Open Access
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Emmanuela Gakidou
,
Ashkan Afshin
,
Amanuel Alemu Abajobir
,
Kalkidan Hassen Abate
,
Cristiana Abbafati
,
Kaja M. Abbas
,
Foad Abd Allah
,
Abdishakur M. Abdulle
,
Semaw Ferede Abera
,
Victor Aboyans
,
Laith J. Abu-Raddad
,
Niveen M. E. Abu-Rmeileh
,
Gebre Yitayih Abyu
,
Isaac Akinkunmi Adedeji
,
Olatunji Adetokunboh
,
Mohsen Afarideh
,
Sutapa Agrawal
,
HAMID AHMADIEH
,
Muktar Beshir Ahmed
,
Miloud Taki Eddine Aichour
,
Amani Nidhal Aichour
,
Ibtihel Aichour
,
Rufus Olusola Akinyemi
,
Nadia Akseer
,
Fares Alahdab
,
Ziyad Al-Aly
,
Khurshid Alam
,
Noore Alam
,
Tahiya Alam
,
Deena Alasfoor
,
Kefyalew Addis Alene
,
Komal Ali
,
Reza Alizadeh Navaei
,
Ala’a Alkerwi
,
François Alla
,
Peter Allebeck
,
Rajaa Al-Raddadi
,
Ubai Alsharif
,
Khalid A Altirkawi
,
Nelson Alvis-Guzman
,
Azmeraw T. Amare
,
Erfan Amini
,
Walid Ammar
,
Yaw Ampem Amoako
,
Hossein Ansari
,
Josep M. Anto
,
Carl Abelardo T Antonio
,
Palwasha Anwari
,
Nicholas Arian
,
Johan Ärnlöv
,
Al Artaman
,
Krishna Kumar Aryal
,
Hamid Asayesh
,
Solomon Weldegebreal Asgedom
,
Tesfay Mehari Atey
,
Leticia Avila Burgos
,
Euripide Frinel G Arthur Avokpaho
,
Ashish Awasthi
,
Peter Azzopardi
,
Umar Bacha
,
Alaa Badawi
,
Kalpana Balakrishnan
,
Shoshana H. Ballew
,
Aleksandra Barac
,
Ryan M Barber
,
Suzanne L. Barker-Collo
,
Till Bärnighausen
,
Simón Barquera
,
Lars Barregard
,
Lope H. Barrero
,
Carolina Batis
,
Katherine E. Battle
,
Blair R Baumgarner
,
Bernhard T. Baune
,
Justin Beardsley
,
Neeraj Bedi
,
Ettore Beghi
,
Michelle L. Bell
,
Derrick A. Bennett
,
James R. Bennett
,
Isabela M. Bensenor
,
Adugnaw Berhane
,
Derbew Fikadu Berhe
,
Eduardo Bernabé
,
Balem Demtsu Betsu
,
Mircea Beuran
,
Addisu Shunu Beyene
,
Anil Bhansali
,
Zulfiqar A. Bhutta
,
Burcu Kucuk Bicer
,
Boris Bikbov
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Charles Birungi
,
Stan Biryukov
,
Christopher D Blosser
,
Dube Jara Boneya
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Ibrahim R Bou Orm
,
Michael Brauer
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Nicholas J.K. Breitborde
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Hermann Brenner
,
Traolach S. Brugha
,
Lemma Negesa Bulto Bulto
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Zahid A. Butt
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Lucero Cahuana Hurtado
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Rosario Cárdenas
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Juan Jesus Carrero
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Carlos A Castañeda Orjuela
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Ferrán Catalá López
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Kelly Cercy
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Hsing-Yi Chang
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Fiona J Charlson
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Odgerel Chimed Ochir
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Vesper Hichilombwe Chisumpa
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Abdulaal A Chitheer
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Hanne Christensen
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Massimo Cirillo
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Aaron J. Cohen
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Haley Comfort
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Cyrus Cooper
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Josef Coresh
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Leslie Cornaby
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Paolo Angelo Cortesi
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Michael H. Criqui
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Lalit Dandona
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Gail Davey
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Kairat Davletov
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Barbora de Courten
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Barthelemy Kuate Defo
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Louisa Degenhardt
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Aniruddha Deshpande
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Shirin Djalalinia
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Klara Dokova
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David Teye Doku
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Aaron Van Donkelaar
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E. Ray Dorsey
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Tim R Driscoll
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Manisha Dubey
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Bruce Bartholow Duncan
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Sarah Duncan
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Hedyeh Ebrahimi
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Aman Yesuf Endries
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Sergey Petrovich Ermakov
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Holly E. Erskine
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Babak Eshrati
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Sharareh Eskandarieh
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Kara Estep
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Carla Sofia E Sá Farinha
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Andre Faro
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Kyle J Foreman
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Jingwen Guo
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Mohamed Hsairi
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Guoqing Hu
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John J. Huang
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Kim Moesgaard Iburg
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Chad Ikeda
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Caleb Mackay Salpeter Irvine
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Maria Delores Jackson
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Nader Jahanmehr
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Jost B. Jonas
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Mikk Jürisson
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Zubair Kabir
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Corine Kakizi Karema
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Amir Kasaeian
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Marek Majdan
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JOHN J. McGRATH
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Peter Memiah
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Mansour Shamsipour
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Morteza SHAMSIZADEH
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Sheikh Mohammed Shariful Islam
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Jayendra Sharma
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RAJESH SHARMA
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Jun She
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Jiabin Shen
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Peilin Shi
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Kenji Shibuya
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Chloe Shields
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Mekonnen Sisay Shiferaw
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Haitham Shoman
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Inga Dora Sigfusdottir
