Abstract
Background: Asthma and atopic dermatitis are common allergic conditions that contribute to substantial health loss, economic burden, and pain across individuals of all ages worldwide. Therefore, as a component of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we present updated estimates of the prevalence, disability-adjusted life-years (DALYs), incidence, and deaths due to asthma and atopic dermatitis and the burden attributable to modifiable risk factors, with forecasted prevalence up to 2050. Methods: Asthma and atopic dermatitis prevalence, incidence, DALYs, and mortality, with corresponding 95% uncertainty intervals (UIs), were estimated for 204 countries and territories from 1990 to 2021. A systematic review identified data from 389 sources for asthma and 316 for atopic dermatitis, which were further pooled using the Bayesian meta-regression tool. We also described the age-standardised DALY rates of asthma attributable to four modifiable risk factors: high BMI, occupational asthmagens, smoking, and nitrogen dioxide pollution. Furthermore, as a secondary analysis, prevalence was forecasted to 2050 using the Socio-demographic Index (SDI), air pollution, and smoking as predictors for asthma and atopic dermatitis. To assess trends in the burden of asthma and atopic dermatitis before (2010–19) and during (2019–21) the COVID-19 pandemic, we compared their average annual percentage changes (AAPCs). Findings: In 2021, there were an estimated 260 million (95% UI 227–298) individuals with asthma and 129 million (124–134) individuals with atopic dermatitis worldwide. Asthma cases declined from 287 million (250–331) in 1990 to 238 million (209–272) in 2005 but increased to 260 million in 2021. Atopic dermatitis cases consistently rose from 107 million (103–112) in 1990 to 129 million (124–134) in 2021. However, age-standardised prevalence rates decreased—by 40·0% (from 5568·3 per 100 000 to 3340·1 per 100 000) for asthma and 8·3% (from 1885·4 per 100 000 to 1728·5 per 100 000) for atopic dermatitis. In 2021, there were substantial variations in the burden of asthma and atopic dermatitis across different SDI groups, with the highest age-standardised DALY rate found in south Asia for asthma (465·0 [357·2–648·9] per 100 000) and the high-income super-region for atopic dermatitis (3552·5 [3407·2–3706·1] per 100 000). During the COVID-19 pandemic, the decline in asthma prevalence had stagnated (AAPC pre-pandemic –1·39% [–2·07 to –0·71] and during the pandemic 0·47% [–1·86 to 2·79]; p=0·020); however, there was no significant difference in atopic dermatitis prevalence in the same period (pre-pandemic –0·28% [–0·33 to –0·22] and during the pandemic –0·35% [–0·78 to 0·08]; p=0·20). Modifiable risk factors were responsible for 29·9% of the global asthma DALY burden; among them, high BMI was the greatest contributor (39·4 [19·6–60·2] per 100 000), followed by occupational asthmagens (20·8 [16·7–26·5] per 100 000) across all regions. The age-standardised DALY rate of asthma attributable to high BMI was highest in high-SDI settings, whereas the contribution of occupational asthmagens was highest in low-SDI settings. According to our forecasting models, we expect 275 million (224–330) asthma cases and 148 million (140–158) atopic dermatitis cases in 2050, with population growth driving this increase. However, age-standardised prevalence rates are expected to remain stable (–23·2% [–44·4 to 5·3] for asthma and –1·4% [–9·1 to 7·0] for atopic dermatitis) from 2021 to 2050. Interpretation: Although the increases in the total number of asthma and atopic dermatitis cases will probably continue until 2050, age-standardised prevalence rates are expected to remain stable. A considerable portion of the global burden could be managed through efforts to address modifiable risk factors. Additionally, the contribution of risk factors to the burden substantially varied by SDI, which suggests the need for tailored initiatives for specific SDI settings. The growing number of individuals expected to be affected by asthma and atopic dermatitis in the future suggests that it is essential to improve our understanding of risk factors for asthma and atopic dermatitis and collect disease prevalence data that are globally generalisable. Funding: Gates Foundation.
