Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

Pumping test analysis using a layered cylindrical grid numerical model in a complex, heterogeneous Chalk Aquifer

A groundwater investigation including several pumping tests has been carried out by Thames Water Utilities Limited (TWUL) to improve the understanding of the distribution of hydraulic properties of the Chalk in the Swanscombe area of Kent in south-eastern England. The pumping test behaviour is complicated by: the fractured condition of the Chalk, simultaneous pumping from adjacent boreholes, and variable pumping rates during the test. In addition, the groundwater flow system is complicated by quarrying of the Chalk. Analytical solutions for pumping test analysis fail to represent these complex flow processes and cannot reproduce the observed time drawdown curves. A layered cylindrical grid numerical model has been applied to the results of the Swanscombe pumping test. This model can represent the heterogeneity of the aquifer and the detailed flow processes close to the abstraction borehole such as well storage, seepage face and well losses. It also includes a numerical representation of the moving water table using a grid that deforms to eliminate numerical instabilities. The analyses of the test results demonstrate that they are significantly influenced by fracture flow, which needs to be included to improve the simulation of the groundwater system; not withstanding this, the layered cylindrical grid numerical model reproduced many of the features in observed time-drawdown, which allowed an assessment of the hydraulic characteristics of the aquifer as well as the investigation of the impact of quarries on the test results. This has demonstrated that the numerical model is a powerful tool that can be used to analyse complex pumping tests and aid to improvement of the conceptual understanding of a groundwater system

Enrichment of Rare Earth Elements during magmatic and post-magmatic processes: a case study from the Loch Loyal Syenite Complex, northern Scotland

Concern about security of supply of critical elements used in new technologies, such as the Rare Earth Elements (REE), means that it is increasingly important to understand the processes by which they are enriched in crustal settings. High REE contents are found in syenite-dominated alkaline complexes intruded along the Moine Thrust Zone, a major collisional zone in north-west Scotland. The most northerly of these is the Loch Loyal Syenite Complex, which comprises three separate intrusions. One of these, the Cnoc nan Cuilean intrusion, contains two mappable zones: a Mixed Syenite Zone in which mafic melasyenite is mixed and mingled with leucosyenite and a Massive Leucosyenite Zone. Within the Mixed Syenite Zone, hydrothermal activity is evident in the form of narrow altered veins dominated by biotite and magnetite; these are poorly exposed and their lateral extent is uncertain. The REE mineral allanite is relatively abundant in the melasyenite and is extremely enriched in the biotite–magnetite veins, which have up to 2 % total rare earth oxides in bulk rock analyses. An overall model for development of this intrusion can be divided into three episodes: (1) generation of a Light Rare Earth Element (LREE)-enriched parental magma due to enrichment of the mantle source by subduction of pelagic carbonates; (2) early crystallisation of allanite in melasyenite, due to the saturation of the magma in the LREE; and (3) hydrothermal alteration, in three different episodes identified by petrography and mineral chemistry, generating the intense enrichment of REE in the biotite–magnetite veins. Dating of allanite and titanite in the biotite–magnetite veins gives ages of c. 426 Ma, overlapping with previously published crystallisation ages for zircon in the syenite

Biogeochemical responses to nutrient, moisture and temperature manipulations of soil from Signy Island, South Orkney Islands in the Maritime Antarctic

We have investigated how the microbially-driven processes of carbon (C) mineralization (respiration) and nitrogen (N) mineralization/immobilization in a soil from the northern Maritime Antarctic respond to differences in water availability (20% and 80% water-holding capacity) and temperature (5°C and 15°C) in the presence and absence of different organic substrates (2 mg C as either glucose, glycine or tryptone soy broth (TSB) powder (a complex microbial growth medium)) in a controlled laboratory experiment over 175 days. Soil respiration and N mineralization/immobilization in the presence of a C-rich substrate (glucose) increased with increases in water and temperature. These factors were influential individually and had an additive effect when applied together. For the N-rich substrates (glycine and TSB), microbial responses to increased water or temperature alone were weak or not significant, but these factors interacted to give significantly positive increases when applied together. These data indicate that under the expected changes in environmental conditions in the Maritime Antarctic, where temperature and the availability of water and organic substrates will probably increase, soil microbial activity will lead to more rapid C and N cycling and have a positive feedback on these biogeochemical processes, particularly where or when these factors increase concurrently

HAZID, a computer aid for hazard identification:3. The fluid model and consequence evaluation systems

The hazard and operability, or HAZOP, study is a prime method for the identification of hazards on process plants. This is the third in a series of papers which describes progress in the emulation of hazard identification in the style of HAZOP. The work reported is embodied in a computer aid for hazard identification, or HAZOP emulator, HAZID. The HAZID code is one of a suite of codes developed as part of the STOPHAZ project. The present paper describes the fluid model system and the evaluation of consequences.Companion papers describe: an overview of HAZID, with an account of HAZOP and HAZOP emulation, and of the issues underlying it; the unit model system; the evaluation and improvement of HAZID using case studies and other methods; some development topics. Conclusions from the work are given in the final paper

HAZID, a computer aid for hazard identification:1. The STOPHAZ package and the HAZID code: an overview, the issues and the structure

The hazard and operability, or HAZOP, study is a prime method for the identification of hazards on process plants. This is the first in a series of papers which describes progress in the emulation of hazard identification in the style of HAZOP. The work reported is embodied in a computer aid for hazard identification, or HAZOP emulator, HAZID. The HAZID code is one of a suite of codes developed as part of the STOPHAZ project. The present paper gives an overview of HAZID, with an account of HAZOP and HAZOP emulation, and of the issues underlying it.Companion papers describe the unit model system, the fluid model system and the evaluation of consequences, the evaluation and improvement of HAZID using case studies and other methods, and some development topics. Conclusions from the work are given in the final paper