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Diego Augusto Santos Silva
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João Pedro Silva
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Dayane Gabriele Alves Silveira
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Jasvinder A Singh
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VIRENDRA SINGH
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Dhirendra Narain Sinha
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Eirini Skiadaresi
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Erica Leigh Slepak
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Mathilde Touvier
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Narayanaswamy Venketasubramanian
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Francesco S Violante
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Fiseha Wadilo
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Yuan Pang Wang
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Scott Weichenthal
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ROBERT G. WEINTRAUB
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Daniel J. Weiss
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Andrea Werdecker
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Ronny Westerman
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HARVEY A. WHITEFORD
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Charles Shey Wiysonge
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Belete Getahun Woldeyes
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Charles D.A. Wolfe
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Rachel Woodbrook
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Abdulhalik Workicho
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Denis Xavier
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Simon Yadgir
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Bereket Yakob
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Lijing L. Yan
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Mehdi Yaseri
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Hassen Hamid Yimam
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PAUL YIP
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Naohiro Yonemoto
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Seok Jun Yoon
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Marcel Yotebieng
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Mustafa Z. Younis
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Zoubida Zaidi
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Maysaa El Sayed Zaki
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Luis Zavala Arciniega
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Xueying Zhang
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Stephanie Raman M Zimsen
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Ben Zipkin
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Sanjay Zodpey
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Stephen S. Lim
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Christopher J. L. Murray
Publication type: Journal Article
Publication date: 2017-09-15
scimago Q1
wos Q1
SJR: 12.113
CiteScore: 87.6
Impact factor: 88.5
ISSN: 01406736, 1474547X
PubMed ID:
28919119
General Medicine
Abstract
The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context.We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined.Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9-11·6) decline in deaths and a 10·8% (8·3-13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7-17·5) of deaths and 6·2% (3·9-8·7) of DALYs, and population growth for 12·4% (10·1-14·9) of deaths and 12·4% (10·1-14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9-29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks.Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade.The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
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Journals
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10
20
30
40
50
60
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International Journal of Environmental Research and Public Health
54 publications, 2.86%
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PLoS ONE
47 publications, 2.49%
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Nutrients
40 publications, 2.12%
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Frontiers in Public Health
35 publications, 1.85%
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BMC Public Health
35 publications, 1.85%
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The Lancet
34 publications, 1.8%
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Scientific Reports
34 publications, 1.8%
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Environmental International
30 publications, 1.59%
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Environmental Research
25 publications, 1.32%
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Science of the Total Environment
20 publications, 1.06%
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Environmental Science & Technology
20 publications, 1.06%
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Addiction
19 publications, 1.01%
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BMJ Open
18 publications, 0.95%
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Cochrane Database of Systematic Reviews
16 publications, 0.85%
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Atmosphere
15 publications, 0.79%
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Frontiers in Nutrition
13 publications, 0.69%
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Environmental Science and Pollution Research
13 publications, 0.69%
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Journal of Hypertension
12 publications, 0.63%
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The Lancet Global Health
11 publications, 0.58%
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Atmospheric Environment
11 publications, 0.58%
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Journal of the American Heart Association
10 publications, 0.53%
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Environmental Pollution
10 publications, 0.53%
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The Lancet Planetary Health
10 publications, 0.53%
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Journal of Clinical Hypertension
10 publications, 0.53%
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Hypertension
9 publications, 0.48%
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BMC Medicine
9 publications, 0.48%
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The Lancet Neurology
9 publications, 0.48%
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Public Health Nutrition
9 publications, 0.48%
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Appetite
8 publications, 0.42%
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40
50
60
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Publishers
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50
100
150
200
250
300
350
400
450
500
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Elsevier
477 publications, 25.24%
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Springer Nature
348 publications, 18.41%
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MDPI
156 publications, 8.25%
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Wiley
132 publications, 6.98%
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Frontiers Media S.A.
