Burden of disease attributable to risk factors in European countries: a scoping literature review

Gorasso V. Morgado J.N. Charalampous P. Pires S.M. Haagsma J.A. Santos J.V. Idavain J. Ngwa C.H. Noguer I. Padron-monedero A. Sarmiento R. Pinheiro V. Von der Lippe E. Jakobsen L.S. Devleesschauwer B. Plass D. Aasvang G.M. Ádám B. Alkerwi A. Arabloo J. Baltazar A.L. Uysal H.B. Bikbov B. Bolling A.K. Borrell-Pages M. Carreras G. Castelpietra G. Chen-Xu J. Lagarija Š.C. Corso B. Cuschieri S. De Pauw R. Dhaouadi S. Dokova K. Dopelt K. Economou M. Emeto T.I. Fantke P. Fischer F. Freitas A. Galluzzo L. García-González J.M. Gazzelloni F. Gissler M. Gkitakou A. Gubes S. Canu I.G. Hincapié C.A. Hynds P. Ilic I. Ilic M. Isola G. Kabir Z. Kolkhir P. Konar N.M. Kretzschmar M. Kulimbet M. La Vecchia C. Ladeira C. Lassen B. Lauriola P. Lehtomäki H. Levi M. Majer M. McDonald S.A. Mechili E.A. Misins J. Monasta L. Laguna J.M. Namorado S. Nena E. Ng E.S.W. Nguewa P. Niranjan V. Nola I.A. Obradović M. O’Caoimh R. Öztürk N. Pastorinho M.R. Petrou P. Peyroteo M. Ortiz M.R. Riva S. Rocha-Gomes J. Santoso C.M.A. Schmitt T. Shigdel R. Sigurvinsdottir R. Soriano J.B. Sousa A.C. Sprügel M. Steiropoulos P. Tozija F. Unim B. Vandeninden B. Varga O. Vasic M. Viegas S. Vieira R. Violante F.S. Wyper G.M.A. Yigit V. Zaletel J.
December 2023 BioMed Central Ltd

Archives of Public Health
2023 #81 Issue 1

Objectives: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods: We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. Results: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions: Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates. Registration: The study protocol has been registered on PROSPERO, CRD42020177477 (available at: https://www.crd.york.ac.uk/PROSPERO/).

Burden of disease , Comparative risk assessment , Risk factors

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Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
Environmental Health and Nutrition Laboratory, University of Lisbon, Lisbon, Portugal
Department of Public Health, Erasmus MC, Rotterdam, Netherlands
National Food Institute, Technical University of Denmark, Lyngby, Denmark
MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal
CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal
Public Health Unit, ACES Grande Porto V-Porto Ocidental, Porto, Portugal
Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg, Sweden
Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
Carlos III Institute of Health, National School of Public Health, Madrid, Spain
Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
Public Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
Division for Diet, Disease Prevention and Toxicology, Technical University of Denmark, Lyngby, Denmark
Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
Department for Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
Norwegian Institute of Public Health, Norway
United Arab Emirates University, United Arab Emirates
Ministère de la Santé, Luxembourg
Iran University of Medical Sciences, Iran
Polythecnical Institute of Coimbra, Coimbra Health School, Portugal
Aydin Adnan Menderes University, Turkey
Istituto di Ricerche Farmacologiche, IRCCS Mario Negri, Italy
Sant Pau Institute for Biomedical Research, Spain
Oncologic network, prevention and research institute (ISPRO), Italy
Central Health Directorate, Inpatient and Outpatient Care Service, Italy
Universidade NOVA de Lisboa, Portugal
Institute of Public Health for FBiH, Bosnia and Herzegovina
National Research Council, Italy
University of Malta, Malta
Faculty of Medicine of Tunis, Tunisia
Medical University Prof. Dr Paraskev Stoyanov, Bulgaria
Ashkelon Academic College, Israel
Cyprus University of Technology, Cyprus
James Cook University, Australia
Charité-Universitätsmedizin, Germany
University of Porto, Portugal
National Institute of Health ISS, Italy
Universidad Pablo de Olavide, Spain
Institute and Faculty of Actuaries, United Kingdom
Finnish Institute for Health and Welfare, Finland
Ondokuz Mayis University, Turkey
Instute for Work and Health, Switzerland
University of Zurich, Balgrist University Hospital, Switzerland
Technological University Dublin, Ireland
University of Belgrade, Serbia
University of Kragujevac, Kragujevac, Serbia
University of Catania, Italy
University College Cork, Ireland
Berlin Institute of Health, Germany
Kirsehir Ahi Evran University, Turkey
Center for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Netherlands
Al Farabi Kazakh National University, Kazakhstan
Università degli Studi di Milano, Italy
Instituto Politécnico de Lisboa, Portugal
ISDE, Italy
Central Tuscany Local Healthcare Authority, Italy
University of Zagreb, Croatia
University of Crete, Greece
Centre for Disease Prevention and Control, Latvia
Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Italy
National Institute of Health Dr. Ricardo Jorge, Portugal
Democritus University of Thrace, Greece
The London School of Hygiene & Tropical Medicine, United Kingdom
University of Navarra, IdiSNA, Spain
University College Dublin, Ireland
University of Banja Luka, Bosnia and Herzegovina
Antalya Training and Research Hospital, Turkey
University of Évora, Portugal
University of Nicosia, Cyprus
NOVA Medical School, Portugal
University of South Florida, United States
St Mary’s University, London, United Kingdom
University of Debrecen, Hungary
Maastricht University, Netherlands
University of Bergen, Norway
Reykjavik University, Iceland
Friedrich-Alexander-Universität, Germany
Saints Cyril and Methodius University of Skopje, North Macedonia
Institute of Public Health of Serbia Dr Milan Jovanovic Batut, Serbia
University of Bologna, Italy
Public Health Scotland, United Kingdom
Suleyman Demirel University, Turkey
National Public Health Institute Slovenia, University Medical Centre Ljubljana, Slovenia
Ben Gurion University of the Negev, Israel

