was fluctuating across the years with a decrease in 2011 (18%) from 2007 (35%). Men and women in the age group 30–44 years had the highest peak across the years.ConclusionThe study findings revealed that diabetes disease burden was considerably high in Qatar, particularly in the working age group. DALYs has been increasing across the years.     

杭州市西湖区疾病负担中早死所致生命损失

[目的]研究杭州市西湖区居民疾病负担中早死所致生命损失。[方法]对杭州市西湖区2002—2005年的居民病伤死亡数据进行标化死亡率、失能调整寿命年(DALY)中YLL等指标进行分析。[结果]西湖区居民4年的年平均标化死亡率为235.83/10万,每千人疾病早死所致损失(YLL)为27.84人年。标化死亡率前4位死因为肿瘤、循环系统疾病、呼吸系统疾病和损伤与中毒。YLL前4位为肿瘤、循环系统疾病、损伤与中毒和呼吸系统疾病。[结论]肿瘤、循环系统疾病、损伤与中毒和呼吸系统疾病,是杭州市西湖区死亡率较高、疾病负担较重的疾病,应加强防控。