Burden of COPD and lung cancer attributable to household air pollution in Morocco: a secondary analysis using population attributable fractions

Objective To estimate the burden of household air pollution (HAP) on chronic obstructive pulmonary disease (COPD) and lung cancer in Morocco in 2019 using population attributable fractions (PAFs). Design Secondary analytical study based on sex-specific PAF estimation combining Moroccan exposure prevalence from a Moroccan population-based survey conducted in 2010–2011, pooled relative risks from an international meta-analysis, national disease frequency estimates (for COPD, two prevalence sources were used: 2010–2011 observed Moroccan data and 2019 modelling-based estimates), 2019 burden indicators and direct medical costs.

Participants Adults aged 40 years and older included in the Burden of Obstructive Lung Disease (BOLD I) survey in Fez, Morocco. Main outcome measures Sex-specific PAFs, attributable COPD and lung cancer cases, disability-adjusted life years (DALYs) and annual direct medical costs attributable to HAP.

Results In Morocco, HAP accounted for 14.4% (95% CI 8.4% to 21.6%) of COPD cases in men and 25.3% (95% CI 17.0% to 34.0%) in women, and for 14.2% (95% CI 7.9% to 21.8%) of lung cancer cases in men and 25.0% (95% CI 16.1% to 34.2%) in women.