Table 4.
Disability-adjusted life-years (1000s) attributable to risk factors and risk factor clusters, worldwide
| Men | Women | Both sexes | ||||
|---|---|---|---|---|---|---|
| 1990 | 2010 | 1990 | 2010 | 1990 | 2010 | |
| Unimproved water and sanitation | 27 045 (1409–49 439) | 11 022 (458–21 162) | 25 123 (1262–45 792) | 10 165 (428–19 650) | 52 169 (2700–93 073) | 21 187 (866–40 957) |
| Unimproved water source | 11 075 (792–21 250) | 4080 (266–8172) | 10 097 (722–19 424) | 3694 (242–7511) | 21 172 (1517–40 491) | 7775 (514–15 705) |
| Unimproved sanitation | 18 610 (593–35 486) | 7735 (190–15 338) | 17 441 (522–32 889) | 7192 (187–14 099) | 36 050 (1115–66 871) | 14 927 (377–29 705) |
| Air pollution | ‥ | ‥ | ‥ | ‥ | ‥ | ‥ |
| Ambient particulate matter pollution | 46 667 (40 185–53 381) | 46 732 (41 393–52 602) | 35 032 (29 974–40 402) | 29 431 (25 722–33 273) | 81 699 (71 012–92 859) | 76 163 (68 086–85 171) |
| Household air pollution from solid fuels | 94 276 (73 721–113 071) | 61 645 (45 944–77 497) | 81 632 (66 415–96 472) | 49 317 (38 818–60 315) | 175 909 (141 870–207 095) | 110 962 (86 848–137 813) |
| Ambient ozone pollution | 1409 (460–2456) | 1440 (506–2563) | 1125 (375–1990) | 1016 (331–1758) | 2534 (851–4426) | 2456 (837–4299) |
| Other environmental risks | 2876 (2406–3459) | 9434 (7476–12 045) | 2489 (1974–3015) | 6617 (5322–7938) | 5365 (4534–6279) | 16 051 (13 212–19 503) |
| Residential radon | ‥ | 1514 (191–3383) | ‥ | 600 (84–1355) | ‥ | 2114 (273–4660) |
| Lead exposure | 2876 (2406–3459) | 7920 (6491–9683) | 2489 (1974–3015) | 6017 (4915–7231) | 5365 (4534–6279) | 13 936 (11 750–16 327) |
| Child and maternal undernutrition | 175 366 (146 049–211 406) | 83 202 (67 963–99 704) | 164 599 (139 926–192 077) | 82 894 (69 171–98 757) | 339 965 (289 845–402 489) | 166 095 (139 685–193 981) |
| Suboptimal breastfeeding | 59 902 (36 953–84 059) | 25 572 (15 540–37 260) | 50 359 (32 186–70 526) | 21 965 (13 717–31 340) | 110 261 (69 615–153 539) | 47 537 (29 868–67 518) |
| Non-exclusive breastfeeding | 52 729 (30 540–75 288) | 22 258 (12 464–32 936) | 43 601 (26 173–62 072) | 18 850 (10 926–27 569) | 96 330 (57 274–135 861) | 41 108 (23 668–58 913) |
| Discontinued breastfeeding | 7173 (767–15 819) | 3314 (324–7377) | 6758 (696–14 710) | 3114 (296–6915) | 13 931 (1443–30 062) | 6429 (605–14 426) |
| Childhood underweight | 104 713 (87 668–128 697) | 41 270 (33 478–50 007) | 93 028 (78 656–112 766) | 36 045 (29 430–43 394) | 197 741 (169 224–238 276) | 77 316 (64 497–91 943) |
| Iron deficiency | 21 451 (14 947–30 321) | 19 974 (13 595–28 289) | 30 390 (22 473–40 703) | 28 251 (20 195–39 063) | 51 841 (37 477–71 202) | 48 225 (33 769–67 592) |
