ORIGINAL RESEARCH article
Front. Public Health
Sec. Occupational Health and Safety
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1602789
This article is part of the Research TopicNavigating Environmental Hazards in the Workplace: Impacts and InterventionsView all 8 articles
Global, regional and national mortality burden of laryngeal cancer attributable to occupational exposure to sulfuric acid and asbestos: 1990-2021 and projections to 2040
Provisionally accepted
- 1Department of Otolaryngology, Wushan County People’s Hospital of Chongqing, Chongqing, China
- 2Children Health Care Center, Wushan County People’s Hospital of Chongqing, Chongqing, China
- 3Department of Gastroenterology, Wushan County People’s Hospital of Chongqing, Chongqing, China
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Background: Laryngeal cancer (LC) is the most prevalent form of head and neck cancer, significantly impacting patients' health. Occupational exposure to sulfuric acid (OESA) and asbestos (OEA) is a recognized risk factor for LC, but the associated mortality burden remains unclear. This study aimed to evaluate the global trends of LC attributable to OESA and OEA, and to project future trends.Methods: Based on the Global Burden of Disease Study 2021, we analyzed the number of deaths, age-standardized death rates (ASDR), and estimated annual percentage changes by age, sex, and socio-demographic index (SDI) of LC attributed to OESA and OEA. Decomposition analysis was used to identify the drivers of disease burden changes. Frontier analysis was used to estimate achievable outcomes based on development levels. Additionally, Bayesian age-period-cohort model was used to predict future trends up to 2040.Results: In 2021, global LC deaths attributable to OESA and OEA were 3,612.35 (95% uncertainty intervals (UI): 1,504.31–6,492.29) and 3,392.00 (95% UI: 1,892.13–5,134.88), respectively, representing increases of 37.5% and 21.4%, respectively, from 1990. The ASDRs for OESA and OEA in 2021 were both 0.04 per 100,000 (95% UI: 0.02–0.07 and 0.02–0.06, respectively), both lower than in 1990. LC deaths attributable to OESA and OEA mainly occur in elderly patients, and men consistently showed higher LC deaths and ASDR than females. The ASDR for OESA was negatively correlated with the SDI, while OEA was positively correlated. Decomposition analysis highlighted differences in disease burden drivers across SDI regions. Frontier analysis showed that countries like Cuba and Pakistan were farthest from the OESA-related mortality burden frontier, while Monaco and Lesotho were farthest from OEA-related mortality burden. From 2022 to 2040, LC deaths attributable to OESA and OEA are projected to increase to 4,810.90 (95% UI: 1,628.04–8,010.74) and 3,648.48 (95% UI: 1,016.75–6,322.42), respectively.Conclusions: Although the ASDR decreased from 1990 to 2021, OESA and OEA remain contributors to LC mortality worldwide, with the number of deaths expected to increase over the next two decades. Disease burden varies significantly across SDI regions, suggesting that preventive measures should be tailored to specific SDI levels.
Keywords: Laryngeal cancer, Occupational Exposure, Sulfuric acid, Asbestos, Mortality, Global burden of disease
Received: 30 Mar 2025; Accepted: 25 Jun 2025.
Copyright: © 2025 Gong, Xu, Hao, Yi, Yuan, Zheng, Gong, Shen and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yongqi Dong, Department of Gastroenterology, Wushan County People’s Hospital of Chongqing, Chongqing, China
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