Department of Epidemiology and Public Health
Department of Public Health and Primary Care
Environmental Health and Nutrition Laboratory
Department of Public Health
National Food Institute
MEDCIDS
CINTESIS
Public Health Unit
Department of Health Statistics
School of Public Health and Community Medicine
Department of Epidemiology and Population Health
Carlos III Institute of Health
Medicine School
Public Health Unit
Department of Epidemiology and Health Monitoring
Division for Diet
Department of Translational Physiology
Department for Exposure Assessment and Environmental Health Indicators
Norwegian Institute of Public Health
United Arab Emirates University
Ministère de la Santé
Iran University of Medical Sciences
Polythecnical Institute of Coimbra
Aydin Adnan Menderes University
Istituto di Ricerche Farmacologiche
Sant Pau Institute for Biomedical Research
Oncologic network
Central Health Directorate
Universidade NOVA de Lisboa
Institute of Public Health for FBiH
National Research Council
University of Malta
Faculty of Medicine of Tunis
Medical University Prof. Dr Paraskev Stoyanov
Ashkelon Academic College
Cyprus University of Technology
James Cook University
Charité-Universitätsmedizin
University of Porto
National Institute of Health ISS
Universidad Pablo de Olavide
Institute and Faculty of Actuaries
Finnish Institute for Health and Welfare
Ondokuz Mayis University
Instute for Work and Health
University of Zurich
Technological University Dublin
University of Belgrade
University of Kragujevac
University of Catania
University College Cork
Berlin Institute of Health
Kirsehir Ahi Evran University
Center for Infectious Disease Control
Al Farabi Kazakh National University
Università degli Studi di Milano
Instituto Politécnico de Lisboa
ISDE
Central Tuscany Local Healthcare Authority
University of Zagreb
University of Crete
Centre for Disease Prevention and Control
Institute for Maternal and Child Health
National Institute of Health Dr. Ricardo Jorge
Democritus University of Thrace
The London School of Hygiene & Tropical Medicine
University of Navarra
University College Dublin
University of Banja Luka
Antalya Training and Research Hospital
University of Évora
University of Nicosia
NOVA Medical School
University of South Florida
St Mary’s University
University of Debrecen
Maastricht University
University of Bergen
Reykjavik University
Friedrich-Alexander-Universität
Saints Cyril and Methodius University of Skopje
Institute of Public Health of Serbia Dr Milan Jovanovic Batut
University of Bologna
Public Health Scotland
Suleyman Demirel University
National Public Health Institute Slovenia
Ben Gurion University of the Negev

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