| Original language | English |
|---|---|
| Pages (from-to) | 425-446 |
| Number of pages | 22 |
| Journal | The Lancet Respiratory Medicine |
| Volume | 13 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2025 |
Access to Document
Other files and links
Fingerprint
Dive into the research topics of 'Global, regional, and national burden of asthma and atopic dermatitis, 1990–2021, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021'. Together they form a unique fingerprint.Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: The Lancet Respiratory Medicine, Vol. 13, No. 5, 05.2025, p. 425-446.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Global, regional, and national burden of asthma and atopic dermatitis, 1990–2021, and projections to 2050
T2 - a systematic analysis of the Global Burden of Disease Study 2021
AU - Oh, Jiyeon
AU - Kim, Soeun
AU - Kim, Min Seo
AU - Abate, Yohannes Habtegiorgis
AU - Abd ElHafeez, Samar
AU - Abdelkader, Atef
AU - Abdi, Parsa
AU - Abdulah, Deldar Morad
AU - Aboagye, Richard Gyan
AU - Abolhassani, Hassan
AU - Abtahi, Dariush
AU - Abualruz, Hasan
AU - Abu-Gharbieh, Eman
AU - Aburuz, Salahdein
AU - Adane, Mesafint Molla
AU - Addo, Isaac Yeboah
AU - Adeleke, Olumide Thomas
AU - Aden, Bashir
AU - Adnani, Qorinah Estiningtyas Sakilah
AU - Adra, Saryia
AU - Afzal, Muhammad Sohail
AU - Ahmad, Sajjad
AU - Ahmad, Tauseef
AU - Ahmadi, Ali
AU - Ahmed, Syed Anees
AU - Al Awaidy, Salah
AU - Al Bakour, Mohamad Anas
AU - Alam, Khurshid
AU - Albashtawy, Mohammed
AU - Al-Eyadhy, Ayman
AU - Al-Gheethi, Adel Ali Saeed
AU - Alhalaiqa, Fadwa Naji
AU - Ali, Syed Shujait
AU - Ali, Waad
AU - Alif, Sheikh Mohammad
AU - Al-Jabi, Samah W.
AU - Alqahtani, Jaber S.
AU - AlQudah, Mohammad
AU - Alrawashdeh, Ahmad
AU - Alshahrani, Najim Z.
AU - Altaany, Zaid
AU - Altaf, Awais
AU - Al-Tammemi, Alaa B.
AU - Altirkawi, Khalid A.
AU - Alvis-Guzman, Nelson
AU - Alwafi, Hassan
AU - Al-Wardat, Mohammad
AU - Al-Worafi, Yaser Mohammed
AU - Aly, Hany
AU - Alyahya, Mohammad Sharif Ibrahim
AU - Alzoubi, Karem H.
AU - Amusa, Ganiyu Adeniyi
AU - Ansar, Adnan
AU - Anuoluwa, Boluwatife Stephen
AU - Anuoluwa, Iyadunni Adesola
AU - Anyasodor, Anayochukwu Edward
AU - Arabloo, Jalal
AU - Aravkin, Aleksandr Y.
AU - Areda, Demelash
AU - Asghari-Jafarabadi, Mohammad
AU - Ashraf, Tahira
AU - Athari, Seyyed Shamsadin
AU - Aujayeb, Avinash
AU - Ayana, Lemessa Assefa A.
AU - Aziz, Shahkaar
AU - Azzam, Ahmed Y.
AU - Barqawi, Hiba Jawdat
AU - Barrow, Amadou
AU - Bastan, Mohammad Mahdi
AU - Batra, Kavita
AU - Behera, Priyamadhaba
AU - Behzadi, Payam
AU - Bell, Michelle L.
AU - Beneke, Alice A.
AU - Berhie, Alemshet Yirga
AU - Beyene, Kebede A.
AU - Bhattacharjee, Priyadarshini
AU - Bhatti, Jasvinder Singh
AU - Bolarinwa, Obasanjo Afolabi
AU - Bouaoud, Souad
AU - Bustanji, Yasser
AU - Butt, Nadeem Shafique
AU - Camargos, Paulo
AU - Cámera, Luis Alberto
AU - Carugno, Andrea
AU - Cenderadewi, Muthia
AU - Cerrai, Sonia
AU - Chakraborty, Sandip
AU - Chan, Jeffrey Shi Kai
AU - Chandika, Rama Mohan
AU - Chattu, Vijay Kumar
AU - Chaudhary, Anis Ahmad
AU - Cheng, Esther T.W.
