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Lookup NU author(s): Dr Priyadarshini BhattacharjeeORCiD
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© 2026 Elsevier LtdBackground: Chronic respiratory diseases are an important global issue, particularly in Asia, where burden patterns vary widely across countries. With more than half the world's population living in Asia, understanding the national and regional burden of chronic respiratory diseases is essential; however, research on this area remains inadequate. We aimed to investigate the burden of chronic respiratory diseases in Asia at national and regional levels, and to identify key risk factors. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2023 provides estimates for assessing the burden of chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease (ILD), and pulmonary sarcoidosis. We focused on 34 countries in Asia, encompassing the high-income Asia Pacific region and central, east, south, and southeast Asia. Estimates for age-standardised prevalence and disability-adjusted life-year (DALY) rates per 100 000 population, including 95% uncertainty intervals (UIs), were extracted by location, sex, year, and Socio-demographic Index (SDI). The average annual percentage change was calculated and presented as a percentage with 95% CIs. Estimates of modifiable attributable risk factors for DALYs and mortality were also included. Findings: In Asia, the age-standardised prevalence and DALY rates for chronic respiratory diseases generally declined from 1990 to 2023; however, the trend varied substantially by disease and country. In 2023, the age-standardised prevalence rate of COPD was highest in south Asia (3044·18 [95% UI 2748·67–3303·04] per 100 000 population), while the age-standardised asthma prevalence rate was highest in the high-income Asia Pacific region (4870·24 [4046·70–5962·78] per 100 000 population) and southeast Asia (4778·18 [3970·25–5735·61] per 100 000 population). Despite southeast Asia and the high-income Asia Pacific region having a similar age-standardised asthma prevalence rate, southeast Asia had a higher age-standardised DALY rate (508·67 [95% UI 394·89–669·92] per 100 000 population) compared with the high-income Asia Pacific region (204·40 [129·23–290·41] per 100 000 population). A decrease in the age-standardised DALY rate for chronic respiratory diseases was observed with increasing SDI, contrasting with its prevalence patterns. Age-standardised DALY rates of COPD decreased in all Asian countries except for Georgia (average annual percentage change 1·37 [95% CI 1·26–1·48]) and Kazakhstan (0·73 [0·55–0·93]), and age-standardised DALY rates of asthma decreased in all countries. Smoking and ambient particulate matter pollution were identified as leading attributable risk factors for chronic respiratory diseases across Asia. Household air pollution from solid fuels was a regionally pronounced risk factor for chronic respiratory diseases, particularly in south Asia (age-standardised DALY rate 657·58 [95% UI 485·04–880·45] per 100 000 population). Although smoking was a major risk factor in males, ambient particulate matter pollution and secondhand smoke emerged as important attributable risk factors for chronic respiratory diseases in females. Interpretation: Countries with lower SDI had markedly higher DALY rates, highlighting the need to address socioeconomic and health-care inequities. Household air pollution from solid fuels continues to impose a substantial but preventable burden in south Asia, calling for clean energy adoption and improved ventilation. Funding: Gates Foundation.
