Mortality burden of cardiovascular disease attributable to ambient PM_2.5 exposure in Portugal, 2011 to 2021

Background: Exposure to high levels of environmental air pollution causes several health outcomes and has been associated with increased mortality, premature mortality, and morbidity. Ambient exposure to PM2.5 is currently considered the leading environmental risk factor globally. A causal relationship between exposure to PM2.5 and the contribution of this exposure to cardiovascular morbidity and mortality was already demonstrated by the American Heart Association. Methods: To estimate the burden of mortality attributable to environmental risk factors, a comparative risk assessment was performed, considering a “top-down” approach. This approach uses an existing estimate of mortality of the disease endpoint by all causes as a starting point. A population attributable fraction was calculated for the exposure to PM2.5the overall burden of IHD and stroke was multiplied by the PAF to determine the burden attributable to this risk factor. The avoidable burden was calculated using the potential impact fraction (PIF) and considering the WHO-AQG 2021 as an alternative scenario. Results: Between 2011 and 2021, the ambient exposure to PM2.5 resulted in a total of 288,862.7 IHD YLL and a total of 420,432.3 stroke YLL in Portugal. This study found a decreasing trend in the mortality burden attributable to PM2.5 exposure, for both males and females and different age-groups. For different regions of Portugal, the same trend was observed in the last years. The mortality burden attributable to long-term exposure to PM2.5 was mainly concentrated in Lisbon Metropolitan Area, North and Centre. Changes in the exposure limits to the WHO recommended value of exposure (WHO-AQG 2021) have a reduction in the mortality burden due to IHD and stroke attributable to PM2.5 exposure, in Portugal. Conclusion: Between 2011 and 2021, approximately 22% and 23% of IHD and stroke deaths were attributable to PM2.5 exposure. Nevertheless, the mortality burden attributable to cardiovascular diseases has been decreasing in last years in Portugal. Our findings provide evidence of the impact of air pollution on human health, which are crucial for decision-making, at the national and regional level.</p

A systematic literature review of disability weights measurement studies: evolution of methodological choices

Background: The disability weight is an essential factor to estimate the healthy time that is lost due to living with a certain state of illness. A 2014 review showed a considerable variation in methods used to derive disability weights. Since then, several sets of disability weights have been developed. This systematic review aimed to provide an updated and comparative overview of the methodological design choices and surveying techniques that have been used in disability weights measurement studies and how they evolved over time. Methods: A literature search was conducted in multiple international databases (early-1990 to mid-2021). Records were screened according to pre-defined eligibility criteria. The quality of the included disability weights measurement studies was assessed using the Checklist for Reporting Valuation Studies (CREATE) instrument. Studies were collated by characteristics and methodological design approaches. Data extraction was performed by one reviewer and discussed with a second. Results: Forty-six unique disability weights measurement studies met our eligibility criteria. More than half (n = 27; 59%) of the identified studies assessed disability weights for multiple ill-health outcomes. Thirty studies (65%) described the health states using disease-specific descriptions or a combination of a disease-specific descriptions and generic-preference instruments. The percentage of studies obtaining health preferences from a population-based panel increased from 14% (2004–2011) to 32% (2012–2021). None of the disability weight studies published in the past 10 years used the annual profile approach. Most studies performed panel-meetings to obtain disability weights data. Conclusions: Our review reveals that a methodological uniformity between national and GBD disability weights studies increased, especially from 2010 onwards. Over years, more studies used disease-specific health state descriptions in line with those of the GBD study, panel from general populations, and data from web-based surveys and/or household surveys. There is, however, a wide variation in valuation techniques that were used to derive disability weights at national-level and that persisted over time.Peer Reviewe

Disability weights for environmental noise-related health states: results of a disability weights measurement study in Europe

