ArticleBMJ open2025
Global, regional and national burden of asthma attributable to NO
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Sex and socioeconomic inequalities in global asthma burden attributable to major risk factors, 1990-2021.Journal of thoracic disease · 2026Article
- The declining but persistent burden of lower respiratory infections from secondhand smoke in children aged under 14 years: Global trends 1990-2021 and forecasts to 2035, based on a secondary dataset analysis of Global Burden of Disease (GBD) 2021.Tobacco induced diseases · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aims to systematically assess the global, regional, and national burden of asthma attributable to nitrogen dioxide (NO₂) pollution. DESIGN AND
settingAnalysis of population-level data from 1990 to 2021 obtained from the Global Burden of Disease Study 2021, covering 204 countries and territories.
participantsParticipants included patients with asthma attributable to NO₂ pollution. MAIN OUTCOMES AND MEASURES: Asthma-related disability-adjusted life-years (DALYs) and age-standardised DALY rates (ASDR) attributable to NO₂ pollution across 204 countries and territories. The estimated annual percentage change (EAPC) was used to assess temporal trends to identify regions with increasing or decreasing asthma burdens.
resultsIn 2021, NO₂ pollution contributed to approximately 176.73 thousand DALYs globally, with an ASDR of 2.48 per 100 000 population (95% uncertainty interval (UI) -2.26 to 10.30). The global ASDR declined significantly from 1990 to 2021, with an EAPC of -1.93% (95% CI -2.14% to -1.72%). High-income North America had the highest ASDR (10.74 per 100 000; 95% UI 10.12 to 46.56), while Australasia experienced the most significant reduction in ASDR over the study period (EAPC -3.92%; 95% CI -4.46% to -3.37%). In contrast, Oceania and Southeast Asia showed increasing trends in asthma burden, with EAPCs of 2.33% (95% CI 1.57% to 3.10%) and 1.14% (95% CI 0.81% to 1.47%), respectively. The 5-9 age group carried the highest asthma burden, reflecting the vulnerability of younger children to NO₂ exposure. A positive correlation between ASDR and sociodemographic index (SDI) was observed (R=0.637, p<0.001), indicating a greater asthma burden in higher SDI regions.
conclusionThe findings highlight significant regional and demographic disparities in asthma burden attributable to NO₂ pollution. Tailored public health strategies are needed to address the rising burden in vulnerable regions. Future research should focus on identifying effective interventions to reduce NO₂ exposure and improve asthma outcomes, especially in rapidly developing areas.
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