Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017

• Autor(a) principal: Ole f Norheim
• Data de Publicação: 2018
• Outros Autores: Syed Mohamed Aljunid, Mehdi Noroozi, bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Elaine o Nsoesie, Peter s Nyasulu, Carla m Obermeyer, Eirini Skiadaresi, Igor Kuzin, Hmwe Hmwe Kyu, Carl Lachat, Deepesh p Lad, Sheetal d Lad, Alessandra Lafranconi, Shahabeddin Sarvi, Tomi Akinyemiju, Ratilal Lalloo, Tea Lallukka, Vegard Skirbekk, Ted r Miller, Basema Saddik, Zohreh Rahimi, Faris Hasan Lami, Justin j Lang, Van c Lansingh, Samantha Leigh Larson, Arman Latifi, Brijesh Sathian, Jeffrey v Lazarus, David l Smith, Paul h Lee, Jayendra Sharma, James Leigh, Nadia Akseer, Megbaru Debalkie Animut, Mostafa Leili, Afarin Rahimi-movaghar, Cheru Tesema Leshargie, Janni Leung, Miriam Levi, Sok King Ong, Maheswar Satpathy, Sonia Lewycka, Kamarul Imran Musa, Shanshan li, Yichong li, Juan Liang, Xiaofeng Liang, Ehsan Sadeghi, yu Liao, Ziyad Al-aly, Mari Smith, Vafa Rahimi-movaghar, Misgan Legesse Liben, Arundhati r Sawant, Jason a Anderson, Badr Hasan Sobaih, Soheila Sobhani, Melvin b Marzan, Ranjani Somayaji, Meenakshi Sharma, Moslem Soofi, Alaa Alashi, Reed j d Sorensen, Hedayat Abbastabar, al Artaman, Joan b Soriano, Ireneous n Soyiri, Eyal Oren, Aliya Naheed, Benjamin Ballard Massenburg, Lee-ling Lim, Angela Spinelli, Luciano a Sposato, Chandrashekhar t Sreeramareddy, Andreea Mirica, Vinay Srinivasan, Vladimir i Starodubov, Nadine Steckling, Dan j Stein, Murray b Stein, Krishna k Aryal, Shai Linn, Manu Raj Mathur, Goran Stevanovic, Syed Mustafa Ali, Heather m Orpana, Leo Stockfelt, Erkin m Mirrakhimov, Mark a Stokes, Lela Sturua, Michelle l Subart, Agus Sudaryanto, Shiwei Liu, Mu'awiyyah Babale Sufiyan, Muhammad Aziz Rahman, Gerhard Sulo, Bruno f Sunguya, Patrick John Sur, Azin Nahvijou, Hamid Asayesh, Rajesh Sagar, Alberto Ortiz, Bryan l Sykes, Rakesh Lodha, Cassandra e i Szoeke, Rafael Tabarés-seisdedos, Prashant Mathur, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Ken Takahashi, Nikhil Tandon, Segen Gebremeskel Tassew, Gurudatta Naik, Sree Bhushan Raju, Giancarlo Logroscino, Mohammad Tavakkoli, Nuno Taveira, Erika Ota, Kunihiro Matsushita, Zerihun Ataro, Arash Tehrani-banihashemi, Tigist Gashaw Tekalign, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Habtamu Temesgen, Alan d Lopez, Mohamad-hani Temsah, Awoke Temesgen Misganaw, Nitish Naik, Omar Temsah, Pallab k Maulik, Abdullah Sulieman Terkawi, Belay Tessema, Stanislav s Otstavnov, Mebrahtu Teweldemedhin, Marcel Ausloos, Sahar Saeedi Moghaddam, Kavumpurathu Raman Thankappan, Andrew Theis, Sathish Thirunavukkarasu, Habtamu Mitiku, Hannah j Thomas, Mete Saylan, Farid Najafi, Matthew Lloyd Thomas, Nihal Thomas, George d Thurston, Stefan Lorkowski, Binyam