Global level
In 2019, there were approximately 0.97 million ACOP incidence cases (95% UI 0.66 million to 1.4 million). In 2019, the age-standardized incidence rate (ASIR) was 13.05/100,000 (95% UI 8.84 to 18.69), and the EAPC was − 0.53% (95%CI -0.67% to -0.40%, p < 0.01) between 1990 and 2019(table 1 and Fig. 1). There were approximately 0.92 million prevalence cases (95% UI 0.74 million to 1.17 million) of ACOP, and the age-standardized prevalence rate (ASPR) per 100,000 population was 11.50 (95% UI 9.23 to 14.64). The EAPC of ASPR from 1990 to 2019 is estimated to be -0.35% (95% UI -0.55 to -0.15, p < 0.01). Over the past 30 years, the ASR YLDs of ACOP (-0.41%, 95% UI -0.65% to -0.17%) has remained steady, while the age-standardized rate of deaths, prevalence, DALYs and YLLs had significantly decreased, with their EAPC respectively to be -1.95% (95% CI -2.26% to -1.64%, p < 0.01), -0.35% (95% CI -0.55% to -0.15%, p < 0.01), -2.24% (95% CI to -2.52% to -1.96%, p < 0.01), -2.30% (95% CI -2.60% to -2.01%, p < 0.01).
Regional level
Regionally, the highest ASIR of ACOP per 100,000 people in 2019 occurred in Eastern Europe (52.24 (95%UI 35.30 to 72.05)), Central Europe (48.04 (95%UI 30.81 to 70.20)) and Central Asia (34.28 (95%UI 22.88 to 49.55). The lowest is Central sub-Africa (4.71 (95%UI 3.05 to 6.98), Tropical Latin America 5.26 (95%UI 2.22 to 9.44), and Western Sub-Africa (5.48 (95%UI 3.51 to 8.03).
From 1990 to 2019, The ASIR EAPC of East Asia was the highest, 1.37% (95%CI 1.13%-1.60%, p < 0.01). The ASPR EAPC of Southern Latin America was the highest, 1.13% (95%CI 0.98%-1.28%, p < 0.01), while Tropical Latin America had the lowest ASPR EAPC. It was − 1.76% (95%CI 2.58% to -0.93%, p < 0.01). From 1990 to 2019, EAPC in ASIR and ASPR indicated a downward trend in most regions (Table 1, Fig. 2).
In general, in the past 30 years, every 100,000 population in the most regions of ASDR DALY ratio decreased, and Central Europe (-4.51% (95% CI, -4.71% to -4.31%, p < 0.01) had the biggest drop, while Andean Latin America has risen trend (1.15% (95% CI 0.75–1.55%, p < 0.01)). For the EAPC of DALY, Andean Latin America remains the highest (0.92% (95% CI 0.54–1.3%, p < 0.01)), while Central Europe is the lowest (-4.45% (95%CI -4.66% to -4.23%, p < 0.01)) (Table 2).
For EAPC of ASR YLDs, Southern Latin America was the highest (1.13% (95%CI 0.97–1.29%, p < 0.01) and Tropical Latin America was the lowest (-1.89% (95%CI -2.71–1.07%, p < 0.01)). For EAPC of ASR YLLs, Andean Latin America was the highest (0.96% (95%CI 0.52–1.41%, p < 0.01)) and Central Europe was the lowest (-4.79% (95%CI -5.02–4.55%, p < 0.01)) (Table 3).
Table 3
The number, age-standardized rate (ASR), and estimated annual percentage change (EAPC) of accidental carbon monoxide poisoning YLDs and YLLs in 2019.
| Prevalence | Incidence |
Number,2019 (95%UI) | ASR/10000 2019(95%UI) | EAPC(%) (95%CI) | p | Number,2019 (95%UI) | ASR/10000 2019(95%UI) | EAPC(%) (95%CI) | p |
Global | 922323·64 ( 742036·25 to 1170319·04 ) | 11·5 ( 9·23 to 14·64 ) | -0·35 ( -0·55 to -0·15 ) | < 0·01 | 973600·97 ( 664806·26 to 1398273·55 ) | 13·05 ( 8·84 to 18·69 ) | -0·53 ( -0·67 to -0·4 ) | < 0·01 |
Sex | | | | | | | | |
Males | 462665·81 ( 375240·17 to 579780·13 ) | 11·64 ( 9·43 to 14·6 ) | -0·21 ( -0·39 to -0·03 ) | < 0·01 | 462046·48 ( 317765·85 to 653759·31 ) | 12·19 ( 8·33 to 17·27 ) | -0·58 ( -0·67 to -0·49 ) | < 0·01 |