AU - Chichagi, Fatemeh
AU - Chimoriya, Ritesh
AU - Ching, Patrick R.
AU - Chirinos-Caceres, Jesus Lorenzo
AU - Chong, Yuen Yu
AU - Chopra, Hitesh
AU - Chu, Dinh Toi
AU - Corlateanu, Alexandru
AU - Cruz-Martins, Natalia
AU - da Silva, Alanna Gomes
AU - Dababo, Nour
AU - Dadras, Omid
AU - Dai, Xiaochen
AU - Damiani, Giovanni
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Dellavalle, Robert Paul
AU - Devanbu, Vinoth Gnana Chellaiyan
AU - Dhane, Amol S.
AU - Dharmaratne, Samath Dhamminda
AU - Dhulipala, Vishal R.
AU - Di Pumpo, Marcello
AU - Diaz, Michael J.
AU - Dima, Adriana
AU - Ding, Delaney D.
AU - Do, Thanh Chi
AU - Do, Thao Huynh Phuong
AU - Doshi, Ojas Prakashbhai
AU - Drucker, Aaron M.
AU - Durojaiye, Oyewole Christopher
AU - E'mar, Abdel Rahman
AU - Efendi, Defi
AU - Ekholuenetale, Michael
AU - Ekundayo, Temitope Cyrus
AU - El Arab, Rabie Adel
AU - El Bayoumy, Ibrahim Farahat
AU - El Meligy, Omar Abdelsadek Abdou
AU - Elagali, Ahmed Elabbas Mustafa
AU - Elhadi, Muhammed
AU - Elsohaby, Ibrahim
AU - Emeto, Theophilus I.
AU - Fagbamigbe, Adeniyi Francis
AU - Fahim, Ayesha
AU - Faiz, Razana
AU - Fakhradiyev, Ildar Ravisovich
AU - Fatehizadeh, Ali
AU - Fazeli, Pooria
AU - Fazylov, Timur
AU - Feizkhah, Alireza
AU - Ferreira, Nuno
AU - Fetensa, Getahun
AU - Fischer, Florian
AU - Fonzo, Marco
AU - Foroutan, Behzad
AU - Fukumoto, Takeshi
AU - Gaipov, Abduzhappar
AU - Gandhi, Aravind P.
AU - Gautam, Rupesh K.
AU - Gebregergis, Miglas Welay
AU - Gebrehiwot, Mesfin
AU - Gebremeskel, Teferi Gebru
AU - Getahun, Genanew K.
AU - Ghadirian, Fataneh
AU - Ghamari, Seyyed Hadi
AU - Gholamalizadeh, Maryam
AU - Gillum, Richard F.
AU - Girmay, Alem Abera
AU - Gohari, Kimiya
AU - Goleij, Pouya
AU - Guan, Shi Yang
AU - Gunawardane, Damitha Asanga
AU - Gupta, Sapna
AU - Hadi, Najah R.
AU - Haghmorad, Dariush
AU - Halwani, Rabih
AU - Hamoudi, Rifat
AU - Has, Eka Mishbahatul Marah
AU - Hasaballah, Ahmed I.
AU - Hasani, Hamidreza
AU - Hasnain, Md Saquib
AU - Hassan, Nageeb
AU - Hay, Simon I.
AU - Heibati, Behzad
AU - Heidari, Mohammad
AU - Heydari, Majid
AU - Holla, Ramesh
AU - Horita, Nobuyuki
AU - Hosseinzadeh, Hassan
AU - Hosseinzadeh, Mehdi
AU - Hundie, Tsegaye Gebreyes
AU - Hwang, Bing Fang
AU - Ikiroma, Adalia
AU - Ilesanmi, Olayinka Stephen
AU - Ilic, Irena M.