Introduction:Measurement of the burden of disease using disability-adjusted life years requires disability weights to quantify health losses for non-fatal consequences of disease and injury. We aimed to obtain a set of disability weights for environmental and non-environmental noise-related health states (NOISE) using a nationally representative sample survey among the general population of four European countries; and to compare the resulting NOISE disability weights with those estimated in the Global Burden of Disease 2010 (GBD 2010) and European (EURO) disability weights measurement studies.Methods: We administered a web-based survey among a cohort of individuals from Hungary, Italy, Sweden and the Netherlands. It included paired comparison questions on 82 different health states. Each respondent performed 13 paired comparison tasks. We analysed paired comparison responses with probit regression analysis, and regression results were anchored on the disability weight scale between 0 (equivalent to full health) and 1 (equivalent to death).Results:In total, 4056 respondents participated in the study. Comparison of the regression results from paired comparison responses for each country-specific dataset with those run on the pooled dataset showed high linear correlations (0.96–0.98, p&lt;0.001). The resulting disability weights ranged from 0.005 for mild impairment of distance vision and mild anaemia to 0.761 for intensive care unit admission. The disability weight for moderate and severe annoyance was 0.006 and 0.011, respectively. Comparison of disability weights showed a higher correlation between EURO and NOISE disability weights (pseudo R-squared=0.955, Pearson correlation=0.954) compared with GBD 2010 and NOISE disability weights (pseudo R-squared=0.893, Pearson correlation=0.946).Conclusions:The NOISE disability weights are consistent and highly correlated across the four European countries. The NOISE disability weights set can be used to estimate the burden of disease attributable to noise-related outcomes across Europe

Disability weights for environmental noise-related health states: results of a disability weights measurement study in Europe

Introduction:Measurement of the burden of disease using disability-adjusted life years requires disability weights to quantify health losses for non-fatal consequences of disease and injury. We aimed to obtain a set of disability weights for environmental and non-environmental noise-related health states (NOISE) using a nationally representative sample survey among the general population of four European countries; and to compare the resulting NOISE disability weights with those estimated in the Global Burden of Disease 2010 (GBD 2010) and European (EURO) disability weights measurement studies.Methods: We administered a web-based survey among a cohort of individuals from Hungary, Italy, Sweden and the Netherlands. It included paired comparison questions on 82 different health states. Each respondent performed 13 paired comparison tasks. We analysed paired comparison responses with probit regression analysis, and regression results were anchored on the disability weight scale between 0 (equivalent to full health) and 1 (equivalent to death).Results:In total, 4056 respondents participated in the study. Comparison of the regression results from paired comparison responses for each country-specific dataset with those run on the pooled dataset showed high linear correlations (0.96–0.98, p&lt;0.001). The resulting disability weights ranged from 0.005 for mild impairment of distance vision and mild anaemia to 0.761 for intensive care unit admission. The disability weight for moderate and severe annoyance was 0.006 and 0.011, respectively. Comparison of disability weights showed a higher correlation between EURO and NOISE disability weights (pseudo R-squared=0.955, Pearson correlation=0.954) compared with GBD 2010 and NOISE disability weights (pseudo R-squared=0.893, Pearson correlation=0.946).Conclusions:The NOISE disability weights are consistent and highly correlated across the four European countries. The NOISE disability weights set can be used to estimate the burden of disease attributable to noise-related outcomes across Europe

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the Disability-Adjusted Life Years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3,053 studies of which 2,948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.Incluye referencias bibliográfica

The burden of injury in Central, Eastern, and Western European sub‑region: a systematic analysis from the Global Burden of Disease 2019 Study

Abstract Background: Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. Methods: We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. Results: In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. Conclusions: Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries

HGCA2.0: An RNA-Seq Based Webtool for Gene Coexpression Analysis in Homo sapiens

Genes with similar expression patterns in a set of diverse samples may be considered coexpressed. Human Gene Coexpression Analysis 2.0 (HGCA2.0) is a webtool which studies the global coexpression landscape of human genes. The website is based on the hierarchical clustering of 55,431 Homo sapiens genes based on a large-scale coexpression analysis of 3500 GTEx bulk RNA-Seq samples of healthy individuals, which were selected as the best representative samples of each tissue type. HGCA2.0 presents subclades of coexpressed genes to a gene of interest, and performs various built-in gene term enrichment analyses on the coexpressed genes, including gene ontologies, biological pathways, protein families, and diseases, while also being unique in revealing enriched transcription factors driving coexpression. HGCA2.0 has been successful in identifying not only genes with ubiquitous expression patterns, but also tissue-specific genes. Benchmarking showed that HGCA2.0 belongs to the top performing coexpression webtools, as shown by STRING analysis. HGCA2.0 creates working hypotheses for the discovery of gene partners or common biological processes that can be experimentally validated. It offers a simple and intuitive website design and user interface, as well as an API endpoint