Females | 459657·83 ( 368937·21 to 589512·88 ) | 11·34 ( 9·08 to 14·6 ) | -0·47 ( -0·7 to -0·25 ) | < 0·01 | 511554·49 ( 345044·53 to 740756·12 ) | 13·93 ( 9·38 to 20·16 ) | -0·49 ( -0·67 to -0·31 ) | < 0·01 |
Social-demographic index | | | | | | | | |
Low SDI | 56441·03 ( 42476·34 to 76471·07 ) | 5·52 ( 4·22 to 7·4 ) | 0·06 ( -0·15 to 0·26 ) | 0·818335 | 74998·84 ( 45881·55 to 114061·69 ) | 5·09 ( 3·27 to 7·57 ) | 0·14 ( -0·07 to 0·35 ) | 0·533126 |
Low-middle SDI | 129622·66 ( 101301·08 to 172020·03 ) | 7·5 ( 5·87 to 9·92 ) | 0·22 ( -0·05 to 0·48 ) | 0·345423 | 145342·43 ( 91206·58 to 219097·84 ) | 7·72 ( 4·94 to 11·5 ) | 0·18 ( -0·08 to 0·44 ) | 0·50128 |
Middle SDI | 254783·04 ( 203469·91 to 325467·88 ) | 10·08 ( 8·04 to 12·92 ) | 0·07 ( -0·15 to 0·29 ) | 0·728868 | 257925·31 ( 171880·61 to 374220·63 ) | 11·68 ( 7·72 to 16·96 ) | 0·31 ( 0·1 to 0·52 ) | 0·062847 |
High-middle SDI | 281024·46 ( 231221·76 to 347442·08 ) | 16·98 ( 13·86 to 21·38 ) | -0·47 ( -0·6 to -0·34 ) | < 0·01 | 284561·96 ( 194703·97 to 390357·35 ) | 23·78 ( 16·18 to 33·39 ) | -0·64 ( -0·72 to -0·57 ) | < 0·01 |
High SDI | 200045·38 ( 162484·83 to 246866·26 ) | 16·71 ( 13·45 to 21·09 ) | -0·05 ( -0·45 to 0·36 ) | 0·364601 | 193993·19 ( 129477·46 to 280161·92 ) | 24·39 ( 15·75 to 36·34 ) | 0·05 ( -0·39 to 0·48 ) | 0·620337 |
Region | | | | | | | | |
Central Asia | 23164·5 ( 18267·2 to 30072·68 ) | 25·15 ( 19·88 to 32·56 ) | 0·67 ( 0·48 to 0·86 ) | < 0·01 | 32765·52 ( 21923·76 to 46985·2 ) | 34·28 ( 22·88 to 49·55 ) | 0·33 ( 0·19 to 0·48 ) | 0·031405 |
Central Europe | 41254·86 ( 33405·76 to 52526·77 ) | 30·88 ( 24·74 to 39·97 ) | 0·35 ( 0·1 to 0·6 ) | 0·143983 | 38551·08 ( 25716·24 to 54472·4 ) | 48·04 ( 30·81 to 70·2 ) | 0·17 ( -0·04 to 0·39 ) | 0·90581 |
Eastern Europe | 71121·4 ( 58918·33 to 85056·55 ) | 27·94 ( 23·08 to 33·84 ) | -1·1 ( -1·35 to -0·84 ) | < 0·01 | 91658·53 ( 63871·52 to 122143·29 ) | 52·24 ( 35·3 to 72·05 ) | -1·32 ( -1·71 to -0·92 ) | < 0·01 |
Australasia | 3382·79 ( 2760·64 to 4166·04 ) | 10·1 ( 8·13 to 12·63 ) | -0·01 ( -0·16 to 0·14 ) | 0·111542 | 4104·83 ( 2774·19 to 5960·68 ) | 16·84 ( 11·02 to 24·72 ) | 0·02 ( -0·11 to 0·15 ) | 0·065405 |
High-income Asia Pacific | 50746·4 ( 40753·69 to 64622·61 ) | 22·64 ( 17·88 to 29·48 ) | -0·39 ( -0·69 to -0·09 ) | < 0·01 | 36807·88 ( 24718·69 to 52984·87 ) | 30·84 ( 19·67 to 46·18 ) | -0·3 ( -0·61 to 0·02 ) | < 0·01 |
High-income North America | 68451·36 ( 55810·12 to 83211·6 ) | 16·15 ( 13·08 to 19·86 ) | 0·04 ( -0·92 to 1 ) | 0·847404 | 80268·54 ( 51276·39 to 117876·33 ) | 25·93 ( 16·18 to 39·22 ) | 0·49 ( -0·44 to 1·43 ) | 0·463889 |
Southern Latin America | 11430·57 ( 9158·96 to 14559·89 ) | 16·17 ( 12·89 to 20·7 ) | 1·13 ( 0·98 to 1·28 ) | < 0·01 | 14061·36 ( 9039·23 to 20785·28 ) | 23·47 ( 15·01 to 34·4 ) | 0·99 ( 0·86 to 1·12 ) | < 0·01 |
Western Europe | 67968·41 ( 55474·8 to 84013·25 ) | 13·08 ( 10·49 to 16·54 ) | -0·06 ( -0·22 to 0·09 ) | 0·017371 | 66669·19 ( 45352·1 to 95423·42 ) | 19·89 ( 12·86 to 29·47 ) | -0·08 ( -0·25 to 0·1 ) | 0·01312 |
Andean latin america | 3963·26 ( 3069·1 to 5224·04 ) | 6·28 ( 4·87 to 8·26 ) | 0·88 ( 0·79 to 0·98 ) | < 0·01 | 5335·13 ( 3251·31 to 8168·51 ) | 8·23 ( 5·02 to 12·62 ) | 1·14 ( 1·03 to 1·25 ) | < 0·01 |
Caribbean | 5816·57 ( 4550·81 to 7552·64 ) | 11·96 ( 9·35 to 15·57 ) | 0·72 ( 0·61 to 0·84 ) | < 0·01 | 5518·68 ( 3530·06 to 8211·54 ) | 12·5 ( 7·92 to 18·71 ) | 0·61 ( 0·49 to 0·73 ) | < 0·01 |
Central Latin America | 25938·39 ( 19776·33 to 34741·82 ) | 10·22 ( 7·8 to 13·69 ) | -0·09 ( -0·28 to 0·09 ) | 0·032122 | 31837·32 ( 17407·81 to 52006·13 ) | 13·02 ( 7·08 to 21·32 ) | 0·14 ( -0·05 to 0·33 ) | 0·876803 |