AU - Imam, Mohammad Tarique
AU - Inbaraj, Leeberk Raja
AU - Islam, Md Rabiul
AU - Islam, Sheikh Mohammed Shariful
AU - Ismail, Nahlah Elkudssiah
AU - Ispayeva, Zhanat Bakhitovna
AU - Iyasu, Assefa N.
AU - J, Vinothini
AU - Jafarzadeh, Abdollah
AU - Jain, Akhil
AU - Jain, Nityanand
AU - Jairoun, Ammar Abdulrahman
AU - Jalilzadeh Yengejeh, Reza
AU - Janodia, Manthan Dilipkumar
AU - Javidnia, Javad
AU - Jayaram, Shubha
AU - Jonas, Jost B.
AU - Joseph, Nitin
AU - Joshua, Charity Ehimwenma
AU - Jozwiak, Jacek Jerzy
AU - K, Vaishali
AU - Kadashetti, Vidya
AU - Kaliyadan, Feroze
AU - Kanmiki, Edmund Wedam
AU - Kant, Surya
AU - Kasraei, Hengameh
AU - Kaur, Harkiran
AU - Keykhaei, Mohammad
AU - Khajuria, Himanshu
AU - Khamesipour, Faham
AU - Khan, Maseer
AU - Khan, Moien AB
AU - Khatatbeh, Moawiah Mohammad
AU - Kheirallah, Khalid A.
AU - Khidri, Feriha Fatima
AU - Khosravi, Sepehr
AU - Khubchandani, Jagdish
AU - Kim, Yun Jin
AU - Kisa, Adnan
AU - Kisa, Sezer
AU - KM, Shivakumar
AU - Kompani, Farzad
AU - Korzh, Oleksii
AU - Kuddus, Mohammed
AU - Kuehni, Claudia E.
AU - Kuitunen, Ilari
AU - Kulimbet, Mukhtar
AU - Kulkarni, Vishnutheertha
AU - Kumar, Dewesh
AU - Kumar, G. Anil
AU - Kumar, Prakash
AU - Kumar, Rakesh
AU - Kumar, Vijay
AU - Kuttikkattu, Ambily
AU - Lahariya, Chandrakant
AU - Latief, Kamaluddin
AU - Lauriola, Paolo
AU - Lawal, Basira Kankia
AU - Le, Thao Thi Thu
AU - Le, Trang Diep Thanh
AU - Ledda, Caterina
AU - Lee, Sang woong
AU - Lee, Seung Won
AU - Lee, Yo Han
AU - Li, Ming Chieh
AU - Li, Wei
AU - Ligade, Virendra S.
AU - Lim, Stephen S.
AU - Lin, Queran
AU - Liu, Gang
AU - Liu, Wei
AU - Liu, Xuefeng
AU - López-Gil, José Francisco
AU - Mahalleh, Mehrdad
AU - Maharaj, Sandeep B.
AU - Mahmoudvand, Golnaz
AU - Majeed, Azeem
AU - Malik, Ahmad Azam
AU - Malik, Iram
AU - Marzo, Roy Rillera
AU - Matei, Clara N.
AU - Mathioudakis, Alexander G.
AU - Mathur, Navgeet
AU - Matthew, Indu Liz
AU - Maugeri, Andrea
AU - McPhail, Steven M.
AU - Mehmood, Asim
AU - Mekene Meto, Tesfahun
AU - Meles, Hadush Negash
AU - Menezes, Ritesh G.
AU - Mensah, George A.
AU - Mestrovic, Tomislav
AU - Mettananda, Sachith
AU - Minervini, Giuseppe
AU - Mirrakhimov, Erkin M.
AU - Misganaw, Awoke
AU - Mohamed, Nouh Saad
AU - Mohammadian-Hafshejani, Abdollah
AU - Mohammed, Shafiu
AU - Mojiri-Forushani, Hoda
AU - Mokdad, Ali H.
AU - Monasta, Lorenzo
AU - Moodi Ghalibaf, Amir Ali
AU - Mougin, Vincent
AU - Mukherjee, Sumoni
AU - Mulita, Admir
AU - Munjal, Kavita
AU - Murillo-Zamora, Efren
AU - Murray, Christopher J.L.