| Vitamin A deficiency | 15 689 (7475–29 165) | 5672 (2904–9348) | 14 598 (7068–25 637) | 5098 (2566–8168) | 30 288 (14 884–54 488) | 10 770 (5625–17 149) |
| Zinc deficiency | 12 666 (2938–23 883) | 4880 (1203–9316) | 11 709 (2640–22 049) | 4256 (1131–7821) | 24 375 (5385–45 685) | 9136 (2458–16 903) |
| Tobacco smoking (including second-hand smoke) | 104 840 (91 849–119 255) | 115 496 (98 595–130 090) | 46 926 (39 634–58 092) | 41 342 (30 473–48 563) | 151 766 (136 367–169 522) | 156 838 (136 543–173 057) |
| Tobacco smoking | 84 956 (73 038–97 937) | 105 635 (88 332–120 347) | 28 784 (21 829–40 090) | 31 272 (19 859–38 467) | 113 740 (100 454–131 675) | 136 907 (117 201–153 778) |
| Second-hand smoke | 19 884 (14 493–25 591) | 9861 (7669–12 312) | 18 142 (13 748–22 355) | 10 070 (7931–12 429) | 38 026 (28 832–47 544) | 19 931 (15 707–24 223) |
| Alcohol and drug use | 88 000 (79 774–96 333) | 119 130 (107 244–130 842) | 33 648 (30 426–37 108) | 42 178 (38 018–46 786) | 121 648 (111 426–132 342) | 161 308 (146 934–175 282) |
| Alcohol use | 77 550 (70 706–84 835) | 101 875 (92 405–111 165) | 28 479 (25 762–31 372) | 34 188 (30 882–37 479) | 106 029 (98 299–114 763) | 136 063 (125 361–146 788) |
| Drug use | 10 178 (7787–13 073) | 16 248 (12 679–20 132) | 4993 (3811–6417) | 7562 (5922–9471) | 15 171 (11 714–19 369) | 23 810 (18 780–29 246) |
| Physiological risk factors | ‥ | ‥ | ‥ | ‥ | ‥ | ‥ |
| High fasting plasma glucose | 30 177 (25 148–34 980) | 49 148 (41 619–57 197) | 26 181 (22 243–30 349) | 39 864 (34 103–45 972) | 56 358 (48 720–65 030) | 89 012 (77 743–101 390) |
| High total cholesterol | 22 519 (18 230–27 029) | 23 179 (17 148–29 650) | 17 006 (13 940–20 640) | 17 721 (13 153–22 508) | 39 526 (32 704–47 202) | 40 900 (31 662–50 484) |
| High blood pressure | 73 120 (65 538–81 302) | 99 566 (88 193–110 943) | 63 897 (57 903–70 789) | 73 991 (66 161–81 931) | 137 017 (124 360–149 366) | 173 556 (155 939–189 025) |
| High body-mass index | 25 391 (19 752–31 108) | 48 310 (39 429–57 750) | 26 174 (20 911–31 642) | 45 300 (37 218–54 219) | 51 565 (40 786–62 557) | 93 609 (77 107–110 600) |
| Low bone mineral density | 1764 (1448–2208) | 3105 (2295–3831) | 1361 (1102–1686) | 2111 (1627–2618) | 3125 (2589–3811) | 5216 (4133–6418) |
| Dietary risk factors and physical inactivity | 102 663 (94 539–111 011) | 149 576 (138 035–160 263) | 74 611 (68 196–81 173) | 104 757 (97 047–112 535) | 177 274 (164 710–190 286) | 254 333 (237 748–270 495) |
| Diet low in fruits | 47 979 (37 530–57 842) | 65 523 (51 056–78 959) | 32 474 (25 061–39 155) | 38 573 (29 923–46 512) | 80 453 (63 298–95 763) | 104 095 (81 833–124 169) |
