{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T20:01:59Z","timestamp":1793736119702,"version":"4.6.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Occupational risks contribute substantially to the global burden of pneumoconiosis, chronic obstructive pulmonary disease (COPD), tracheal-bronchus-and-lung (TBL) cancer, and asthma; however, comprehensive, up-to-date global, regional, and national estimates remain limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from the Global Burden of Disease Study (GBD) 2021 were analyzed to quantify the burden of these diseases attributable to occupational exposure across 204 countries between 1990 and 2021, stratified by sex, age, socio-demographic index (SDI), and geographic region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2021, occupational risks led to 30,546 deaths due to pneumoconiosis, 285,628 deaths due to COPD, 585,451 deaths due to TBL (the highest among the four diseases), and 18,315 deaths due to asthma, with disability-adjusted life years (DALYs) of 1.8, 6.1, 12.6, and 0.4 million, respectively. Male patients exhibited higher burdens of all diseases, reflecting greater exposure to male-dominated industries. Geographically, middle SDI regions had the highest absolute cases for pneumoconiosis and COPD, high-SDI regions for TBL cancer, and low-middle SDI regions for asthma. While age-standardized rates declined for most outcomes over time, the absolute burdens increased owing to population growth and aging, with demographic factors driving up to 80% of the increase in total cases. Health inequities persisted, with lower SDI regions bearing a disproportionate burden, despite modest improvements in absolute inequalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings highlight the need for strengthened occupational health regulations, targeted interventions in high-risk regions, and policies addressing population dynamics to mitigate the impact of workplace exposure on respiratory health.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1652216","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:38:58Z","timestamp":1759901938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Global, regional, and national disease burden of pneumoconiosis, chronic obstructive pulmonary disease, tracheal-bronchus-and-lung cancer, and asthma attributable to occupational risks, 1990\u20132021: a systematic analysis for the global burden of disease study 2021"],"prefix":"10.3389","volume":"13","author":[{"given":"Shan","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Dang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyuan","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.4997\/JRCPE.2013.111","article-title":"Occupational lung disease","volume":"43","author":"Reid","year":"2013","journal-title":"J R Coll Physicians Edinb"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1164\/ajrccm.161.2.ats3-00","article-title":"Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS)","volume":"161","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/S0140-6736(07)61380-4","article-title":"Global burden of COPD: risk factors, prevalence, and future trends","volume":"370","author":"Mannino","year":"2007","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1080\/10937404.2019.1642601","article-title":"Development of a database on tumors and tumor sites in humans and in experimental animals for 'group 1 agents identified through volume 109 of the IARC monographs","volume":"22","author":"Grosse","year":"2019","journal-title":"J Toxicol Environ Health B Crit Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1186\/s12889-024-18847-6","article-title":"Survival and disease burden analyses of occupational pneumoconiosis during 1958-2021 in Huangshi city, China: a retrospective cohort study","volume":"24","author":"Chen","year":"2024","journal-title":"BMC Public Health"},{"key":"ref6","first-page":"1401","article-title":"Indoor air pollution and airway disease","volume":"8","author":"Viegi","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1056\/NEJM199507133330207","article-title":"Occupational asthma","volume":"333","author":"Chan-Yeung","year":"1995","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1183\/09031936.06.00124605","article-title":"Global burden of COPD: systematic review and meta-analysis","volume":"28","author":"Halbert","year":"2006","journal-title":"Eur Respir J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1023\/a:1018465507029","article-title":"Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons","volume":"8","author":"Boffetta","year":"1997","journal-title":"Cancer Causes Control"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1136\/oemed-2023-109277","article-title":"Critical reviews of exposure assessment in carcinogenic hazard identification: the IARC monographs experience","volume":"81","author":"Middleton","year":"2024","journal-title":"Occup Environ Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1S","DOI":"10.1378\/chest.08-0201","article-title":"Diagnosis and management of work-related asthma: American College of Chest Physicians consensus statement","volume":"134","author":"Tarlo","year":"2008","journal-title":"Chest"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1164\/rccm.167.5.787","article-title":"American thoracic society statement: occupational contribution to the burden of airway disease","volume":"167","author":"Balmes","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1002\/ajim.10216","article-title":"Dying for work: the magnitude of US mortality from selected causes of death associated with occupation","volume":"43","author":"Steenland","year":"2003","journal-title":"Am J Ind Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1002\/ajim.4700210511","article-title":"Exposure-response relationships for coal mine dust and obstructive lung disease following enactment of the Federal Coal Mine Health and safety act of 1969","volume":"21","author":"Seixas","year":"1992","journal-title":"Am J Ind Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(24)00933-4","article-title":"Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1016\/S0140-6736(12)61689-4","article-title":"Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010","volume":"380","author":"Murray","year":"2012","journal-title":"Lancet"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1016\/S0140-6736(12)61766-8","article-title":"A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010","volume":"380","author":"Lim","year":"2012","journal-title":"Lancet"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"102598","DOI":"10.1016\/j.arr.2024.102598","article-title":"Global, regional, and national burden of spinal cord injury from 1990 to 2021 and projections for 2050: a systematic analysis for the global burden of disease 2021 study","volume":"103","author":"Lu","year":"2025","journal-title":"Ageing Res Rev"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1055\/s-0043-1766117","article-title":"Global trends in occupational lung disease","volume":"44","author":"Cohen","year":"2023","journal-title":"Semin Respir Crit Care Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2259","DOI":"10.1016\/S0140-6736(24)00769-4","article-title":"GBD 