Abstract
BackgroundTehran, the 22nd most populous city in the world, has the highest mortality rate due to respiratory system diseases (RSDs) in Iran. This study aimed to investigate spatiotemporal patterns of mortality due to these diseases in Tehran between 2008 and 2018.MethodsWe used a dataset available from Tehran Municipality including all cases deceased due RSDs in this city between 2008 and 2018. Global Moran’s I was performed to test whether the age-adjusted mortality rates were randomly distributed or had a spatial pattern. Furthermore, Anselin Local Moran’s I was conducted to identify potential clusters and outliers.ResultsDuring the 10-year study, 519,312 people died in Tehran, 43,177 because of RSDs, which corresponds to 831.1 per 10,000 deaths and 5.0 per 10,000 population. The death rate was much higher in men (56.8%) than in women (43.2%) and the highest occurred in the > 65 age group (71.2%). Overall, three diseases dominated the mortality data: respiratory failure (44.2%), pneumonia (15.9%) and lung cancer (10.2%). The rates were significantly higher in the central and southeastern parts of the city and lower in the western areas. It increased during the period 2008–2018 and showed a clustered spatial pattern between 2008 and 2013 but presented a random geographical pattern afterwards.ConclusionsThis study provides a first report of the spatial distribution of mortality due to RSDs in Tehran and shows a significant increase in respiratory disease mortality in the last ten years. Effective control of the excess fatality rates would warrant a combination of urban prevention and treatment strategies including environmental health plans.
Highlights
Tehran, the 22nd most populous city in the world, has the highest mortality rate due to respiratory system diseases (RSDs) in Iran
The mortality rate due to respiratory system diseases (MRRSDs) average was 5.0 per 10,000, with men being at higher risk of death than women (56.8% versus 43.2%)
Since most providers of cigarettes and water pipes are more common in the southeastern parts of the city than other municipalities [40], these results are in line with previous studies confirming that smoking in Tehran increases the incidence of lung cancer [26]
Summary
The 22nd most populous city in the world, has the highest mortality rate due to respiratory system diseases (RSDs) in Iran. The most prevalent RSDs are chronic obstructive pulmonary diseases (COPD), asthma, acute lower respiratory tract infections, tuberculosis and lung cancer Their incidence is affected by genetic disposition, gender, lifestyle and age, as well as environmental factors, such as the quality of air and water [4]. In Iran, the mortality rate due to respiratory system diseases (MRRSDs) was 9.8% of total deaths in 2019 [6], with the level as high as 14% in the capital city Tehran. This means that 5000 people in Tehran die of RSDs every year, making it one of the most common causes of death in the city from 2008 to 2018 [7]. There is a strong need for an analysis of the current epidemiological status of RSDs in Tehran with special regard to the potential spatial multiplicity of MRRSDs presence
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