Some risk factors deviated from the pattern of the proportional burden (percent of region-specifc DALYs attributable to a risk factor) being closely associated with epidemiological and demographic transition (shift from communicable to non-communicable disease with increasing mean age of death). The proportion of DALYs attributable to tobacco smoking including second-hand smoke was largest in North America—where smoking among women has generally been prevalent for a long time—and central and eastern Europe. Central and eastern Europe and central Asia also had the largest proportion of disease burden attributable to risk factors with large effects on cardiovascular diseases, which are disproportionately high in these regions. Exposure to particulate matter from household and ambient sources had the most varied pattern with respect to the epidemiological transition, partly because of the heterogeneous pattern of exposure and the effects on both children and adult causes of ill health. Household air pollution from solid fuels accounted for a large proportion of disease burden in central, eastern, and western sub-Saharan Africa and it is a leading risk factor in some Asian regions and Oceania. In central and east Asia in 2010, ambient particulate matter pollution surpassed household air pollution in terms of its burden.
