Heterogeneity of disease burden due to lead exposure in China from 1990 to 2023

Objective To systematically analyze the level of disease burden,changing trend,population distribution and disease composition attributed to lead exposure in China from 1990 to 2023,so as to provide basis for accurate prevention and control.Methods Based on the data of Global Burden of Disease(GBD)in 2023,the indicators of lead-induced death,disability-adjusted life years(DALY),premature death and disability-lost life years(YLD)in China were extracted.Age standardized rate(ASMR,ASDR)and estimated annual percentage change(EAPC)were used to evaluate the time trend,and ASDR was decomposed to analyze its composition and further analyze its age,gender and disease spectrum characteristics.Results From 1990 to 2023,the absolute number of deaths and DALY attributed to lead exposure in China increased by 112.46% and 60.80%,respectively,but the age standardized rate showed a decline trend(ASMR EAPC =-1.501%,ASDR EAPC=-1.820%),the decline is faster than the world.The burden of disease shows significant demographic differences:the burden of men in all ages is about twice that of women;and the mortality rate and DALY rate in the age group ≥75 reached the peak.ASDR decomposition shows that the decline is mainly driven by YLL rate(down 45.43%),while the change range of YLD rate is limited.Disease spectrum analysis reveals heterogeneity:ischemic heart disease is the primary cause of YLL,while congenital mental retardation is the main component of YLD,and its rate value has not changed significantly during the observation period.The burden of hypertensive heart disease has been significantly improved;Stroke presents the challenge of“YLL rate decreasing and YLD rate basically unchanged”;Conclusion The prevention and control of lead exposure diseases in China has achieved remarkable results in reducing the standardized risk,but the aging population leads to the continuous absolute burden,and the non-fatal disability burden remains high.In the future,prevention and control should adopt the strategy of “reducing death”and“reducing disability”,focusing on high-risk groups of the elderly and men,and implementing precise intervention for diseases with aggravated burden such as ischemic heart disease.