Burden of Disease Analysis of COPD Attributable to Occupational PGFs in the BRICS Countries, 1990–2021

Jia Zeng,* Jiao Xie,* Shaoqin Huang, Jing Cheng, Qiuxuan Zeng National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shaoqin Huang, Email [email protected] Jing Cheng, Email [email protected]: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. The BRICS countries (Brazil, Russia, India, China, and South Africa), which are undergoing rapid industrialization, face significant occupational exposures to particulate matter, gases, and fumes (PGFs)—important risk factors for COPD. This study aims to assess the disease burden of COPD attributable to occupational PGFs in the BRICS countries from 1990 to 2021.Methods: This analysis was based on data from the Global Burden of Disease (GBD) 2021 database, covering the period from 1990 to 2021 for the BRICS countries. The study examined the burden of COPD attributable to occupational PGFs by assessing absolute counts and age-standardized rates (ASRs) for deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs); estimated annual percentage changes (EAPCs) were also calculated for these metrics. Furthermore, a decomposition analysis was performed to identify contributors to changes in COPD burden, stratified by the Sociodemographic Index (SDI). Forecasting of disease burden trends was carried out using exponential smoothing (ES) and autoregressive integrated moving average (ARIMA) models.Results: From 1990 to 2021, the BRICS countries experienced a decline in ASRs for deaths, DALYs, and YLLs from COPD attributable to occupational PGFs. In contrast, the ASR for YLDs showed an increase. However, the absolute numbers of all outcomes rose. This divergence was primarily driven by population growth, which accounted for 85.2% of the rise in DALYs, far outweighing the effects of population aging (8.7%) and changes in age-specific rates (6.1%). By 2021, the absolute burden amounted to 12.60 million DALYs, 585,451 deaths, 10.55 million YLLs, and 2.05 million YLDs. Trend analysis confirmed this pattern, with significant negative estimated annual percentage changes (EAPCs) for DALYs, deaths, and YLLs, but a positive EAPC for YLDs. The burden was highest among men and the elderly (65– 79 years) within BRICS, and in low- and middle-income regions globally.Conclusion: Despite declining age-standardized rates, the increasing absolute burden of COPD attributable to occupational PGFs in BRICS countries underscores the urgent need for workplace-focused interventions. Priority should be given to engineering controls, improved ventilation, respiratory protection programs, and occupational health standards in high-risk industries to reduce PGFs exposure at its source.Keywords: COPD, occupational PGFs, global burden, BRICS countries, risk factors