AU - Musaigwa, Fungai
AU - Mustafa, Ghulam
AU - Naik, Ganesh R.
AU - Najdaghi, Soroush
AU - Nangia, Vinay
AU - Narimani Davani, Delaram
AU - Nascimento, Gustavo G.
AU - Natto, Zuhair S.
AU - Nauman, Javaid
AU - Nayak, Biswa Prakash
AU - Nematollahi, Mohammad Hadi
AU - Nguyen, Nhien Ngoc Y.
AU - Nguyen, Van Thanh
AU - Niazi, Robina Khan
AU - Nikpoor, Amin Reza
AU - Noor, Syed Toukir Ahmed
AU - Nri-Ezedi, Chisom Adaobi
AU - Nugen, Fred
AU - Nunemo, Mengistu H.
AU - Nuñez-Samudio, Virginia
AU - Nurrika, Dieta
AU - Nzoputam, Ogochukwu Janet
AU - Oancea, Bogdan
AU - Odetokun, Ismail A.
AU - Okati-Aliabad, Hassan
AU - Okwute, Patrick Godwin
AU - Olagunju, Andrew T.
AU - Ordak, Michal
AU - Ouyahia, Amel
AU - P A, Mahesh
AU - Padubidri, Jagadish Rao
AU - Pandey, Anamika
AU - Pandey, Ashok
AU - Pandi-Perumal, Seithikurippu R.
AU - Pantazopoulos, Ioannis
AU - Pardhan, Shahina
AU - Park, Eun Kee
AU - Parthasarathi, Ashwaghosha
AU - Patel, Jay
AU - Pathan, Aslam Ramjan
AU - Patil, Shankargouda
AU - Peprah, Prince
AU - Pereira, Gavin
AU - Pereira, Maria Odete
AU - Perianayagam, Arokiasamy
AU - Perna, Simone
AU - Poddighe, Dimitri
AU - Poluru, Ramesh
AU - Pourbabaki, Reza
AU - Pourshams, Akram
AU - Prabhu, Disha
AU - Pradhan, Jalandhar
AU - Prates, Elton Junio Sady
AU - Qattea, Ibrahim
AU - Rahman, Mohammad Hifz Ur
AU - Rahman, Mosiur
AU - Rahman, Muhammad Aziz
AU - Rahmani, Amir Masoud
AU - Rahmani, Shayan
AU - Rahmati, Masoud
AU - Rajizadeh, Mohammad Amin
AU - Rajput, Prashant
AU - Rancic, Nemanja
AU - Rao, Mithun
AU - Rasali, Drona Prakash
AU - Rashedi, Sina
AU - Rasouli-Saravani, Ashkan
AU - Rathish, Devarajan
AU - Rawaf, David Laith
AU - Rawaf, Salman
AU - Redwan, Elrashdy M.
AU - Rezaei, Nazila
AU - Rezaei, Nima
AU - Rezaeian, Mohsen
AU - Rodrigues, Mónica
AU - Rodriguez, Jefferson Antonio Buendia
AU - Roever, Leonardo
AU - Rokni, Mohsen
AU - Ronfani, Luca
AU - Root, Kevin T.
AU - Ross, Allen Guy
AU - Rout, Himanshu Sekhar
AU - Roy, Simanta
AU - Saad, Aly M.A.
AU - Saadeddin, Adnan
AU - Saber-Ayad, Maha Mohamed
AU - Sabet, Cameron John
AU - Saddik, Basema Ahmad
AU - Saeb, Mohammad Reza
AU - Saeed, Umar
AU - Saheb Sharif-Askari, Fatemeh
AU - Saheb Sharif-Askari, Narjes
AU - Sahebkar, Amirhossein
AU - Sajid, Mirza Rizwan
AU - Salami, Afeez Abolarinwa
AU - Salciccioli, Justin D.
AU - Saleh, Mohamed A.
AU - Samargandy, Saad
AU - Samodra, Yoseph Leonardo
AU - Samuel, Vijaya Paul
AU - Samy, Abdallah M.