Tropical Latin America | 8719·93 ( 6850·5 to 10919·45 ) | 3·65 ( 2·86 to 4·6 ) | -1·76 ( -2·58 to -0·93 ) | < 0·01 | 11137·53 ( 4872·43 to 19526·48 ) | 5·26 ( 2·22 to 9·44 ) | -1·54 ( -2·35 to -0·73 ) | < 0·01 |
North Africa and Middle East | 50519·3 ( 39214·24 to 66447·61 ) | 8·42 ( 6·57 to 11·03 ) | -0·08 ( -0·25 to 0·09 ) | 0·034172 | 63975·69 ( 41589·07 to 93104·13 ) | 10·06 ( 6·58 to 14·65 ) | 0·13 ( 0 to 0·26 ) | 0·782643 |
South Asia | 111627·97 ( 85395·87 to 149407·07 ) | 6·23 ( 4·78 to 8·3 ) | 0·13 ( -0·16 to 0·41 ) | 0·753686 | 119073·18 ( 69912·1 to 189141·11 ) | 6·19 ( 3·71 to 9·77 ) | 0·19 ( -0·09 to 0·48 ) | 0·428334 |
East Asia | 276936·06 ( 224595·08 to 343544·28 ) | 16·3 ( 13·22 to 20·29 ) | 0·82 ( 0·55 to 1·1 ) | < 0·01 | 245933·41 ( 169852·04 to 335131·87 ) | 21·53 ( 14·86 to 29·62 ) | 1·37 ( 1·13 to 1·6 ) | < 0·01 |
Oceania | 575·45 ( 444·65 to 765·34 ) | 4·79 ( 3·72 to 6·32 ) | 0·28 ( 0·19 to 0·37 ) | < 0·01 | 970·39 ( 595·12 to 1458·2 ) | 6·34 ( 3·92 to 9·51 ) | 0·3 ( 0·21 to 0·38 ) | < 0·01 |
Southeast asia | 40246·5 ( 30727·03 to 53725·62 ) | 5·82 ( 4·44 to 7·78 ) | 0·14 ( -0·08 to 0·37 ) | 0·579501 | 46792·81 ( 28370·83 to 73213·05 ) | 7·22 ( 4·37 to 11·31 ) | 0·29 ( 0·03 to 0·55 ) | 0·133507 |
Central Sub-Saharan Africa | 5976·22 ( 4506·81 to 8113·07 ) | 5·08 ( 3·87 to 6·81 ) | -0·06 ( -0·29 to 0·17 ) | 0·238808 | 8076·04 ( 4971·28 to 12325·55 ) | 4·71 ( 3·05 to 6·98 ) | 0·12 ( -0·08 to 0·32 ) | 0·607337 |
Eastern Sub-Saharan Africa | 21919·55 ( 16295·79 to 29812·57 ) | 5·97 ( 4·5 to 8 ) | 0·08 ( -0·17 to 0·33 ) | 0·976247 | 31149·36 ( 18905·31 to 48066·13 ) | 5·8 ( 3·77 to 8·62 ) | 0·05 ( -0·17 to 0·27 ) | 0·783346 |
Southern sub-Saharan Africa | 6077·21 ( 4473·92 to 8401·46 ) | 7·83 ( 5·77 to 10·81 ) | -0·21 ( -0·45 to 0·02 ) | 0·012179 | 4973·62 ( 2817·93 to 8083·37 ) | 5·98 ( 3·4 to 9·71 ) | -0·45 ( -0·68 to -0·21 ) | < 0·01 |
Western Sub-Saharan Africa | 26486·96 ( 19673·46 to 36244·01 ) | 6·45 ( 4·85 to 8·74 ) | 0 ( -0·16 to 0·16 ) | 0·261051 | 33940·91 ( 20708·39 to 50765·22 ) | 5·48 ( 3·51 to 8·03 ) | 0·03 ( -0·14 to 0·19 ) | 0·49903 |
| Deaths | DALYs (Disability-Adjusted Life Years) |
Number,2019 (95%UI) | ASR/10000 2019(95%UI) | EAPC(%) (95%CI) | p | Number,2019 (95%UI) | ASR/10000 2019(95%UI) | EAPC(%) (95%CI) | p |
Global | 41142·25 ( 32957·28 to 45934·81 ) | 0·52 ( 0·41 to 0·58 ) | -1·95 ( -2·26 to -1·64 ) | < 0·01 | 1838312·36 ( 1465241·82 to 2101515·48 ) | 23·48 ( 18·62 to 27·21 ) | -2·24 ( -2·52 to -1·96 ) | < 0·01 |
Sex | | | | | | | | |
Males | 27175·24 ( 20084·98 to 31351·35 ) | 0·69 ( 0·51 to 0·8 ) | -2·07 ( -2·41 to -1·73 ) | < 0·01 | 1214806·63 ( 905559·66 to 1418200·91 ) | 30·73 ( 22·8 to 36·07 ) | -2·3 ( -2·61 to -1·99 ) | < 0·01 |
Females | 13967·01 ( 10557·59 to 16588·96 ) | 0·34 ( 0·26 to 0·41 ) | -1·67 ( -1·93 to -1·4 ) | < 0·01 | 623505·73 ( 467640·64 to 756551·35 ) | 16·26 ( 12·05 to 20·06 ) | -2·11 ( -2·34 to -1·88 ) | < 0·01 |
Social-demographic index | | | | | | | | |
Low SDI | 5803·72 ( 4257·49 to 8729·12 ) | 0·78 ( 0·61 to 1·09 ) | -0·44 ( -0·57 to -0·32 ) | < 0·01 | 297032·81 ( 207365·9 to 487139·84 ) | 30·01 ( 22·21 to 45·19 ) | -0·5 ( -0·6 to -0·39 ) | < 0·01 |
Low-middle SDI | 5829·64 ( 4300·41 to 6986·47 ) | 0·36 ( 0·27 to 0·43 ) | -1·13 ( -1·27 to -0·99 ) | < 0·01 | 307899·7 ( 220124·23 to 378175·4 ) | 17·42 ( 12·54 to 21·44 ) | -1·41 ( -1·52 to -1·3 ) | < 0·01 |
