bims-cieche 2025-11-02 papers

Issue of 2025–11–02
two papers selected by
Jonas Stefaan Steel, IDEWE

Environ Health. 2025 Oct 30. 24(1): 84

Global burden of lung cancer attributable to occupational asbestos exposure: 1990 to 2021.

Qiulin Huang, Yongran Cheng, Ruijiao Lei, Zijian Chen, Wei Gu, Kari Hemminki, Tianhui Chen.

BACKGROUND: Asbestos is a well-established occupational carcinogen, with strong evidence linking its exposure to lung cancer. Despite increasing awareness of its health risks, asbestos continues to be used in many countries. We aimed to evaluate the global burden of lung cancer attributable to occupational asbestos exposure and to analyze its epidemiological patterns across time and by regions, sex, and age.
METHODS: We utilized lung cancer data from the Global Burden of Disease (GBD) 2021 database, including information on new cases, deaths, and disability-adjusted life-years (DALYs), along with their age-standardized rates by gender and age groups. Temporal trends were examined using Joinpoint regression models with 95% confidence intervals (CIs). The timeline data on global asbestos bans were retrieved from the International Ban Asbestos Secretariat.
RESULTS: We observed, approximately 25 years after the complete ban on asbestos use, a declining trend for lung cancer incidence, as well as for mortality and DALYs due to asbestos exposure. In 2021, occupational asbestos exposure accounted for 9.4% of global lung cancer deaths and 7.2% of DALYs. Between 1990 and 2021, the number of asbestos-related lung cancer deaths increased from 0.13 million to 0.19 million, while DALYs rose from 2.58 million to 3.34 million. The highest deaths and DALYs were observed in regions with high Socio-demographic Index (SDI), though the most rapid increases occurred in lower SDI regions. Over time, lung cancer burden shifted towards older populations, especially those aged over 70.
CONCLUSIONS: We found, for the first time, that a complete ban on asbestos with a lag time of 25 years could effectively reduce lung cancer incidence along with asbestos-related deaths and DALYs. These findings underscore the urgent need for a complete ban on asbestos (especially chrysotile).

Keywords: Asbestos ban; Chrysotile; Global Burden of Disease (GBD) 2021; Lung cancer; Occupational asbestos exposure

DOI: https://doi.org/10.1186/s12940-025-01217-z

J Thorac Dis. 2025 Sep 30. 17(9): 6927-6943

Global trends and projections of tracheal, bronchial, and lung (TBL) cancers associated with occupational exposure to diesel engine exhaust (DEE): insights from the Global Burden of Disease (GBD) 2021 Study for 1990 to 2021 and projections to 2035.

Weizhen Guo, Jian Ding, Gang Cheng, Qian Xue, Di Wu, Cheng Yang, Jiabing Tong, Zegeng Li.

Background: Occupational exposure to diesel engine exhaust (DEE) is recognized as a major causative agent of tracheal, bronchial, and lung (TBL) cancers. This source emits hazardous substances, including carcinogenic compounds such as polycyclic aromatic hydrocarbons and benzene. In 2012, the International Agency for Research on Cancer (IARC) classified DEE as a Group 1 human carcinogen. However, the global disease burden due to occupational exposure-related TBL is not well understood. Utilizing the Global Burden of Disease (GBD) data for 2021, we examined the trends in mortality, disability-adjusted life years (DALYs), and standardized rates of occupational DEE-associated TBL from 1990 to 2021, with projections extending up to 2035. The study aims to identify regional, gender, and socioeconomic disparities to inform the creation of effective prevention and control strategies.
Methods: A global analysis of occupational DEE-related TBL cancers was conducted using data from the GBD 2021 study. The analysis involved estimation of deaths, DALYs, and age-standardized rates [age-standardised mortality rate (ASMR)/age-standardized DALY rates (ASDR)] for 204 countries and regions worldwide. Joinpoint regression models were employed to calculate average annual percentage change (AAPC), while decomposition analyses were employed to explore the effect of population growth, ageing, and epidemiological changes on disease burden. Furthermore, frontier analyses were employed to examine the relationship between DALYs and the socio-demographic development index (SDI) in each country, whereas the Bayesian age-period-cohort (BAPC) modelling was employed to project the burden of disease to 2035.
Results: From 1990 to 2021, the global number of occupational DEE-related TBL deaths increased from 7,896 to 21,620, and DALYs increased from 249,939 to 630,161. However, moreover, ASMR decreased slightly (0.31 to 0.24/100,000). The highest ASMR and ASDR values were observed in East Asia (0.51 and 14.67/100,000) and the lowest in western sub-Saharan Africa (0.04 and 1.22/100,000). The findings revealed a twofold higher disease burden in males compared to females, most notably in middle SDI regions. Decomposition analysis indicated that population growth (47.91%) and ageing (46.31%) were the primary drivers. Projections indicate that global deaths are expected to increase to 23,100 by 2035, while ASMR is likely to decrease to 0.410 per 100,000 people.
Conclusions: The global burden of TBL cancer is significantly influenced by occupational DEE exposure, exhibiting notable regional, socioeconomic development level and gender disparities. Although the disease rate per person is going down, the total number of cases is still rising. This shows a clear need for better workplace safety rules, cleaner technology, and focused efforts to prevent avoidable illness.

Keywords: Global Burden of Disease (GBD); joinpoint regression; occupational exposure to diesel engine exhaust (occupational exposure to DEE); prediction; tracheal, bronchial, and lung cancer (TBL cancer)

DOI: https://doi.org/10.21037/jtd-2025-1003