AU - Saravanan, Aswini
AU - Sathian, Brijesh
AU - Sawhney, Monika
AU - Saxena, Sonia
AU - Schumacher, Austin E.
AU - Sendekie, Ashenafi Kibret
AU - Senthilkumaran, Subramanian
AU - Sethi, Yashendra
AU - Shahid, Wajeehah
AU - Shahwan, Moyad Jamal
AU - Shaikh, Masood Ali
AU - Sham, Sunder
AU - Shamim, Muhammad Aaqib
AU - Shamsutdinova, Alfiya
AU - Shanawaz, Mohd
AU - Shannawaz, Mohammed
AU - Sharfaei, Sadaf
AU - Sharifan, Amin
AU - Sharifi Rad, Javad
AU - Sharma, Anupam
AU - Sharma, Manoj
AU - Sheidaei, Ali
AU - Sheikh, Aziz
AU - Shekouhi, Ramin
AU - Shenoy, Manjunath Mala
AU - Shenoy, Rekha Raghuveer
AU - Shetty, Pavanchand H.
AU - Shetty, Premalatha K.
AU - Shittu, Aminu
AU - Shorofi, Seyed Afshin
AU - Si, Yafei
AU - Siddig, Emmanuel Edwar
AU - Singh, Amit
AU - Singh, Harmanjit
AU - Singh, Jasvinder A.
AU - Singh, Paramdeep
AU - Singh, Virendra
AU - Skryabina, Anna Aleksandrovna
AU - Sobia, Farrukh
AU - Solanki, Shipra
AU - Sood, Aayushi
AU - Soraneh, Soroush
AU - Soriano, Joan B.
AU - Srinivasamurthy, Suresh Kumar
AU - Stockfelt, Leo
AU - Swain, Chandan Kumar
AU - Szarpak, Lukasz
AU - Szeto, Mindy D.
AU - Tabatabaei, Seyyed Mohammad
AU - Tabish, Mohammad
AU - Taha, Zanan Mohammed Ameen
AU - Taiba, Jabeen
AU - Talaat, Iman M.
AU - Tampa, Mircea
AU - Tamuzi, Jacques Lukenze
AU - Tan, Ker Kan
AU - Tanwar, Manoj
AU - Tat, Nathan Y.
AU - Temsah, Mohamad Hani
AU - Thangaraju, Pugazhenthan
AU - Thayakaran, Rasiah
AU - Thayumana Sundaram, Mahalakshmi
AU - Ticoalu, Jansje Henny Vera
AU - Tomo, Sojit
AU - Topor-Madry, Roman
AU - Tran, Jasmine T.
AU - Tran, Ngoc Ha
AU - Tran, Thang Huu
AU - Tran Minh Duc, Nguyen
AU - Tsatsakis, Aristidis
AU - Tualeka, Abdul Rohim
AU - Tumurkhuu, Munkhtuya
AU - Umar, Muhammad
AU - Upadhyay, Era
AU - Valenti, Mario
AU - Van den Eynde, Jef
AU - Vasankari, Tommi Juhani
AU - Verras, Georgios Ioannis
AU - Vieira, Rafael José
AU - Vinayak, Manish
AU - Violante, Francesco S.