Middle SDI | 11888·67 ( 8321·58 to 13842·99 ) | 0·5 ( 0·35 to 0·58 ) | -0·86 ( -1·14 to -0·58 ) | < 0·01 | 508553·26 ( 369387·51 to 581799·46 ) | 21·05 ( 15·27 to 23·97 ) | -1·85 ( -2·07 to -1·64 ) | < 0·01 |
High-middle SDI | 15065·98 ( 13067·69 to 16569·59 ) | 0·87 ( 0·76 to 0·95 ) | -3·01 ( -3·56 to -2·47 ) | < 0·01 | 604689·84 ( 534668·88 to 660767·45 ) | 39·08 ( 34·61 to 42·67 ) | -3·16 ( -3·68 to -2·64 ) | < 0·01 |
High SDI | 2543·52 ( 2379·91 to 2716·92 ) | 0·21 ( 0·2 to 0·22 ) | -1·46 ( -1·71 to -1·22 ) | < 0·01 | 119555·85 ( 109896·44 to 130171·01 ) | 11·44 ( 10·52 to 12·46 ) | -1·48 ( -1·76 to -1·2 ) | < 0·01 |
Region | | | | | | | | |
Central Asia | 1123·54 ( 985·39 to 1310·46 ) | 1·23 ( 1·09 to 1·43 ) | -2·64 ( -2·96 to -2·32 ) | < 0·01 | 54866·17 ( 48212·71 to 63980·56 ) | 57·15 ( 50·34 to 66·69 ) | -2·85 ( -3·15 to -2·54 ) | < 0·01 |
Central Europe | 746·24 ( 653·62 to 840·52 ) | 0·48 ( 0·42 to 0·54 ) | -4·51 ( -4·71 to -4·31 ) | < 0·01 | 28320·93 ( 24632·69 to 32107·24 ) | 22·63 ( 19·77 to 25·7 ) | -4·45 ( -4·66 to -4·23 ) | < 0·01 |
Eastern Europe | 7789·55 ( 6900·89 to 8732·97 ) | 2·98 ( 2·64 to 3·33 ) | -2·79 ( -3·64 to -1·94 ) | < 0·01 | 314927·07 ( 278424·43 to 351729·93 ) | 136·49 ( 121·29 to 151·85 ) | -2·85 ( -3·67 to -2·01 ) | < 0·01 |
Australasia | 27·05 ( 23·73 to 30·08 ) | 0·09 ( 0·08 to 0·1 ) | -1·84 ( -2·44 to -1·24 ) | < 0·01 | 1539·7 ( 1345·12 to 1753·64 ) | 5·47 ( 4·77 to 6·21 ) | -1·79 ( -2·3 to -1·27 ) | < 0·01 |
High-income Asia Pacific | 343·84 ( 312·13 to 419·98 ) | 0·14 ( 0·13 to 0·18 ) | -3·68 ( -4·18 to -3·17 ) | < 0·01 | 16761·45 ( 14539·01 to 20683·91 ) | 8·33 ( 7·22 to 10·46 ) | -3·75 ( -4·31 to -3·19 ) | < 0·01 |
High-income North America | 1132·91 ( 1044·02 to 1177·75 ) | 0·27 ( 0·25 to 0·29 ) | 0·68 ( 0·41 to 0·94 ) | < 0·01 | 53408·69 ( 48436·7 to 56963·48 ) | 14·59 ( 13·22 to 15·55 ) | 0·54 ( 0·25 to 0·84 ) | < 0·01 |
Southern Latin America | 275·09 ( 247·09 to 297·51 ) | 0·39 ( 0·34 to 0·42 ) | 0·71 ( 0·13 to 1·29 ) | 0·013336 | 13485·2 ( 12005·13 to 14864·56 ) | 20·53 ( 18·11 to 22·84 ) | 0·71 ( 0·12 to 1·29 ) | 0·064088 |
Western Europe | 536·08 ( 502·19 to 564·36 ) | 0·09 ( 0·09 to 0·1 ) | -2·88 ( -3·11 to -2·65 ) | < 0·01 | 24250·22 ( 21820·32 to 27273·28 ) | 5·37 ( 4·84 to 6·02 ) | -2·65 ( -2·89 to -2·42 ) | < 0·01 |
Andean latin america | 48·4 ( 21·5 to 67·39 ) | 0·08 ( 0·03 to 0·11 ) | 1·15 ( 0·75 to 1·55 ) | < 0·01 | 2840·9 ( 1454·58 to 3871·46 ) | 4·41 ( 2·27 to 6·01 ) | 0·92 ( 0·54 to 1·3 ) | < 0·01 |
Caribbean | 78·45 ( 50·66 to 180·73 ) | 0·17 ( 0·11 to 0·38 ) | -1·35 ( -1·85 to -0·85 ) | < 0·01 | 5098·88 ( 3320·1 to 10381·98 ) | 11·22 ( 7·19 to 22·49 ) | -1·13 ( -1·62 to -0·63 ) | < 0·01 |
Central Latin America | 356·64 ( 306·57 to 411·51 ) | 0·14 ( 0·12 to 0·17 ) | -2·2 ( -2·34 to -2·07 ) | < 0·01 | 19827·76 ( 16888·59 to 22841·23 ) | 7·88 ( 6·7 to 9·07 ) | -2·33 ( -2·47 to -2·18 ) | < 0·01 |
Tropical Latin America | 74·63 ( 66·86 to 79·77 ) | 0·03 ( 0·03 to 0·03 ) | -1·77 ( -2·04 to -1·49 ) | < 0·01 | 4396·01 ( 3871·12 to 4892·24 ) | 1·94 ( 1·71 to 2·16 ) | -1·9 ( -2·23 to -1·57 ) | < 0·01 |
North Africa and Middle East | 2817·76 ( 1870·27 to 3629·5 ) | 0·49 ( 0·33 to 0·64 ) | -1·75 ( -1·79 to -1·71 ) | < 0·01 | 151154·95 ( 103138·9 to 197021·54 ) | 24·26 ( 16·49 to 31·69 ) | -2·16 ( -2·24 to -2·09 ) | < 0·01 |
South Asia | 3630·48 ( 2431·02 to 4480·31 ) | 0·21 ( 0·14 to 0·26 ) | -1·46 ( -1·63 to -1·3 ) | < 0·01 | 221525·84 ( 144912·35 to 277969·55 ) | 11·86 ( 7·74 to 14·82 ) | -1·32 ( -1·47 to -1·17 ) | < 0·01 |