Tilahun, Simon Øverland, Taavi Tillmann, Quyen g to, Euripide f g a Avokpaho, Babak Moazen, Felix Akpojene Ogbo, Myriam Tobollik, Marcello Tonelli, Vinay Nangia, Paulo a Lotufo, Roman Topor-madry, Anna e Torre, Miguel Tortajada-girbés, Mathilde Touvier, Marcos Roberto Tovani-palone, Mayowa Ojo Owolabi, Jeffrey a Towbin, Khurshid Alam, Bahram Mohajer, Bach Xuan Tran, Rafael Lozano, Khanh Bao Tran, Ashish Awasthi, Jobert Richie Nansseu, Thomas Clement Truelsen, nu Thi Truong, Afewerki Gebremeskel Tsadik, Lorainne Tudor Car, e Murat Tuzcu, Mohsen Mazidi, Hayley d Tymeson, Rajesh Sharma, Karzan Abdulmuhsin Mohammad, Mahesh p a, Stefanos Tyrovolas, Kingsley n Ukwaja, Irfan Ullah, Bruno Ramos Nascimento, Rachel l Updike, Beatriz Paulina Ayala Quintanilla, Muhammad Shariq Usman, Colm Mcalinden, Ulrich Otto Mueller, Olalekan a Uthman, Muthiah Vaduganathan, Moslem Mohammadi, Afsane Vaezi, Pascual r Valdez, Cristiana Abbafati, Aaron Van Donkelaar, Elena Varavikova, Bruce Neal, Santosh Varughese, Nahla Hamed Anber, John j Mcgrath, Tommi Juhani Vasankari, Vidhya Venkateswaran, Rakesh Ayer, Noushin Mohammadifard, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco s Violante, Sergey Konstantinovitch Vladimirov, Ubai Alsharif, Ayman Al-eyadhy, Vasily Vlassov, Martin Mckee, Goura Kishor Rath, Stein Emil Vollset, Theo Vos, Kia Vosoughi, Mousa Mohammadnia-afrouzi, Giang Thu vu, Isidora s Vujcic, Tambe b Ayuk, Tim c d Lucas, Fasil Shiferaw Wagnew, Yasir Waheed, Ravi Mehrotra, Stephen g Waller, Rosana Pacella, Nahid Neamati, Judd l Walson, Yafeng Wang, Seyed Moayed Alavian, Yanping Wang, Raimundas Lunevicius, Yuan-pang Wang, Elisabete Weiderpass, Robert g Weintraub, Kala m Mehta, Fitsum Weldegebreal, Jeffrey Dstanaway, Foad Abd-allah, Peter s Azzopardi, Ionut Negoi, Abhijit p Pakhare, Stefan ma, Amirhossein Sahebkar, Andrea Werdecker, Adhena Ayaliew Werkneh, j Jason West, Rajesh Kumar Rai, Ronny Westerman, Harvey a Whiteford, Justyna Widecka, Tissa Wijeratne, Andrea Sylvia Winkler, Erlyn Rachelle King Macarayan, Alison b Wiyeh, Mehran Alijanzadeh, Shafiu Mohammed, Charles Shey Wiysonge, Amir h Pakpour, Varshil Mehta, Arefeh Babazadeh, Charles d a Wolfe, Tien Yin Wong, Shouling wu, Ísis Eloah Machado, Denis Xavier, Gelin xu, Simon Yadgir, Ali Yadollahpour, Usha Ram, Ruxandra Irina Negoi, Mehdi Sayyah, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Adrian Pana, Hosein Safari, Lijing l Yan, Hamid Badali, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Alex Yeshaneh, Farnam Mohebi, Toni Meier, Ebrahim m Yimer, Subas Neupane, Fabiana Madotto, Paul Yip, Engida Yisma, Naohiro Yonemoto, Songhomitra Panda-jonas, Seok-jun Yoon, Marcel Yotebieng, Alaa Badawi, Mustafa z Younis, Mahdi Safdarian, Ali h Mokdad, Jun She, Mahmoud Yousefifard, Chuanhua yu, Charles Richard James