AU - Wada, Henok Toga
AU - Werdecker, Andrea
AU - Wickramasinghe, Nuwan Darshana
AU - Yadav, Lalit
AU - Yadav, Mukesh Kumar
AU - Yismaw, Yazachew
AU - Yonemoto, Naohiro
AU - Yu, Chuanhua
AU - Zaki, Nazar
AU - Zastrozhin, Michael
AU - Zhang, Zhi Jiang
AU - Zhao, Hanqing
AU - Zia, Hafsa
AU - Zielinska, Magdalena
AU - Shin, Jae Il
AU - Yon, Dong Keon
N1 - Publisher Copyright: © 2025 Elsevier Ltd
PY - 2025/5
Y1 - 2025/5
N2 - Background: Asthma and atopic dermatitis are common allergic conditions that contribute to substantial health loss, economic burden, and pain across individuals of all ages worldwide. Therefore, as a component of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we present updated estimates of the prevalence, disability-adjusted life-years (DALYs), incidence, and deaths due to asthma and atopic dermatitis and the burden attributable to modifiable risk factors, with forecasted prevalence up to 2050. Methods: Asthma and atopic dermatitis prevalence, incidence, DALYs, and mortality, with corresponding 95% uncertainty intervals (UIs), were estimated for 204 countries and territories from 1990 to 2021. A systematic review identified data from 389 sources for asthma and 316 for atopic dermatitis, which were further pooled using the Bayesian meta-regression tool. We also described the age-standardised DALY rates of asthma attributable to four modifiable risk factors: high BMI, occupational asthmagens, smoking, and nitrogen dioxide pollution. Furthermore, as a secondary analysis, prevalence was forecasted to 2050 using the Socio-demographic Index (SDI), air pollution, and smoking as predictors for asthma and atopic dermatitis. To assess trends in the burden of asthma and atopic dermatitis before (2010–19) and during (2019–21) the COVID-19 pandemic, we compared their average annual percentage changes (AAPCs). Findings: In 2021, there were an estimated 260 million (95% UI 227–298) individuals with asthma and 129 million (124–134) individuals with atopic dermatitis worldwide. Asthma cases declined from 287 million (250–331) in 1990 to 238 million (209–272) in 2005 but increased to 260 million in 2021. Atopic dermatitis cases consistently rose from 107 million (103–112) in 1990 to 129 million (124–134) in 2021. However, age-standardised prevalence rates decreased—by 40·0% (from 5568·3 per 100 000 to 3340·1 per 100 000) for asthma and 8·3% (from 1885·4 per 100 000 to 1728·5 per 100 000) for atopic dermatitis. In 2021, there were substantial variations in the burden of asthma and atopic dermatitis across different SDI groups, with the highest age-standardised DALY rate found in south Asia for asthma (465·0 [357·2–648·9] per 100 000) and the high-income super-region for atopic dermatitis (3552·5 [3407·2–3706·1] per 100 000). During the COVID-19 pandemic, the decline in asthma prevalence had stagnated (AAPC pre-pandemic –1·39% [–2·07 to –0·71] and during the pandemic 0·47% [–1·86 to 2·79]; p=0·020); however, there was no significant difference in atopic dermatitis prevalence in the same period (pre-pandemic –0·28% [–0·33 to –0·22] and during the pandemic –0·35% [–0·78 to 0·08]; p=0·20). Modifiable risk factors were responsible for 29·9% of the global asthma DALY burden; among them, high BMI was the greatest contributor (39·4 [19·6–60·2] per 100 000), followed by occupational asthmagens (20·8 [16·7–26·5] per 100 000) across all regions. The age-standardised DALY rate of asthma attributable to high BMI was highest in high-SDI settings, whereas the contribution of occupational asthmagens was highest in low-SDI settings. According to our forecasting models, we expect 275 million (224–330) asthma cases and 148 million (140–158) atopic dermatitis cases in 2050, with population growth driving this increase. However, age-standardised prevalence rates are expected to remain stable (–23·2% [–44·4 to 5·3] for asthma and –1·4% [–9·1 to 7·0] for atopic dermatitis) from 2021 to 2050. Interpretation: Although the increases in the total number of asthma and atopic dermatitis cases will probably continue until 2050, age-standardised prevalence rates are expected to remain stable. A considerable portion of the global burden could be managed through efforts to address modifiable risk factors. Additionally, the contribution of risk factors to the burden substantially varied by SDI, which suggests the need for tailored initiatives for specific SDI settings. The growing number of individuals expected to be affected by asthma and atopic dermatitis in the future suggests that it is essential to improve our understanding of risk factors for asthma and atopic dermatitis and collect disease prevalence data that are globally generalisable. Funding: Gates Foundation.