East Asia | 15312·93 ( 10191·08 to 18394·32 ) | 0·92 ( 0·62 to 1·09 ) | -0·45 ( -0·78 to -0·11 ) | 0·010381 | 590208·67 ( 403810·1 to 699317·92 ) | 40·33 ( 28·37 to 46·97 ) | -1·41 ( -1·7 to -1·12 ) | < 0·01 |
Oceania | 30·22 ( 20·6 to 45·96 ) | 0·27 ( 0·18 to 0·4 ) | 0·71 ( 0·51 to 0·91 ) | < 0·01 | 1691 ( 1175·63 to 2688·98 ) | 12·96 ( 9·1 to 19·56 ) | 0·75 ( 0·55 to 0·95 ) | < 0·01 |
Southeast asia | 660·58 ( 460·9 to 969·92 ) | 0·1 ( 0·07 to 0·15 ) | -2·74 ( -2·96 to -2·53 ) | < 0·01 | 37391·74 ( 27185·14 to 50990·18 ) | 5·55 ( 4·05 to 7·6 ) | -2·6 ( -2·78 to -2·42 ) | < 0·01 |
Central Sub-Saharan Africa | 817·7 ( 525·64 to 1386·48 ) | 1·14 ( 0·79 to 1·79 ) | 0·26 ( 0·05 to 0·47 ) | 0·01973 | 37549·82 ( 22871·74 to 69948·58 ) | 38·65 ( 25·29 to 65·12 ) | 0·28 ( 0·06 to 0·5 ) | 0·372917 |
Eastern Sub-Saharan Africa | 2968·84 ( 2283·8 to 4043·54 ) | 1·46 ( 1·16 to 1·9 ) | -0·08 ( -0·22 to 0·05 ) | 0·129063 | 126966·92 ( 93341·56 to 184836·53 ) | 44·79 ( 34·72 to 60·81 ) | -0·18 ( -0·31 to -0·05 ) | < 0·01 |
Southern sub-Saharan Africa | 294·31 ( 182·25 to 388·25 ) | 0·37 ( 0·23 to 0·49 ) | -1·34 ( -1·69 to -0·99 ) | < 0·01 | 18506·08 ( 11421·27 to 24938·55 ) | 22·5 ( 13·86 to 30·29 ) | -1·2 ( -1·46 to -0·94 ) | < 0·01 |
Western Sub-Saharan Africa | 2077·02 ( 1393·93 to 3659·5 ) | 0·71 ( 0·51 to 1·12 ) | -0·39 ( -0·47 to -0·31 ) | < 0·01 | 113594·37 ( 72442·68 to 215831·72 ) | 27·49 ( 18·82 to 47·33 ) | -0·4 ( -0·46 to -0·33 ) | < 0·01 |
| YLDs (Years Lived with Disability) | YLLs (Years of Life Lost) |
Number,2019 (95%UI) | ASR/10000 2019(95%UI) | EAPC(%) (95%CI) | p | Number,2019 (95%UI) | ASR/10000 2019(95%UI) | EAPC(%) (95%CI) | p |
Global | 82847·33 ( 50525·7 to 127161·37 ) | 1·04 ( 0·64 to 1·6 ) | -0·41 ( -0·65 to -0·17 ) | < 0·01 | 1755465·03 ( 1383510·25 to 2023273·65 ) | 22·43 ( 17·57 to 26·07 ) | -2·3 ( -2·6 to -2·01 ) | < 0·01 |
Sex | | | | | | | | |
Males | 40502·21 ( 24825·57 to 61912·64 ) | 1·02 ( 0·63 to 1·57 ) | -0·24 ( -0·46 to -0·01 ) | 0·046163 | 1174304·42 ( 865604·25 to 1376430·25 ) | 29·71 ( 21·75 to 34·96 ) | -2·35 ( -2·67 to -2·03 ) | < 0·01 |
Females | 42345·12 ( 25785·06 to 65428·1 ) | 1·06 ( 0·65 to 1·64 ) | -0·56 ( -0·81 to -0·31 ) | < 0·01 | 581160·61 ( 425013·78 to 714973·52 ) | 15·19 ( 10·99 to 19·01 ) | -2·19 ( -2·44 to -1·93 ) | < 0·01 |
Social-demographic index | | | | | | | | |
Low SDI | 6621·59 ( 3951·28 to 10227·88 ) | 0·62 ( 0·37 to 0·96 ) | 0·02 ( -0·19 to 0·22 ) | 0·659252 | 290411·22 ( 201640·94 to 481338·88 ) | 29·39 ( 21·42 to 44·47 ) | -0·5 ( -0·62 to -0·39 ) | < 0·01 |
Low-middle SDI | 13860·52 ( 8352·19 to 21421·32 ) | 0·79 ( 0·48 to 1·21 ) | 0·08 ( -0·18 to 0·35 ) | 0·444437 | 294039·18 ( 206617·51 to 365222·18 ) | 16·63 ( 11·75 to 20·54 ) | -1·46 ( -1·58 to -1·34 ) | < 0·01 |
Middle SDI | 23206·35 ( 14039·17 to 35958·36 ) | 0·93 ( 0·56 to 1·45 ) | -0·19 ( -0·43 to 0·05 ) | 0·13847 | 485346·91 ( 339068·71 to 559933·06 ) | 20·12 ( 14·16 to 23·1 ) | -1·91 ( -2·14 to -1·68 ) | < 0·01 |
High-middle SDI | 23118·61 ( 14378·29 to 34786·44 ) | 1·47 ( 0·91 to 2·24 ) | -0·4 ( -0·61 to -0·2 ) | < 0·01 | 581571·23 ( 511410·52 to 636754·53 ) | 37·61 ( 33·25 to 41·02 ) | -3·23 ( -3·76 to -2·69 ) | < 0·01 |
High SDI | 15998·68 ( 9715·21 to 24321·83 ) | 1·44 ( 0·87 to 2·23 ) | -0·26 ( -0·66 to 0·14 ) | 0·167053 | 103557·17 ( 96512·1 to 111123·38 ) | 10 ( 9·32 to 10·73 ) | -1·61 ( -1·89 to -1·34 ) | < 0·01 |
Region | | | | | | | | < 0·01 |
Central Asia | 2310·9 ( 1432·33 to 3584·99 ) | 2·48 ( 1·54 to 3·84 ) | 0·77 ( 0·55 to 1 ) | < 0·01 | 52555·27 ( 46097·2 to 61782·34 ) | 54·67 ( 48·02 to 64·03 ) | -2·94 ( -3·26 to -2·62 ) | 0·091961 |
