Abstract
Summary
Musculoskeletal diseases (MSDs) are the leading cause of disability and facing them demands updated reports on their burden for efficient policymaking. We showed Iran had the highest female-to-male ratio and highest increase in the burden of musculoskeletal diseases, in the past three decades, worldwide. We further confirmed the role of population aging as the main cause.
Purpose
MSDs comprise most of the top causes of years lived with disability (YLDs) worldwide and are rapidly increasing in lower- and middle-income countries. Here, we present disability and mortality due to MSDs in Iran at the national level from 1990 to 2017.
Methods
We used Global Burden of Disease (GBD) 2017 Study data and standard methodology and presented the burden of MSDs in rates of years of life lost (YLLs), YLDs, and disability-adjusted life years (DALYs) during 1990–2017, for population aged ≥ 5 years old. We further explored attributable risk factors and decomposed the changing trend in DALYs to assess underlying causes.
Results
In Iran, MSDs were responsible for 1.82 million (95%uncertainty interval [UI] 1.3–2.4) DALYs, in 2017. During the past 28 years, with 1.75% annualized percentage change (APC), Iran had the highest percentage increase in the all-ages MSD DALYs rate worldwide, while the age-standardized DALYs APC was negligible. Low back pain was the greatest contributor to DALYs and caused 4.5% of total DALYs. The female population is experiencing considerably higher burden of MSDs, with 115% and 48% higher all-ages YLLs and YLDs rates per 100,000, respectively (YLLs 28.7; YLDs 2629.1), than males (YLLs 13.2; YLDs 1766.1). However, due to wide UIs, difference was not significant. Only 17.6% of MSD YLDs are attributable to assessed risk factors.
Conclusion
Despite that MSDs are rising as an important cause of disability in Iran, these conditions are not sufficiently addressed in health policies. There is urgent need for cross-sectoral engagement, especially addressing the MSDs in females.
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Data availability
The GBD 2017 dataset is freely available online at http://ghdx.healthdata.org/gbd-2017 and the R and STATA codes used in this work are available from the corresponding author upon reasonable requests.
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Acknowledgments
Seyed Sina Irvani would like to thank the Clinical Research Development Unit (CRDU) of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, for their support.
Funding
The Global Burden of Diseases (GBDs) study received funding from the Bill and Melinda Gates Foundation.
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Shahrezaee, M., Keshtkari, S., Moradi-Lakeh, M. et al. Burden of musculoskeletal disorders in Iran during 1990–2017: estimates from the Global Burden of Disease Study 2017. Arch Osteoporos 15, 103 (2020). https://doi.org/10.1007/s11657-020-00767-8
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DOI: https://doi.org/10.1007/s11657-020-00767-8