Global magnitude and long-term trend of ischemic heart disease burden attributed to household air pollution from solid fuels in 204 countries and territories, 1990-2019

Understanding the spatiotemporal variation in the household air pollution from solid fuels (HAP)-related ischemic heart disease (IHD) burden on a global scale from 1990 to 2019 is essential to reduce IHD burden, as well as control HAP exposure. Based on the Global Burden of Disease Study 2019, the numbers and age-standardized rates of IHD mortality and disability-adjusted life years (DALYs) (ASMR and ASDR) attributed to HAP were analyzed by sex and age at global, regional, and national levels. The estimated annual percentage change was calculated to evaluate the temporal trend in burden rates. In 2019, IHD attributed to HAP resulted in 511 170 deaths and 13.18 million DALYs globally. The corresponding ASMR and ASDR were higher in males, increased with age peaking at about 80-94 years, and varied greatly across the world. Despite a remarkable decline in HAP-related IHD was achieved across the world over the past decades, an undesirable increase could be observed in some low-income but with high-burden countries. Sustained and comprehensive efforts are needed to control HAP and reduce the IHD burden, especially in countries and territories with a heavy or increasing burden, such as the Solomon Islands, Vanuatu, Afghanistan, Philippines, Zimbabwe, Lesotho, and Somalia.

Automated summary

Understanding the global spatiotemporal variation in household air pollution from solid fuels (HAP)-related ischemic heart disease (IHD) burden is crucial for reducing IHD burden and controlling HAP exposure. This study analyzed the numbers and rates of IHD mortality and disability-adjusted life years (DALYs) attributed to HAP at global, regional, and national levels. In 2019, IHD attributed to HAP resulted in 511,170 deaths and 13.18 million DALYs globally. The burden rates were higher in males, increased with age, and varied greatly across the world. Despite a decline in HAP-related IHD burden globally, some low-income countries experienced an undesirable increase. Sustained and comprehensive efforts are needed to control HAP and reduce IHD burden in countries with a high or increasing burden.