Central Europe | 3531·7 ( 2196·12 to 5359·3 ) | 2·82 ( 1·73 to 4·31 ) | 0·36 ( 0·08 to 0·63 ) | 0·029857 | 24789·24 ( 21667·1 to 28025·65 ) | 19·81 ( 17·36 to 22·4 ) | -4·79 ( -5·02 to -4·55 ) | < 0·01 |
Eastern Europe | 5165·76 ( 3326·04 to 7482·82 ) | 2·18 ( 1·4 to 3·19 ) | -1·02 ( -1·18 to -0·85 ) | < 0·01 | 309761·31 ( 274001·57 to 346597·64 ) | 134·31 ( 119·12 to 149·76 ) | -2·87 ( -3·7 to -2·03 ) | < 0·01 |
Australasia | 271·6 ( 168·32 to 405·95 ) | 0·86 ( 0·53 to 1·3 ) | -0·02 ( -0·19 to 0·14 ) | 0·875996 | 1268·1 ( 1100·47 to 1424·83 ) | 4·6 ( 4 to 5·2 ) | -2·03 ( -2·62 to -1·44 ) | < 0·01 |
High-income Asia Pacific | 4391·79 ( 2645·27 to 6802·78 ) | 2·13 ( 1·26 to 3·34 ) | -0·53 ( -0·87 to -0·19 ) | < 0·01 | 12369·66 ( 11360·49 to 15934·7 ) | 6·19 ( 5·69 to 8·31 ) | -4·37 ( -4·95 to -3·78 ) | < 0·01 |
High-income North America | 4696·52 ( 2891·46 to 7131·11 ) | 1·19 ( 0·72 to 1·84 ) | -0·57 ( -1·57 to 0·44 ) | 0·258699 | 48712·16 ( 44573·74 to 50726·17 ) | 13·4 ( 12·24 to 13·97 ) | 0·64 ( 0·34 to 0·93 ) | < 0·01 |
Southern Latin America | 1079·73 ( 657·79 to 1628·84 ) | 1·56 ( 0·95 to 2·35 ) | 1·13 ( 0·97 to 1·29 ) | < 0·01 | 12405·47 ( 10936·64 to 13649·48 ) | 18·97 ( 16·57 to 21·1 ) | 0·68 ( 0·06 to 1·3 ) | < 0·01 |
Western Europe | 5672·78 ( 3513·32 to 8539·22 ) | 1·19 ( 0·72 to 1·81 ) | -0·06 ( -0·2 to 0·09 ) | 0·384482 | 18577·44 ( 17597·25 to 19417·17 ) | 4·18 ( 3·93 to 4·38 ) | -3·14 ( -3·37 to -2·91 ) | < 0·01 |
Andean latin america | 410·22 ( 249·75 to 642·98 ) | 0·65 ( 0·39 to 1·01 ) | 0·62 ( 0·53 to 0·71 ) | < 0·01 | 2430·68 ( 1057·08 to 3442·1 ) | 3·76 ( 1·63 to 5·31 ) | 0·96 ( 0·52 to 1·41 ) | < 0·01 |
Caribbean | 617·76 ( 371·92 to 952·93 ) | 1·28 ( 0·77 to 1·98 ) | 0·72 ( 0·62 to 0·82 ) | < 0·01 | 4481·12 ( 2745·33 to 9764·7 ) | 9·94 ( 5·96 to 21·22 ) | -1·31 ( -1·84 to -0·78 ) | < 0·01 |
Central Latin America | 2502·9 ( 1442·42 to 3980·68 ) | 0·99 ( 0·57 to 1·56 ) | -0·23 ( -0·41 to -0·05 ) | 0·014928 | 17324·86 ( 14803·01 to 19996·7 ) | 6·9 ( 5·89 to 7·98 ) | -2·53 ( -2·68 to -2·39 ) | < 0·01 |
Tropical Latin America | 698·5 ( 415·42 to 1091·22 ) | 0·3 ( 0·18 to 0·47 ) | -1·89 ( -2·71 to -1·07 ) | < 0·01 | 3697·51 ( 3273·72 to 3979·54 ) | 1·65 ( 1·45 to 1·78 ) | -1·9 ( -2·17 to -1·62 ) | 0·356572 |
North Africa and Middle East | 5214·89 ( 3145·38 to 8045·32 ) | 0·86 ( 0·52 to 1·32 ) | -0·34 ( -0·53 to -0·14 ) | < 0·01 | 145940·06 ( 97657·19 to 191366·7 ) | 23·41 ( 15·61 to 30·66 ) | -2·21 ( -2·29 to -2·13 ) | < 0·01 |
South Asia | 12520·2 ( 7557·05 to 19284·35 ) | 0·69 ( 0·42 to 1·06 ) | -0·01 ( -0·29 to 0·27 ) | 0·907673 | 209005·64 ( 133048·89 to 266468·53 ) | 11·17 ( 7·1 to 14·2 ) | -1·38 ( -1·54 to -1·21 ) | < 0·01 |
East Asia | 22548·96 ( 13740·2 to 34229·89 ) | 1·41 ( 0·85 to 2·15 ) | 0·49 ( 0·18 to 0·8 ) | < 0·01 | 567659·71 ( 380308·5 to 677363·21 ) | 38·92 ( 26·95 to 45·57 ) | -1·45 ( -1·76 to -1·15 ) | < 0·01 |
Oceania | 60·85 ( 36·36 to 94·25 ) | 0·49 ( 0·29 to 0·75 ) | 0·24 ( 0·15 to 0·33 ) | < 0·01 | 1630·15 ( 1123·47 to 2628·78 ) | 12·48 ( 8·43 to 19·05 ) | 0·77 ( 0·56 to 0·98 ) | < 0·01 |
Southeast asia | 4054·51 ( 2366·15 to 6397·83 ) | 0·59 ( 0·34 to 0·92 ) | 0·04 ( -0·16 to 0·25 ) | 0·465955 | 33337·23 ( 23392·99 to 47143·92 ) | 4·96 ( 3·49 to 6·96 ) | -2·8 ( -2·99 to -2·61 ) | < 0·01 |
Central Sub-Saharan Africa | 742·83 ( 447·36 to 1144·25 ) | 0·6 ( 0·36 to 0·92 ) | -0·1 ( -0·34 to 0·14 ) | 0·561209 | 36806·98 ( 22022·36 to 69049·44 ) | 38·05 ( 24·57 to 64·49 ) | 0·29 ( 0·06 to 0·51 ) | < 0·01 |