2021 collaborators. Findings from the global burden of disease study 2021","volume":"403","author":"Murray","year":"2024","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1080\/17476348.2016.1190274","article-title":"Occupational exposure and risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis","volume":"10","author":"Alif","year":"2016","journal-title":"Expert Rev Respir Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1016\/S0140-6736(22)00470-6","article-title":"Chronic obstructive pulmonary disease","volume":"399","author":"Christenson","year":"2022","journal-title":"Lancet"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1186\/s12889-022-13541-x","article-title":"The burden of pneumoconiosis in China: an analysis from the global burden of disease study 2019","volume":"22","author":"Li","year":"2022","journal-title":"BMC Public Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e440","DOI":"10.1097\/JOM.0000000000002258","article-title":"Exploration of three incidence trend prediction models based on the number of diagnosed pneumoconiosis cases in China from 2000 to 2019","volume":"63","author":"Zhou","year":"2021","journal-title":"J Occup Environ Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"166346","DOI":"10.1016\/j.scitotenv.2023.166346","article-title":"Global, regional, and national burden of asbestosis from 1990 to 2019 and the implications for prevention and control","volume":"904","author":"Ou","year":"2023","journal-title":"Sci Total Environ"},{"key":"ref26","first-page":"103033","article-title":"Evolving trends in lung cancer risk factors in the ten most populous countries: an analysis of data from the 2019 Global Burden of Disease Study. EClinicalMedicine","author":"Jani","year":"2025"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"519","DOI":"10.3325\/cmj.2013.54.519","article-title":"An estimate of asthma prevalence in Africa: a systematic analysis","volume":"54","author":"Adeloye","year":"2013","journal-title":"Croat Med J"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1136\/oemed-2017-104944","article-title":"Identifying occupational carcinogens: an update from the IARC monographs","volume":"75","author":"Loomis","year":"2018","journal-title":"Occup Environ Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1158\/1055-9965.EPI-21-1428","article-title":"Occupational exposure to polycyclic aromatic hydrocarbons and lung cancer risk: results from a pooled analysis of case-control studies (SYNERGY)","volume":"31","author":"Olsson","year":"2022","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1002\/ajim.22245","article-title":"Occupational diseases in the People's Republic of China between 2000 and 2010","volume":"56","author":"Ding","year":"2013","journal-title":"Am J Ind Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e0255617","DOI":"10.1371\/journal.pone.0255617","article-title":"A systematic review and meta-analysis on international studies of prevalence, mortality and survival due to coal mine dust lung disease","volume":"16","author":"Lu","year":"2021","journal-title":"PLoS One"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1745-6673-1-11","article-title":"Chronic obstructive pulmonary disease (COPD) and occupational exposures","volume":"1","author":"Boschetto","year":"2006","journal-title":"J Occup Med Toxicol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1097\/01.jom.0000152923.07801.e1","article-title":"Occupational contribution to the burden of chronic obstructive pulmonary disease","volume":"47","author":"Balmes","year":"2005","journal-title":"J Occup Environ Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1056\/NEJMra1301758","article-title":"Occupational asthma","volume":"370","author":"Tarlo","year":"2014","journal-title":"N Engl J Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1625623","DOI":"10.3389\/fpubh.2025.1625623","article-title":"The study for asthma in older adults: a combined analysis of the effects of occupational asthmagens, high body-mass index and smoking","volume":"13","author":"Wang","year":"2025","journal-title":"Front Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e341","DOI":"10.1016\/S2542-5196(19)30109-3","article-title":"Implementation of national policies for a total asbestos ban: a global comparison","volume":"3","author":"Lin","year":"2019","journal-title":"Lancet Planet Health"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1136\/oemed-2019-106321","article-title":"Trends in global, regional and national incidence of pneumoconiosis caused by different aetiologies: an analysis from the global burden of disease study 2017","volume":"77","author":"Shi","year":"2020","journal-title":"Occup Environ Med"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1007\/s40572-017-0151-2","article-title":"The global burden of occupational disease","volume":"4","author":"Rushton","year":"2017","journal-title":"Curr Environ Health Rep."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"107980","DOI":"10.1016\/j.envint.2023.107980","article-title":"The prevalences and levels of occupational exposure to dusts and\/or fibres (silica, asbestos and coal): a systematic review and meta-analysis from the WHO\/ILO joint estimates of the work-related burden of disease and injury","volume":"178","author":"Schl\u00fcnssen","year":"2023","journal-title":"Environ Int"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/15548627.2020.1797280","article-title":"Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1","volume":"17","author":"Klionsky","year":"2021","journal-title":"Autophagy"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1080\/15459624.2013.863131","article-title":"Global estimates of the burden of injury and illness at work in 2012","volume":"11","author":"Takala","year":"2014","journal-title":"J Occup Environ Hyg"},{"key":"ref43","first-page":"19","article-title":"Assessment of exposure in occupational epidemiology","volume":"20","author":"Kauppinen","year":"1994","journal-title":"Scand J Work Environ Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1016\/j.ccm.2020.08.009","article-title":"Health disparities in environmental and occupational lung disease","volume":"41","author":"Brigham","year":"2020","journal-title":"Clin Chest Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1056\/NEJMra1201534","article-title":"Measuring the global burden of disease","volume":"369","author":"Murray","year":"2013","journal-title":"N Engl J Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s40572-021-00330-8","article-title":"Sex and gender differences in occupational Hazard exposures: a scoping review of the recent literature","volume":"8","author":"Biswas","year":"2021","journal-title":"Curr Environ Health Rep"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1652216\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:38:59Z","timestamp":1759901939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1652216\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":46,"alternative-id":["10.3389\/fpubh.2025.1652216"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1652216","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"article-number":"1652216"}}