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

SEASONAL ABUNDANCE AND FEEDING EFFICIENCY OF THE FALSE SPIDER MITE TENUIPALPUS PERNICIS (CHAUDHRI, AKBAR AND RASOOL) ON GUAVA (PSIDIUM GUAJAVA)

The false spider mite (Tenuipalpus pernicis) population size was average in November, 2007 — January, 2008 on guava (Psidium guajava) (17.9 ± 0.33 mites / 6.25 cm2 and 15.4 ± 0.43 mites / 6.25 cm2 respectively). It peaked during May, 2008 (32.8 ± 0.28 mites / 6.25 cm2, mean ± SD is calculated) when the mean temperature, RH and rainfall were 31.28 0C, 72.62% and 1.05 mm, respectively. The population density started to decline thereafter with the minimum in August, 2008 (4.5 ± 0.51 mites /6.25 cm2) when the mean temperature, RH and rainfall were 28.910C, 84.50% and 15.53 mm. respectively. Heavy precipitation in June and July probably adversely affected the mite population. Correlation of the mite density with temperature and relative humidity (RH) were positive while that with rainfall was negative.Correlation with RH was non-significant. We quantified the decrease in chlorophyll, proteins, carbohydrates and minerals in guava leaves due to mite infestation

HOUSE DUST MITES IN RELATION TO DIFFERENT HABITAT CONDITIONS OF KOLKATA METROPOLIS, INDIA

House dust mites play an important role in the pathogenesis of allergic diseases. Both the common species of the genus Dermatophagoides viz. Dermatophagoides pteronyssinus and D. farinae and other two allergenic species Blomia tropicalis and Austroglycyphagus geniculatus are found to be abundant in the dust samples collected from beds of patients suffering from nasobronchial allergic disorders residing at Kolkata metropolitan areas. The presence of these four mites in large quantity in the patients environment are clinically correlated with the aetiopathology of various allergic manifestations like allergic rhinitis, bronchial asthma etc. House dust mites usually occupy different niches in the homes of asthmatics and are significantly higher in beds than else where in the house. However, the distribution and abundance of these mites are influenced by several microclimatic conditions. The aim and objective of the present study is to assess the impact of different microclimatic conditions like type of houses, type of mattresses and bed and floors of the room on the distribution and abundance of house dust mite population. In view to provide the patients with best possible diagnosis and treatment, proper identification of offending allergens and their subsequent reduction from the patient’s environment is of outmost importance which in turn may be helpful for the prophylactic management of these dreadful diseases in Kolkata metropolis

LIFE-CYCLE OF HOUSE DUST MITE DERMATOPHAGOIDES PTERONYSSINUS (ACARI: PYROGYLPHIDAE) UNDER LABORATORY CONDITIONS IN KOLKATA METROPOLIS

The life cycle of Dermatophagoides pteronyssinus was studied at 25 OC and 80% relative humidity. Observation was made on freshly laid eggs until they develop into adults and periods between different stages were recorded. The eggs required an average 11.26 days to develop into adults. The ranges of life longevity of mated males and females were 18–64 days and 20–54 days, respectively. The conditions used in the rearing experiments may be considered optimal for maintaining culture of D. pteronyssinus