Eastern Sub-Saharan Africa | 2560·84 ( 1507·94 to 4011·54 ) | 0·66 ( 0·39 to 1·04 ) | 0·08 ( -0·18 to 0·33 ) | 0·406205 | 124406·08 ( 90694·56 to 182067·89 ) | 44·13 ( 33·88 to 60·22 ) | -0·18 ( -0·32 to -0·05 ) | < 0·01 |
Southern sub-Saharan Africa | 710·34 ( 404·26 to 1110·54 ) | 0·91 ( 0·52 to 1·43 ) | -0·13 ( -0·38 to 0·12 ) | 0·326998 | 17795·74 ( 10768·61 to 24149·88 ) | 21·59 ( 13 to 29·39 ) | -1·24 ( -1·51 to -0·97 ) | < 0·01 |
Western Sub-Saharan Africa | 3083·76 ( 1794·94 to 4877·55 ) | 0·72 ( 0·42 to 1·13 ) | 0·02 ( -0·14 to 0·17 ) | 0·627087 | 110510·62 ( 69131·82 to 213219·14 ) | 26·78 ( 18·04 to 46·62 ) | -0·41 ( -0·48 to -0·34 ) | < 0·01 |
National and territorial level
In 2019, the three lowest ASIR countries were Pakistan (3.72, 95%UI 2.27 to 5.73), Bangladesh (3.87, 95%UI 2.33 to 5.97), and Central African Republic (3.93, 95%UI 2.63 to 5.67) respectively. The highest incidence rate of the three countries was Estonia (77.97, 95%UI 51.69 to109.40), Latvia (68.25, 45.13 to 97.70), and Lithuania (65.53, 95%UI 45.30 to 90) (Fig. 3A, Additional file 2 table 1).
The countries with the highest ASPR were Estonia (51.02 (95% UI 41.13 to 65.68)), Latvia (44.33 (95% UI 35.70 to 56.68)) and Lithuania (38.64 (95% UI 31.68 to 48.47)). The countries with the lowest ASPR were Pakistan (3.51 (95% UI 2.60 to 4.76)), Bangladesh (3.52 (95% UI 2.66 to 4.76)), and Brazil (3.65 (95% UI 2.86 to 4.60)).
The countries with the highest ASDR were Republic of Moldova (3.59 (95% UI 3.14 to 4.06)), Russian Federation (3.13 (95% UI 2.71 to 3.61)) and Belarus (2.71 (95% UI 1.92 to 3.62)) respectively. The lowest countries were Barbados (0.02 (95% UI 0.01 to 0.02)), Singapore (0.02 (95% UI 0.02 to 0.03)) and Suriname (0.03 (95% UI 0.02 to 0.04)) (Fig. 3B, Additional file 2 table 2).
The highest ASR of DALYs were Republic of Moldova (145.67 (95% UI 127.63 to 163.84)), Russian Federation (144.02 (95% UI 125.34 to 164.49)) and Ukraine (125.10 (95% UI 100.92 to 149.59)) respectively. The lowest three countries were Thailand (1.84 (95% UI 1.21 to 2.50)), Maldives (1.86 (95% UI 1.34 to 2.38)) and Brazil (1.92 (95% UI 1.68 to 2.13)).
All the data of national and territorial levels are in Additional file 2 Table 1–3. The ASR and EAPC of prevalence, deaths, DALYs, YLDs, and YLLs are listed in Additional file 2 Fig. 1–10.
Age and sex patterns
Compared to 1990 by age and SDI regions, in 2019, most of ACOP parameters were lower (Fig. 4). In 2019, whether it’s by age or SDI regions, ASPR, ASIR, ASDR, YLDs, and YLLs were higher in males (Fig. 2 & Fig. 5). ASPR, ASDR, and YLDs increased with age. However, ASIR showed a trend of increasing first and then decreasing, and its peak was about 15–19 years old, which was the same trend in males and females. For females, YLLs and DALYs also indicated a trend of increasing with age, while the males group peaked after 35–39 years old and maintained a high level, which was very different.
Risk factors
There are two risk factors listed in the database: alcohol use and occupational injury. In the past 30 years, occupational injury is the main risk of ACOP. By sexes, the risk of occupation the risk of males is higher than that of females (Fig. 6). The 30-year-trend of global deaths, DALYs, YLDs, and YLLs are listed in Fig. 7. The figure of different SDI regions (e.g., Low SDI, Low-middle SDI, Middle SDI, Middle-high SDI, High SDI) are listed in the Additional file 2 Fig. 11–15. Most of them are in line with the law.