AB - Background: Asthma and atopic dermatitis are common allergic conditions that contribute to substantial health loss, economic burden, and pain across individuals of all ages worldwide. Therefore, as a component of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we present updated estimates of the prevalence, disability-adjusted life-years (DALYs), incidence, and deaths due to asthma and atopic dermatitis and the burden attributable to modifiable risk factors, with forecasted prevalence up to 2050. Methods: Asthma and atopic dermatitis prevalence, incidence, DALYs, and mortality, with corresponding 95% uncertainty intervals (UIs), were estimated for 204 countries and territories from 1990 to 2021. A systematic review identified data from 389 sources for asthma and 316 for atopic dermatitis, which were further pooled using the Bayesian meta-regression tool. We also described the age-standardised DALY rates of asthma attributable to four modifiable risk factors: high BMI, occupational asthmagens, smoking, and nitrogen dioxide pollution. Furthermore, as a secondary analysis, prevalence was forecasted to 2050 using the Socio-demographic Index (SDI), air pollution, and smoking as predictors for asthma and atopic dermatitis. To assess trends in the burden of asthma and atopic dermatitis before (2010–19) and during (2019–21) the COVID-19 pandemic, we compared their average annual percentage changes (AAPCs). Findings: In 2021, there were an estimated 260 million (95% UI 227–298) individuals with asthma and 129 million (124–134) individuals with atopic dermatitis worldwide. Asthma cases declined from 287 million (250–331) in 1990 to 238 million (209–272) in 2005 but increased to 260 million in 2021. Atopic dermatitis cases consistently rose from 107 million (103–112) in 1990 to 129 million (124–134) in 2021. However, age-standardised prevalence rates decreased—by 40·0% (from 5568·3 per 100 000 to 3340·1 per 100 000) for asthma and 8·3% (from 1885·4 per 100 000 to 1728·5 per 100 000) for atopic dermatitis. In 2021, there were substantial variations in the burden of asthma and atopic dermatitis across different SDI groups, with the highest age-standardised DALY rate found in south Asia for asthma (465·0 [357·2–648·9] per 100 000) and the high-income super-region for atopic dermatitis (3552·5 [3407·2–3706·1] per 100 000). During the COVID-19 pandemic, the decline in asthma prevalence had stagnated (AAPC pre-pandemic –1·39% [–2·07 to –0·71] and during the pandemic 0·47% [–1·86 to 2·79]; p=0·020); however, there was no significant difference in atopic dermatitis prevalence in the same period (pre-pandemic –0·28% [–0·33 to –0·22] and during the pandemic –0·35% [–0·78 to 0·08]; p=0·20). Modifiable risk factors were responsible for 29·9% of the global asthma DALY burden; among them, high BMI was the greatest contributor (39·4 [19·6–60·2] per 100 000), followed by occupational asthmagens (20·8 [16·7–26·5] per 100 000) across all regions. The age-standardised DALY rate of asthma attributable to high BMI was highest in high-SDI settings, whereas the contribution of occupational asthmagens was highest in low-SDI settings. According to our forecasting models, we expect 275 million (224–330) asthma cases and 148 million (140–158) atopic dermatitis cases in 2050, with population growth driving this increase. However, age-standardised prevalence rates are expected to remain stable (–23·2% [–44·4 to 5·3] for asthma and –1·4% [–9·1 to 7·0] for atopic dermatitis) from 2021 to 2050. Interpretation: Although the increases in the total number of asthma and atopic dermatitis cases will probably continue until 2050, age-standardised prevalence rates are expected to remain stable. A considerable portion of the global burden could be managed through efforts to address modifiable risk factors. Additionally, the contribution of risk factors to the burden substantially varied by SDI, which suggests the need for tailored initiatives for specific SDI settings. The growing number of individuals expected to be affected by asthma and atopic dermatitis in the future suggests that it is essential to improve our understanding of risk factors for asthma and atopic dermatitis and collect disease prevalence data that are globally generalisable. Funding: Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=105000889015&partnerID=8YFLogxK
U2 - 10.1016/S2213-2600(25)00003-7
DO - 10.1016/S2213-2600(25)00003-7
M3 - Article
C2 - 40147466
AN - SCOPUS:105000889015
SN - 2213-2600
VL - 13
SP - 425
EP - 446
JO - The Lancet Respiratory Medicine
JF - The Lancet Respiratory Medicine
IS - 5
ER -