Burden of carbon monoxide poisoning in China, 1990–2019: A systematic analysis of data from the global burden of disease study 2019

BACKGROUND: Carbon monoxide (CO) poisoning is one of the most common toxic occupational diseases, but related data in China are scarce. A better understanding of the burden of CO poisoning is essential for improving its management. METHODS: A systematic analysis of data from the Global Burden of Disease (GBD) Study 2019 was conducted. Following the general analytical strategy used in the GBD Study 2019, the sex- and age-specific incidence and mortality rates of CO poisoning and disability-adjusted life years (DALYs) due to CO poisoning in China were analyzed. Estimated average annual percentage changes (AAPCs) in age-standardized rates were calculated by joinpoint regression analysis. The effects of age, period and cohort on the incidence of CO poisoning and DALYs due to CO poisoning were estimated by an age-period-cohort model. RESULTS: The age-standardized incidence and mortality rates as well as DALYs of CO poisoning per 100,000 population were estimated to be 21.82 [95% uncertainty interval (UI): 15.05–29.98], 0.93 (95% UI: 0.63–1.11), and 40.92 (95% UI: 28.43–47.85), respectively, in 2019. From 1990 to 2019, the AAPCs in the age-standardized incidence significantly increased in both males and females, while the age-standardized mortality rates and DALYs significantly decreased in both males and females. The incidence of CO poisoning peaked in individuals aged 15–19 years. Males had a higher burden of CO poisoning than females. The age effect showed that the relative risks (RRs) of incident CO poisoning decreased with age among males and females and that individuals aged 15–24 years had the highest RRs. The RRs of incident CO poisoning increased with time. The cohort effect showed that the incidence increased in successive birth cohorts. CONCLUSIONS: The incidence of CO poisoning in China increased from 1990 to 2019. More attention should be given to improving the burden of CO poisoning in Chinese adolescents. The results of this study can be used by health authorities to inform preventative measures to reduce the burden of CO poisoning.