Newton, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Luis Zavala-arciniega, Eun-kee Park, Anthony Lin Zhang, Fantahun Ayenew Mekonnen, Hue Thi Mai, Hao Zhang, Mariam Molokhia, Kai Zhang, Kalpana Balakrishnan, Maigeng Zhou, Josephine w Ngunjiri, Stephanie r m Zimsen, Sanjay Zodpey, Christopher j l Murray, Ayele Geleto Bali, Carl Abelardo t Antonio, Yohannes a Melaku, Kylie Ball, Charles d h Parry, Fatemeh Momeniha, Shoshana h Ballew, Maciej Banach, Joseph Adel Mattar Banoub, Jemal Abdela, Anh Quynh Nguyen, Aleksandra Barac, Marek Majdan, Suzanne Lyn Barker-collo, Samiah Alam, Till Winfried Bärnighausen, Lope h Barrero, Sanjay Basu, Lorenzo Monasta, Bernhard t Baune, Hadi Parsian, Shahrzad Bazargan-hejazi, Neeraj Bedi, Reza Majdzadeh, Ettore Beghi, Grant Nguyen, Addisu Melese, Masoud Behzadifar, Ahmed Abdelalim, Meysam Behzadifar, Yannick Béjot, Yoshan Moodley, Bayu Begashaw Bekele, Eyasu Tamru Bekru, Mahfuzar Rahman, Ezra Belay, Shanti Patel, Yihalem Abebe Belay, Mulugeta Melku, Michelle l Bell, ha Thu Nguyen, Aminu k Bello, Derrick a Bennett, Isabela m Bensenor, Ghobad Moradi, Azeem Majeed, Ibrahim Abdollahpour, Gilles Bergeron, Adugnaw Berhane, Eduardo Bernabe, Peter t n Memiah, Robert s Bernstein, Sanghamitra Pati, Mircea Beuran, David Laith Rawaf, Tina Beyranvand, Hesham m Al-mekhlafi, Neeraj Bhala, Maziar Moradi-lakeh, Ashish Bhalla, Suraj Bhattarai, Zulfiqar a Bhutta, Ziad a Memish, Rizwan Suliankatchi Abdulkader, Belete Biadgo, Ali Bijani, Boris Bikbov, Reza Malekzadeh, Khalid Altirkawi, Huong Lan Thi Nguyen, Ver Bilano, Nooshin Abbasi, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Walter Mendoza, Donal Bisanzio, Tuhin Biswas, Tone Bjørge, Deborah Carvalho Malta, Brigette f Blacker, Molla Abebe, Archie Bleyer, Rohan Borschmann, Huong Thanh Nguyen, Mehdi Moradinazar, Snehal t Patil, Elke Schaeffner, Ibrahim r Bou-orm, Soufiane Boufous, Abdullah a Mamun, Rupert Bourne, Oliver j Brady, Michael Brauer, Alexandra Brazinova, Nicholas j k Breitborde, Hermann Brenner, Zegeye Abebe, Kefyalew Addis Alene, Fatemeh Rajati, Minh Nguyen, Aziz Sheikh, Andrey Nikolaevich Briko, Ajay Patle, Gabrielle Britton, Traolach Brugha, Rachelle Buchbinder, Richard t Burnett, Reinhard Busse, Zahid a Butt, Leah e Cahill, Desalegn Tadese Mengistu, Yahya Safari, Chhabi Lal Ranabhat, Lucero Cahuana-hurtado, Reza Alizadeh-navaei, Ismael r Campos-nonato, Semaw f Abera, George c Patton, Rosario Cárdenas, Giulia Carreras, Juan j Carrero, Félix Carvalho, Ana-laura Manda, Sare Safi, Carlos a Castañeda-orjuela, Paula Moraga, Jacqueline Castillo Rivas, Franz Castro, Nam ba Nguyen, Ferrán Catalá-lópez, Kate Causey, Kelly m Cercy, Deepak Paudel, Tinuke o Olagunju, Olifan Zewdie Abil, George a Mensah, Ester Cerin, Yazan Chaiah, Lidia Morawska, Hsing-yi Chang, Jung-chen