The Burden of Idiopathic Developmental Intellectual Disability Attributed to Lead Exposure in Asian Children and Adolescents, 1990-2021: Trends, Inequalities, and Future Projections for the Global Burden of Disease Study 2021

ObjectivesThis study aimed to analyze the burden of idiopathic developmental intellectual disability (IDII) attributed to lead exposure in Asian children and adolescents aged <20 years from 1990 to 2021.MethodsWe estimated the disease burden using disability-adjusted life years (DALYs). Temporal trends from 1990 to 2021 were analyzed using joinpoint regression. Decomposition analyses were performed to disaggregate changes in DALYs. Health inequality analyses and frontier analyses were applied to explore the relationship between DALYs and the socio-demographic index (SDI). The Bayesian age-period-cohort model was employed to predict the future disease burden by 2035.ResultsThe number of IDII DALYs attributable to lead exposure among children and adolescents in Asia decreased from 1.11 million (95% uncertainty interval [UI]: 0.48-1.96 million) in 1990 to 0.82 million (95% uncertainty interval: 0.36-1.49 million) in 2021, which was primarily driven by epidemiologic changes. Females and the 10-14-year age group faced the highest risk. Lower-SDI regions, especially South Asia, bore a disproportionately higher burden, with absolute health inequality narrowing but relative inequality remaining prevalent between 1990 and 2021. Projections to 2035 showed a continued decline in disease burden in India and Pakistan, in contrast to rising in Afghanistan and Yemen.ConclusionsThis study underscored the critical need to strengthen targeted lead exposure interventions addressing gender, age, and regional disparities.