| Diet low in vegetables | 18 755 (12 859–24 939) | 24 169 (16 503–32 480) | 12 803 (8412–17 503) | 14 389 (9434–19 284) | 31 558 (21 349–41 921) | 38 559 (26 006–51 658) |
| Diet low in whole grains | 17 033 (13 513–20 522) | 24 881 (19 486–29 709) | 12 370 (9625–14 895) | 15 881 (12 615–18 949) | 29 404 (23 097–35 134) | 40 762 (32 112–48 486) |
| Diet low in nuts and seeds | 24 918 (16 268–31 946) | 32 615 (21 258–41 958) | 15 607 (9915–20 208) | 18 674 (11 716–24 404) | 40 525 (26 308–51 741) | 51 289 (33 482–65 959) |
| Diet low in milk | 818 (248–1366) | 1171 (350–1977) | 710 (210–1210) | 931 (264–1605) | 1527 (461–2555) | 2101 (619–3544) |
| Diet high in red meat | 642 (306–1014) | 1026 (484–1629) | 566 (263–903) | 827 (374–1362) | 1208 (571–1909) | 1853 (870–2946) |
| Diet high in processed meat | 10 477 (2801–17 479) | 12 901 (4012–21 421) | 6882 (2340–11 119) | 8038 (2932–12 685) | 17 359 (5137–27 949) | 20 939 (6982–33 468) |
| Diet high in sugar-sweetened beverages | 3085 (2120–4151) | 4858 (3154–6549) | 2358 (1586–3484) | 3695 (2356–5255) | 5443 (3769–7373) | 8553 (5823–11 418) |
| Diet low in fibre | 8485 (3787–13 262) | 10 893 (4903–17 191) | 4862 (2188–7562) | 5559 (2500–8639) | 13 347 (5970–20 751) | 16 452 (7401–25 783) |
| Diet low in calcium | 1083 (752–1406) | 1570 (1113–2058) | 753 (521–975) | 1019 (720–1319) | 1836 (1316–2368) | 2590 (1873–3322) |
| Diet low in seafood omega-3 fatty acids | 13 620 (9915–17 307) | 18 300 (13 267–23 201) | 8120 (5900–10 388) | 9899 (7241–12 596) | 21 740 (15 869–27 537) | 28 199 (20 624–35 974) |
| Diet low in polyunsaturated fatty acids | 6185 (2891–9362) | 7521 (3455–11 583) | 3727 (1788–5709) | 4159 (1973–6396) | 9912 (4655–14 976) | 11 680 (5360–17 798) |
| Diet high in trans fatty acids | 4979 (3571–6413) | 7339 (5240–9300) | 3085 (2226–3944) | 4253 (3106–5416) | 8064 (5893–10 305) | 11 592 (8395–14 623) |
| Diet high in sodium | 26 807 (17 646–35 273) | 37 378 (24 639–49 428) | 19 376 (12 521–25 596) | 23 852 (15 544–31 682) | 46 183 (30 363–60 604) | 61 231 (40 124–80 342) |
| Physical inactivity and low physical activity | ‥ | 37 007 (30 583–43 466) | ‥ | 32 311 (27 698–37 217) | ‥ | 69 318 (58 646–80 182) |
| Occupational risk factors | 42 660 (35 146–50 545) | 48 317 (38 407–58 677) | 12 754 (9357–16 658) | 14 171 (10 344–18 842) | 55 414 (45 312–66 718) | 62 488 (49 471–76 240) |
| Occupational carcinogens | 1346 (917–1958) | 2087 (1315–2928) | 412 (284–611) | 594 (368–855) | 1758 (1220–2477) | 2681 (1773–3689) |
| Occupational exposure to asbestos | 362 (236–555) | 521 (279–709) | 122 (78–189) | 132 (61–184) | 484 (354–695) | 653 (389–840) |
| Occupational exposure to arsenic | 29 (11–56) | 45 (17–84) | 12 (5–24) | 18 (7–33) | 41 (16–77) | 63 (24–114) |