Chang, Kai-lan Chang, Emma Nichols, Fiona j Charlson, Helena Manguerra, Aparajita Chattopadhyay, Vijay Kumar Chattu, Gert b m Mensink, Miao li Chee, Katherine r Paulson, Ching-yu Cheng, Joana Morgado-da-costa, Haftom Niguse Abraha, Adrienne Chew, Peggy Pei-chia Chiang, Mohammad Ali Mansournia, Odgerel Chimed-ochir, Jing Nie, Ken Lee Chin, Seid Tiku Mereta, Abdulaal Chitheer, Jee-young j Choi, Rajiv Chowdhury, Hanne Christensen, Shane Douglas Morrison, Wayra Citlali Paz Ballesteros, Lorenzo Giovanni Mantovani, Devasahayam j Christopher, Sheng-chia Chung, Ashkan Afshin, Aklilu Roba Abrham, Atte Meretoja, Dina Nur Anggraini Ningrum, Flavia m Cicuttini, Massimo Cirillo, Aaron j Cohen, Daniel Collado-mateo, Joemer c Maravilla, Marilita m Moschos, Cyrus Cooper, Owen r Cooper, Neil Pearce, Josef Coresh, Tahiya Alam, Leslie Cornaby, Paolo Angelo Cortesi, Yirga Legesse Nirayo, Monica Cortinovis, Mohammad Hifz ur Rahman, Laith Jamal Abu-raddad, Megan Costa, Simin Mouodi, Ewerton Cousin, Michael h Criqui, Elizabeth a Cromwell, Tuomo j Meretoja, David k Cundiff, Alexandre Pereira, Alemneh Kabeta Daba, Wagner Marcenes, Berihun Assefa Dachew, Nobuo Nishi, Abel Fekadu Dadi, Albertino Antonio Moura Damasceno, Seyyed Meysam Mousavi, Lalit Dandona, Niveen me Abu-rmeileh, Tomislav Mestrovic, Rakhi Dandona, Sarah c Darby, Ashley Marks, Paul i Dargan, Ahmad Daryani, David m Pereira, Rajat Das Gupta, Salman Rawaf, José Das Neves, Mina Anjomshoa, Tamirat Tesfaye Dasa, Maria Inês Schmidt, Aditya Prasad Dash, Peilin Shi, Dragos Virgil Davitoiu, Kairat Davletov, Manfred Mario Kokou Accrombessi, Vanessa de la Cruz-góngora, Fernando Pio de la Hoz, Diego de Leo, Norberto Perico, Molly r Nixon, Dariush Mozaffarian, Haftay Berhane Mezgebe, Fares Alahdab, Jan-walter de Neve, Louisa Degenhardt, Selina Deiparine, Robert p Dellavalle, Gebre Teklemariam Demoz, Edgar Denova-gutiérrez, Kebede Deribe, Dilaram Acharya, Nikolaos Dervenis, Aniruddha Deshpande, Randall v Martin, Bartosz Miazgowski, Kalayu Brhane Mruts, Marzieh Nojomi, Nelson Alvis-guzman, Don c Des Jarlais, Getenet Ayalew Dessie, Gabrielle Aline Deveber, Subhojit Dey, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Roya Safari-faramani, Mesfin Tadese Dinberu, Sasa Rajsic, Eric l Ding, Achenef Asmamaw Muche, Pawan Acharya, Shuhei Nomura, Helen Derara Diro, Konrad Pesudovs, Shirin Djalalinia, Huyen Phuc do, Jacob Olusegun Olusanya, Klara Dokova, David Teye Doku, Ione j c Schneider, Kerrie e Doyle, Tim r Driscoll, Mohammad Ali Sahraian, Manisha Dubey, Eleonora Dubljanin, k Srinath Reddy, Eyasu Ejeta Duken, Kenji Shibuya, Abdu a Adamu, Max Petzold, Bruce b Duncan, Ben Schöttker, Andre r Duraes, Natalie Ebert, Hedyeh Ebrahimi, Haniye Sadat Sajadi, Soheil Ebrahimpour, David Edvardsson, Mekonnen Sisay Shiferaw, Andem Effiong, Colin d