Author(s): Jo H, Kim TH, Park J, Oh J, Kim MS, Abid SUA, Adhikary RK, Adnani QES, Agrawal A, Ahmad D, Ahmad K, Ahmad S, Ahmad T, Ahmed AM, Ahmed H, Ahmed MF, Ahmed N, Ahmed SA, Akkaif MA, Al Hasan SM, Alam K, Ali MU, Ali R, Ali SS, Ali SY, Alif SM, Aljunid SM, Al-Mamun M, Altaf A, Annadurai K, Ansari S, Arockiaraj J, Arooj M, Aryntayeva N, Asdaq SMB, Ashraf MAB, Ashraf SA, Ashraf T, Asri Y, Assariparambil AR, Babu GR, Badiye AD, Baig AA, Bakkannavar SM, Banik B, Bardhan M, Basu S, Beeraka NM, Bente Kamal Tune SN, Bhandari J, Bhandari N, Bhat AN, Bhat A, Bhatnagar A, Bhattacharjee P, Biswas B, Biswas MS, Bitar AN, Bui LP, Butt NS, Butt ZA, Cenderadewi M, Chakraborty C, Chakraborty S, Chan JSK, Chattu VK, Chaudhuri S, Chen A-T, Chen H, Chopra H, Chu D-T, Chung S, Devanbu VGC, Devegowda D, Dewan SMR, Dhane AS, Dharmagadda S, Dharmaratne SD, Dhital NB, Dhungel B, Ding G, Ding X, Do HP, Do THP, Doshi OP, Dutta S, Efendi F, Elsohaby I, Fahim A, Fakhradiyev IR, Fareed M, Fatima Z, Fekadu G, G S, Ganesh B, Gao X, Gautam RK, Ghuge A, Gil AU, Golechha M, Guan S-Y, Gunawardane DA, Gupta G, Gupta L, Gupta RD, Gupta S, Halder P, Hameed S, Hanif A, Haque MA, Hariandja AMA, Has EMM, Hassan Ahmed O, Hay SI, He Q, Holla R, Hoseinzadeh M, Hossain MS, Huang J, Huang Z, Hwang B-F, Inbaraj LR, Iqbal M, Irham LM, Islam MR, Islam MS, Ismail NE, Ismoldayev Y, Ispayeva ZB, Jamaluddin J, James J, Jayaram S, Jiang M, Jonas JB, Joseph N, K V, Kang J, Kapoor N, Kar S, Khajuria H, Khan M, Khan MJ, Khan MF, Khan S, Khan U, Khasbage SU, Khidri FF, Khubchandani J, Kim J, Kim YJ, Kini B S, KM AB, KM S, Kodali PB, Koul PA, Krishan K, Kuddus M, Kulimbet M, Kulshreshtha S, Kumar D, Kumar K, Kumar N, Kumar R, Kumar V, Kurmi OP, Kushawaha PK, Kusuma D, Kuttybayev A, Lahariya C, Lai H, Lakanova B, Latief K, Lee SW, Lee YH, Li C, Li M-C, Li W, Li W, Lian Y, Ligade VS, Lin J, Lin R-T, Liu G, Liu H, Liu X, Liu X, Liu Z, Ma J, Mahalingam S, Malik AA, Manjani L, Mannethodi K, Mansoor F, Marzo RR, Mathur M, Mathur N, Maude RJ, Mehta V, Melwani S, Meo SA, Mettananda S, Minervini G, Ming W-K, Mini GK, Mirrakhimov EM, Mishra V, Mithra P, Mohan S, Mokdad AH, Mondal H, Motappa R, Muhammad JS, Mukherjee S, Murray CJL, Naik GR, Nainu F, Nair S, Nambi G, Nargus S, Nauman J, Navaratna SNK, Nayak BP, Nayak SG, Nguyen CT, Nguyen HTH, Nguyen H-DT, Nguyen MT, Nguyen NP, Niazi RK, Niranjan V, Nomura S, Nurrika D, P A M, Padubidri JR, Paija DM, Paluvai T, Panda-Jonas S, Pandey A, Pandi-Perumal SR, Patel HM, Patel M, Patil S, Pham HN, Pham TT, Poddighe D, Poluru R, Porntaveetus T, Postma MJ, Pradhan J, Pradhan PMS, Prashant A, Puvvula J, Qiu J-Y, Rabiee N, Rachmat B, Raghav YSR, Rahim F, Rahman MHU, Rahman MM, Rahman M, Rahman MA, Rahmani AM, Raj JP, Rajendran J, Rajput P, Rao SJ, Rashid M, Rashid MA, Rathish D, Rauniyar SK, Reddy MMRK, Rizvi MR, Rohilla R, Rony MKK, Rout HS, Roy P, Saeed U, Saha I, Sahebkar A, Sahoo PM, Sahu KS, Sajid MR, Salvi SS, Samodra YL, Sarode GS, Sarode SC, Sathya Narayanan MK, Satpathy M, Saulam J, Saya GK, Senthilkumaran S, Sethi Y, Shahab M, Shaikh MA, Shaikh N, Shamim MA, Shamsutdinova A, Shan D, Shanawaz M, Sharma A, Sharma Paudel SS, Shetty M, Shetty PH, Shetty PK, Shimul MMH, Shiue I, Shrestha S, Simkhada PP, Singh A, Singh H, Singh JA, Singh K, Singh P, Singh PS, Singh S, Singh S, Singh V, Sinha MK, Sinha R, Solikhah S, Song X, Sood A, Sood P, Subramanian B, Subramaniyan V, Sujon H, Sukaew T, Sundaram T, Swain CK, T Y SS, Tabish M, Taiba J, Tanabayeva S, Tanveer M, Tasnim A, Thankappan KR, Thapar R, Thind MK, Thiruvengadam M, Thiruvengadam R, Thomas MS, Ticoalu JHV, Tleshev M, Tomo S, Tran NH, Tran QTH, Tran TH, Tran Minh Duc N, Tripathi T, Tualeka AR, Ullah H, Ullah I, Umar M, Unnikrishnan B, Upadhyay E, Uzzaman N, Vaithinathan AG, Visaga Ambi S, Vu L, Wahidin M, Wander A, Wang K, Wang Y, Wei X, Wicaksana AL, Wickramasinghe ND, Wilandika A, Wu J, Xiao L, Xiao N, Xie W, Xu S, Xu S, Xu X, Yadav MK, Yang C, Yang X, Ye P, Yergaliyev KA, Yin D, Yonemoto N, Yu C, Zafar M, Zainal Abidin E, Zhang CJP, Zhang Y, Zhao H, Zhong CC, Zhumagaliuly A, Zia H, Shin JI, Yon DK, Mokdad AH
Publication type: Article
Publication status: Published
Journal: The Lancet Respiratory Medicine
Year: 2026
Volume: 14
Issue: 3
Pages: 233-255
Print publication date: 03/03/2026
Online publication date: 21/01/2026
Acceptance date: 02/04/2018
ISSN (print): 2213-2600
ISSN (electronic): 2213-2619
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/S2213-2600(25)00404-7
DOI: 10.1016/S2213-2600(25)00404-7
PubMed id: 41579872
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