79 publications, 4.18%
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Ovid Technologies (Wolters Kluwer Health)
71 publications, 3.76%
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Public Library of Science (PLoS)
63 publications, 3.33%
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Taylor & Francis
59 publications, 3.12%
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Oxford University Press
58 publications, 3.07%
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Cambridge University Press
56 publications, 2.96%
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BMJ
31 publications, 1.64%
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SAGE
30 publications, 1.59%
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American Chemical Society (ACS)
28 publications, 1.48%
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American Medical Association (AMA)
20 publications, 1.06%
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Hindawi Limited
16 publications, 0.85%
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JMIR Publications
13 publications, 0.69%
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SciELO
11 publications, 0.58%
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Cold Spring Harbor Laboratory
11 publications, 0.58%
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American Society for Nutrition
9 publications, 0.48%
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Bentham Science Publishers Ltd.
8 publications, 0.42%
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IOP Publishing
8 publications, 0.42%
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American Thoracic Society
7 publications, 0.37%
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Copernicus
7 publications, 0.37%
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Environmental Health Perspectives
7 publications, 0.37%
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Georg Thieme Verlag KG
7 publications, 0.37%
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Ubiquity Press
7 publications, 0.37%
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Royal Society of Chemistry (RSC)
6 publications, 0.32%
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Emerald
5 publications, 0.26%
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Institute of Electrical and Electronics Engineers (IEEE)
5 publications, 0.26%
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- We do not take into account publications without a DOI.
- Statistics recalculated weekly.
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Metrics
1.9k
Total citations:
1891
Citations from 2024:
257
(13.6%)
The most citing journal
Citations in journal:
54
Cite this
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MLA
Cite this
GOST
Copy
Gakidou E. et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 // The Lancet. 2017. Vol. 390. No. 10100. pp. 1345-1422.
GOST all authors (up to 50)
Copy
Gakidou E. et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 // The Lancet. 2017. Vol. 390. No. 10100. pp. 1345-1422.
Cite this
RIS
Cite this
BibTex (up to 50 authors)
Copy
@article{2017_Gakidou,
author = {Emmanuela Gakidou and Ashkan Afshin and Amanuel Alemu Abajobir and Kalkidan Hassen Abate and Cristiana Abbafati and Kaja M. Abbas and Foad Abd Allah and Abdishakur M. Abdulle and Semaw Ferede Abera and Victor Aboyans and Laith J. Abu-Raddad and Niveen M. E. Abu-Rmeileh and Gebre Yitayih Abyu and Isaac Akinkunmi Adedeji and Olatunji Adetokunboh and Mohsen Afarideh and Anurag Agrawal and Sutapa Agrawal and HAMID AHMADIEH and Muktar Beshir Ahmed and Miloud Taki Eddine Aichour and Amani Nidhal Aichour and Ibtihel Aichour and Rufus Olusola Akinyemi and Nadia Akseer and Fares Alahdab and Ziyad Al-Aly and Khurshid Alam and Noore Alam and Tahiya Alam and Deena Alasfoor and Kefyalew Addis Alene and Komal Ali and Reza Alizadeh Navaei and Ala’a Alkerwi and François Alla and Peter Allebeck and Rajaa Al-Raddadi and Ubai Alsharif and Khalid A Altirkawi and Nelson Alvis-Guzman and Azmeraw T. Amare and Erfan Amini and Walid Ammar and Yaw Ampem Amoako and Hossein Ansari and Josep M. Anto and Carl Abelardo T Antonio and Palwasha Anwari and Nicholas Arian and others},
title = {Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016},
journal = {The Lancet},
year = {2017},
volume = {390},
publisher = {Elsevier},
month = {sep},
url = {https://doi.org/10.1016/S0140-6736(17)32366-8},
number = {10100},
pages = {1345--1422},
doi = {10.1016/S0140-6736(17)32366-8}
}
Cite this
MLA
Copy
Gakidou, Emmanuela, et al. “Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.” The Lancet, vol. 390, no. 10100, Sep. 2017, pp. 1345-1422. https://doi.org/10.1016/S0140-6736(17)32366-8.