Rehm, Anne Elise Eggen, Charbel el Bcheraoui, Aletta Elisabeth Schutte, Ziad El-khatib, Hai Quang Pham, Akilew Awoke Adane, Iqbal rf Elyazar, Nasir Salam, Molly Katherine Miller-petrie, Ahmadali Enayati, Aman Yesuf Endries, Benjamin er, Holly e Erskine, Jürgen Rehm, Oumer Sada Muhammed, Sharareh Eskandarieh, Alireza Esteghamati, Kara Estep, Hamed Fakhim, Mika Shigematsu, Michael r Phillips, In-hwan oh, Mahbobeh Faramarzi, Oladimeji m Adebayo, Mohammad Fareed, Talha a Farid, David c Schwebel, Carla Sofia e sá Farinha, Robert c Reiner, Andrea Farioli, Monika Sawhney, Andre Faro, Maryam s Farvid, Mohammad Hosein Farzaei, Payman Salamati, Batool Fatima, Julian David Pillay, Kairsten a Fay, Saeid Safiri, Ali Akbar Fazaeli, Rufus Adesoji Adedoyin, Jalal Arabloo, Valery l Feigin, Marissa b Reitsma, Andrea b Feigl, Seyed-mohammad Fereshtehnejad, Eduarda Fernandes, Prabhat Ranjan, Joao c Fernandes, Giannina Ferrara, Falk Schwendicke, Alize j Ferrari, Ghulam Mustafa, Michael a Piradov, Manuela l Ferreira, Irina Filip, Jonas David Finger, Christopher m Odell, Emmanuela Gakidou, Victor Adekanmbi, Zikria Saleem, Florian Fischer, Pedro r Olivares, Min-jeong Shin, Nataliya a Foigt, Kyle j Foreman, Takeshi Fukumoto, Nancy Fullman, Meghdad Pirsaheb, Thomas Fürst, João m Furtado, Giuseppe Remuzzi, Neal d Futran, Yahya Salimi, Rahman Shiri, Palwasha Anwari, Seana Gall, Silvano Gallus, Zanfina Ademi, Amiran Gamkrelidze, Morsaleh Ganji, Alberto l Garcia-basteiro, William m Gardner, Tobias Pischon, Abadi Kahsu Gebre, Reza Shirkoohi, Andre m n Renzaho, James g Scott, Hamideh Salimzadeh, Amanuel Tesfay Gebremedhin, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna m Geleijnse, Yilma Chisha Dea Geramo, Olatunji o Adetokunboh, Peter w Gething, Ivy Shiue, Kebede Embaye Gezae, Reza Ghadimi, Soraya Seedat, Farhad Pishgar, Joshua a Salomon, Catalina Liliana Andrei, Keyghobad Ghadiri, Khalil Ghasemi Falavarjani, Maryam Ghasemi-kasman, Mamata Ghimire, Farhad Shokraneh, Rakesh Ghosh, Aloke Gopal Ghoshal, Simona Giampaoli, Mario Sekerija, Mina g Adib, Paramjit Singh Gill, Devashri Digvijay Salvi, Tiffany k Gill, Serge Resnikoff, Oleguer Plana-ripoll, Haitham Shoman, Richard f Gillum, Ibrahim Abdelmageed Ginawi, Giorgia Giussani, Elena v Gnedovskaya, Sadaf g Sepanlou, William w Godwin, Srinivas Goli, Hector Gómez-dantés, Inbal Salz, Philimon n Gona, François Alla, Amha Admasie, Luz Myriam Reynales-shigematsu, Sameer Vali Gopalani, Azmeraw t Amare, Alessandra c Goulart, Marc l Serre, Ayman Grada, Morgan e Grams, Giuseppe Grosso, Harish Chander Gugnani, g k Mini, Mustafa Geleto Ansha, Yuming Guo, Rahul Gupta, Rajeev Gupta, Satar Rezaei, Tanush Gupta, Edson Serván-mori, Jose c Adsuar, Dietrich Plass, Reyna Alma Gutiérrez, Sheila c o Martins, Daniela s Gutiérrez-torres, Juanita a