| Occupational exposure to benzene | 36 (15–64) | 52 (21–92) | 28 (11–52) | 40 (15–72) | 65 (27–112) | 92 (39–163) |
| Occupational exposure to beryllium | 2 (1–3) | 3 (1–5) | 1 (0–1) | 1 (0–2) | 2 (1–4) | 4 (2–6) |
| Occupational exposure to cadmium | 5 (2–9) | 10 (4–16) | 2 (1–3) | 3 (1–6) | 7 (3–12) | 13 (6–21) |
| Occupational exposure to chromium | 18 (11–28) | 32 (17–48) | 8 (4–13) | 13 (7–21) | 26 (16–40) | 45 (27–66) |
| Occupational exposure to diesel engine exhaust | 278 (158–436) | 442 (232–682) | 54 (31–88) | 81 (42–126) | 332 (192–517) | 523 (292–789) |
| Occupational exposure to second-hand smoke | 257 (173–383) | 405 (244–544) | 100 (69–162) | 167 (95–228) | 358 (255–500) | 572 (386–762) |
| Occupational exposure to formaldehyde | 11 (4–20) | 17 (6–31) | 7 (3–13) | 9 (4–16) | 18 (8–32) | 25 (11–47) |
| Occupational exposure to nickel | 90 (24–191) | 151 (38–312) | 37 (10–79) | 64 (18–132) | 128 (34–266) | 215 (58–443) |
| Occupational exposure to polycyclic aromatic hydrocarbons | 41 (19–71) | 73 (33–119) | 13 (6–23) | 23 (10–39) | 54 (26–92) | 96 (45–156) |
| Occupational exposure to silica | 199 (129–297) | 333 (199–463) | 31 (21–52) | 49 (26–71) | 230 (154–328) | 382 (239–526) |
| Occupational exposure to sulphuric acid | 52 (14–114) | 66 (19–143) | 5 (1–12) | 6 (2–13) | 57 (16–122) | 71 (21–152) |
| Occupational asthmagens | 1467 (874–2439) | 1359 (917–2153) | 662 (366–1062) | 661 (407–994) | 2129 (1419–3222) | 2020 (1441–2871) |
| Occupational particulate matter, gases, and fumes | 6808 (3162–10 425) | 6682 (3293–10 311) | 2745 (1216–4406) | 2460 (1105–4025) | 9552 (4385–14 636) | 9142 (4377–14 250) |
| Occupational noise | 1936 (1149–3103) | 2284 (1348–3649) | 933 (550–1489) | 1167 (696–1870) | 2869 (1698–4582) | 3451 (2072–5574) |
| Occupational risk factors for injuries | 20 175 (15 588–25 639) | 22 434 (16 711–29 943) | 1090 (836–1437) | 1010 (771–1331) | 21 265 (16 644–26 702) | 23 444 (17 736–30 904) |
| Occupational low back pain | 10 929 (7340–15 116) | 13 471 (8968–18 945) | 6912 (4487–9835) | 8279 (5502–11 602) | 17 841 (11 846–24 945) | 21 750 (14 492–30 533) |
| Sexual abuse and violence | ‥ | 3588 (2669–4679) | ‥ | 19 931 (14 524–26 397) | ‥ | 23 519 (17 961–30 322) |
| Childhood sexual abuse | ‥ | 3588 (2669–4679) | ‥ | 4244 (3082–5533) | ‥ | 7833 (5964–10 005) |
| Intimate partner violence | ‥ | ‥ | ‥ | 16 794 (11 373–23 087) | ‥ | 16 794 (11 373–23 087) |
No data indicates that attributable disability-adjusted life-years were not quantified. Total disability-adjusted life-years (in 1000s) in 1990 were 1 360 569 for men, 1 142 032 for women, and 2 502 601 for both. In 2010, they were 1 370 177 for men, 1 120 208 for women, and 2 490 385 for both.