ArticleFrontiers in public health2026
Global, regional, and national cataract burden attributable to household air pollution and smoking (1990-2021) and projection to 2050.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Household air pollution (HAP) and smoking, as key environmental risk factors, substantially drive the growing global cataract burden and pose serious public health threats, especially in low- and middle-income regions. This study aimed to identify the trends, spatiotemporal patterns, and key influencing factors of cataract burden attributable to HAP and smoking during 1990-2021, and further project its future trends until 2050. Methods: Based on Global Burden of Disease Study (GBD) 2021 data, we computed years lived with disability (YLDs) and age-standardized YLD rates (ASYRs) by age, gender and the Socio-demographic Index (SDI). We employed decomposition analysis to identify drivers of temporal changes, frontier analysis to assess achievable health outcomes, and inequality metrics to evaluate disparities. Future burdens were forecasted using the Autoregressive Integrated Moving Average (ARIMA) model. Results: Globally, there were 1,956,323.97 (95% UI: 612,092.84-4,033,705.23) and 225,174.47 (95% UI: 160,701.43-315,104.99) YLDs due to cataract attributable to HAP and smoking in 2021, respectively, both more than in 1990. Moreover, the ASYRs of cataract attributable to HAP and smoking were 22.84 (95% UI: 7.15-47.05) and 2.60 (95% UI: 1.85-3.63) per 100,000 population in 2021, respectively. Regionally, the highest ASYRs of cataract attributable to HAP and smoking were in Oceania (75.98) and South Asia (5.64), respectively. The cataract YLDs linked to HAP and smoking were predominantly found in middle-aged and older adult populations. Males had a higher smoking-attributable cataract burden than females, whereas females faced a substantial HAP-attributable burden. Low SDI regions exhibited a higher disease burden, with persistent cross-country disparities in health outcomes. Decomposition analysis pinpointed population growth as the core contributing factor. Frontier analysis revealed that countries such as Pakistan were farthest from the cataract burden frontier. ARIMA projections show HAP-related cataract ASYR will fall from 22.71 per 100,000 (2022) to 11.18 per 100,000 (2050, -50.77%), and smoking-attributable ASYR from 2.53 per 100,000 to 1.08 per 100,000 (-57.31%). Conclusion: Despite the observed decline in cataract burden attributable to HAP and smoking from 1990 to 2021, disparities among different sociodemographic regions and sexes were remarkable, and the potential future risks underscore the necessity for continued air quality management and tobacco control measures.
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