Haagsma, Abdallah m Samy, Tesfa Dejenie Habtewold, Vladimir Hachinski, Nima Hafezi-nejad, Tekleberhan b Hagos, Satinath Mukhopadhyay, Antonio Luiz Pinho Ribeiro, Tewodros Tesfa Hailegiyorgis, Mark g Shrime, Gessessew Bugssa Hailu, Arvin Haj-mirzaian, Suzanne Polinder, Kossivi Agbelenko Afanvi, Juan Sanabria, Arya Haj-mirzaian, Randah r Hamadeh, Samer Hamidi, Tomasz Miazgowski, Alexis j Handal, Matthew s Shupler, Graeme j Hankey, Juan a Rivera, Yuantao Hao, Hilda l Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Olanrewaju Oladimeji, Kevan r Polkinghorne, Hadi Hassankhani, Seyedmojtaba Seyedmousavi, si si, Mohsen Afarideh, Hamid Yimam Hassen, Rasmus Havmoeller, Caitlin n Hawley, Kedir Teji Roba, Simon i Hay, Akbar Hedayatizadeh-omran, Behzad Heibati, Komal Ali, Behnam Heidari, Ashraf f Nabhan, Hosein Shabaninejad, Mohsen Heidari, Maarten j Postma, Delia Hendrie, Andualem Henok, Gina Agarwal, Ileana Heredia-pi, Sonia Rodríguez-ramírez, Claudiu Herteliu, Fatemeh Heydarpour, Soraya Siabani, Maria Dolores Sanchez-niño, Gavin Shaddick, Sousan Heydarpour, Desalegn t Hibstu, Tarig b Higazi, Esayas Haregot Hilawe, Richie Poulton, Hans w Hoek, Howard j Hoffman, Michael k Hole, Olatunde Aremu, Ala'a Alkerwi, Anju Aggarwal, Helen Elizabeth Olsen, Tania g Sánchez-pimienta, Enayatollah Homaie Rad, Praveen Hoogar, h Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Abla Mehio Sibai, Akram Pourshams, Sorin Hostiuc, Damian g Hoy, Azadeh Shafieesabet, Leonardo Roever, Taren Sanders, Mohamed Hsairi, Thomas Hsiao, Stephen s Lim, Sargis Aghasi Aghayan, Tariq j Siddiqi, Guoqing hu, Howard hu, John j Huang, Mamusha Aman Hussen, Lambert Tetteh Appiah, Hossein Poustchi, Chantal k Huynh, Yingying Sang, Yesenia Román, Kim Moesgaard Iburg, Inga Dora Sigfusdottir, Nayu Ikeda, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Anurag Agrawal, Mehdi Shahbazi, Caleb Mackay Salpeter Irvine, Sheikh Mohammed Shariful Islam, Farhad Islami, Damian Francesco Santomauro, Rannveig Sigurvinsdottir, Dorairaj Prabhakaran, Luca Ronfani, Maria d Jackson, Kathryn h Jacobsen, Leila Jahangiry, Nader Jahanmehr, Amira a Shaheen, Sudhir Kumar Jain, Mihajlo Jakovljevic, Spencer l James, Francisco Rogerlândio Martins-melo, Sutapa Agrawal, Itamar s Santos, Simerjot k Jassal, Achala Upendra Jayatilleke, Sofia Androudi, Swayam Prakash, Panniyammakal Jeemon, Masood Ali Shaikh, Ravi Prakash Jha, Vivekanand Jha, Mojde Mirarefin, John s ji, Jost b Jonas, Jitendra Jonnagaddala, João Vasco Santos, Zahra Jorjoran Shushtari, Ankur Joshi, Alireza Ahmadi, Gholamreza Roshandel, Teresa Shamah Levy, Jacek Jerzy Jozwiak, Diego Augusto Santos Silva, Narayan Prasad, Mikk Jürisson, Zubair Kabir, Amaha Kahsay, Rizwan Kalani, Milena m Santric Milicevic, Tanuj Kanchan, Surya Kant, Chittaranjan Kar, Anoushka i Millear, Kanyin