The burden of intracerebral hemorrhage attributable to ambient particulate matter pollution in five Asian countries: a 32-year comparative analysis.

Abstract

Objective: To assess the impact of ambient particulate matter exposure on the burden of intracerebral hemorrhage (ICH) in the world, China, Indonesia, North Korea, Myanmar and Vietnam from 1990 to 2021 in different population, and to reveal regional heterogeneity and policy effects.

Methods: Based on the GBD 2021 data, we integrated the Joinpoint, Age-period-cohort model, Decomposition Analysis, Health Inequality Analysis and BAPC model chain achieved a complete cycle analysis including trend mutation detection, analysis of driving factors and long-term prediction.

Results: The global age-standardized mortality rate decreased by 3.22% annually after 2015. In China, the mortality rate decreased by 6.41% annually (95% CI:-8.08 to-4.71) due to policy measures. In Vietnam, the DALY rate increased by 170.53% (RR = 2.33), with 53.10% attributable to epidemiological changes. There were significant gender differences, with the DALYs rate for men being 2.9 times higher than for women. The age-period-cohort model showed that the mortality risk of the 85-year-old population (RR = 7.40) was 67.7 times higher than that of the 25-year-old group (RR = 0.04), and that the pre-1947 birth cohort was at high risk. The decomposition analysis revealed that aging contributed 53.80% to the increase in disease burden in China, while Vietnam was mainly driven by epidemiologicalchanges.

Conclusion: This study confirmed that pollution control can rapidly reduce mortality, but it is necessary to specifically address emerging pollution sources in Southeast Asia and the synergistic risks of aging to establish an interdisciplinary evidence chain for accurate prevention and control.