As shown in Fig. 7, the two risks are similar in countries with different SDIs. By sexes, the pattern is similar to before. Males patients were more than female patients, and occupation injury accounted for a larger proportion than alcohol use.
ACOP and economic parameters
From Fig. 8A, Eastern Europe is the highest ACOP ASIR, ASDR, ASPR, DALYs, YLDs, and YLLs region. Central Europe, Central Asia, and High-income North America are highly in ASIR, ASDR, and YLDs.
While investigating at the national and territorial level, the results are clearer. On the whole, ASIR rises with the rise of SDI, while ASDR is the opposite, and falls with the rise of SDI (Fig. 9A&B). The ASR of prevalence and YLDs have the same trend as ASIR (Additional file 2 Fig. 20, 22). The ASR of DALYs and YLLs have the same trend as ASDR (Additional file 2 Fig. 21, 23). On a whole, in 2019, the countries with lower SDI have a lower ACOP morbidity, but higher mortality.
As shown in Fig. 10, the global level of ACOP parameters was nonlinear fitting with SDI from 1990 to 2019. We find that the nonlinear fittings between parameters are very significant. The figures of different SDI regions’ nonlinear fittings are list in Additional file 2 Fig. 24–28. Then we calculated the correlation coefficient and p-value between ACOP parameters and economic parameters (e.g., Australia coal price, CPI, GDP per capita (PPP), GNI per capita (PPP), SDI) by different periods. All data are listed in Additional file 3 and Additional file 4. The percentages of countries that are significantly related to these factors are counted in Fig. 11 and the specific data is listed in Additional file 2 table 4–5 and Fig. 29–30. Due to the turmoil in certain countries in the 1990s and the dramatic decline in global ACOP mortality around 2005, the data from 2010 to 2019 are considered more stable and representative. We take ASIR and ASPR in 2010 to 2019 by SDI as an example to show the national and territorial level of correlation coefficients in Fig. 11 C, D. Most countries had the same trend in ASIR and ASDR in the past 10 years, and SDI is the most relevant economic parameter with ACOP.
From Additional file 3, there are only 14 countries in which ASIR and SDI are negatively correlated from 2010 to 2019 (Belarus, Belgium, Greenland, Iran, Islamic Rep., Kazakhstan, Lithuania, Moldova, Mongolia, Myanmar, Nepal, Pakistan, Romania, Russian Federation, Ukraine). (Belarus, Belgium, Greenland, Iran, Islamic Rep., Kazakhstan, Lithuania, Moldova, Mongolia, Myanmar, Nepal, Pakistan, Romania, Russian Federation, Ukraine). Among them, Belgium, Greenland, Iran, Islamic Rep., Kazakhstan, Pakistan, Russian Federation are significantly correlated (r ≥ 0.8 & p༜0.05). The remaining countries are positively correlated with SDI. For ASDR, the trend is the opposite. There are 12 countries in which ASDR and SDI are significantly positively correlated(r ≥ 0.8 & p༜0.05) from 2010 to 2019 (Albania, Andorra, Bangladesh, Burkina Faso, Costa Rica, Dominica, Dominican Republic, Iceland, San Marino, Suriname, Venezuela, RB, Zimbabwe).
For risk factors, there are 10 countries in which ASDR and SDI are significantly positively correlated from 2010 to 2019 by occupational injuries (Andorra, Austria, Dominican Republic, Estonia, Iceland, North America, Norway, Portugal, Solomon Islands, Somalia). And 14 countries in which ASR of DALYs and SDI are significantly positively correlated from 2010 to 2019 by occupational injuries (Andorra, Austria, Dominican Republic, Estonia, Iceland, Maldives, North America, Norway, Portugal, Slovenia, Solomon Islands, Somalia, St. Kitts and Nevis, Trinidad, and Tobago). More details such as sexes, different periods, and risk factors are listed in table s.
ACOP trend after excluding the influence of SDI
As ACOP parameters are highly correlated to SDI in most countries, SDI or the economic development behind it could affect the trend of ACOP. We use SDI as a confounding factor in multiple regression analysis. All the results are list in Additional file 5 and 6.
From Additional file 5, 143 countries have the growing trend of ASIR from 2010 to 2019, and 34 countries are significantly related to year (Afghanistan, Azerbaijan, Bahrain, Barbados, Belarus, Brazil, Burundi, Israel, Jordan, Kuwait, Lao PDR, Lebanon, Libya, Malaysia, Maldives, Mauritius, Moldova, Oman, Poland, Saudi Arabia, Sri Lanka, St. Lucia, Sudan, Timor-Leste, Turkey, Ukraine, United Arab Emirates, United Kingdom, Yemen, Rep., Bermuda, Niue, San Marino, Slovakia, Venezuela, RB). The data of ASDR are serious too. 100 countries have the growing trend of ASDR from 2010 to 2019, and 34 countries are significantly related to the year (Barbados, Cambodia, Denmark, Dominican Republic, Guinea, Jordan, Kiribati, Libya, Qatar, South Africa, Tajikistan, Yemen, Rep., American Samoa).
From Additional file 6, there are 99 countries in which had an increasing trend of ASDR from 2010 to 2019 by occupational injuries, and there are significantly related to the year in 13 countries (Australia, Belgium, China, Jordan, Nigeria, Poland, Serbia, Seychelles, Tajikistan, Timor-Leste, Yemen, Rep., Bermuda, Eritrea). For ASR of DALYs, 101 countries had the increasing trend, and 15 countries are statistically related to the year (Australia, Barbados, China, Finland, Hungary, Jordan, Nigeria, Poland, Serbia, Seychelles, Tajikistan, Timor-Leste, Yemen, Rep., Bermuda, Eritrea). More details such as sexes, different periods, and risk factors are listed in table s.