l Ong, Manoochehr Karami, Ali Rostami, Behzad Karami Matin, Mehdi Ahmadi, Walid Ammar, André Karch, Corine Karema, Josep m Antó, Narges Karimi, Seyed m Karimi, João Pedro Silva, Kate Muller, Amir Kasaeian, Dessalegn h Kassa, Getachew Mullu Kassa, Gregory a Roth, Tesfaye Dessale Kassa, Nicholas j Kassebaum, Srinivasa Vittal Katikireddi, Caroline a Purcell, Bruno Piassi Sao Jose, Dayane Gabriele Alves Silveira, Hamid Ahmadieh, Mehran Shams-beyranvand, Anil Kaul, Norito Kawakami, Zhila Kazemi, Ali Kazemi Karyani, Adane Teshome Kefale, Dietrich Rothenbacher, Peter Njenga Keiyoro, Grant Rodgers Kemp, Mohsen Naghavi, Andre Pascal Kengne, Kindie Fentahun Muchie, Mohammadbagher Shamsi, Andre Keren, Manorama b Purwar, Chandrasekharan Nair Kesavachandran, Muktar Beshir Ahmed, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Jasvinder a Singh, Ambuj Roy, Alireza Khajavi, Nauman Khalid, Heidar Sharafi, Andrew t Olagunju, Ibrahim a Khalil, Gulfaraz Khan, Muhammad Shahzeb Khan, Mostafa Qorbani, Muhammad Ali Khan, Narinder Pal Singh, Young-ho Khang, Amani Nidhal Aichour, Mona m Khater, Enrico Rubagotti, Kiomars Sharafi, Mohammad Khazaei, Mayank Sardana, Habibolah Khazaie, Abdullah t Khoja, Ardeshir Khosravi, Virendra Singh, Mohammad Hossein Khosravi, Aliasghar a Kiadaliri, Amir Radfar, Daniel n Kiirithio, Cho-il Kim, Bolajoko Olubukunola Olusanya, Daniel Kim, Richard Ofori-asenso, Abdur Razzaque Sarker, Ibtihel Aichour, Johan Ärnlöv, Young-eun Kim, Yun Jin Kim, Ruth w Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-skarbek, Mehdi Sharif, Anwar Rafay, Mika Kivimäki, Luke d Knibbs, Winfried März, Rodrigo Sarmiento-suárez, Lesley Rushton, Ann Kristin Skrindo Knudsen, Sonali Kochhar, Miloud Taki Eddine Aichour, Yoshihiro Kokubo, Tufa Kolola, Mahdi Sharif-alhoseini, Jacek a Kopec, Soewarta Kosen, Dhirendra Narain Sinha, Parvaiz a Koul, Alireza Rafiei, Nizal Sarrafzadegan, ai Koyanagi, Charumathi Sabanayagam, Michael a Kravchenko, Kewal Krishan, Kristopher j Krohn, Seth Christopher Yaw Appiah, Hans Kromhout, Kalkidan Hassen Abate, Degu Abate, Mohammad Esmaeil Akbari, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Benn Sartorius, g Anil Kumar, Fakher Rahim, Perminder s Sachdev, Manasi Kumar, Hamid Sharifi
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/52324; https://orcid.org/0000-0002-8214-5734
• topic: Saúde global; Carga Global da Doença; Saúde; Carga Global da Doença; Poluição do ar

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations.Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs bydecomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followedby smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million 2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low.nterpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning.