OBJECTIVE To elucidate the burden of lower respiratory tract infections (LRIs) attributable to non-optimal temperature risk and its changing trends in China from 1990 to 2021, and to provide insights for identifying susceptible populations.

METHODS The changing trends in mortality and disability-adjusted life years (DALYs) of LRIs attributed to non-optimal, low and high temperature risks were analyzed through the 2021 global burden of disease (GBD) database. Joinpoint software was used to analyze the trend changes of time series and explore the standardized mortality rate and the standardized DALYs rate of LRIs attributed to non-optimal temperature risk.

RESULTS In 2021, LRIs mortality and DALYs rates attributable to non-optimal temperature risk in China were 1.92 per 100, 000 (down 66.80% from 5.76 per 100, 000 in 1990) and 37.99 per 100, 000 (down 90.47% from 398.77 per 100, 000 in 1990), respectively. The burden of LRIs attributed to non-optimal temperature risks was higher in males than that in females, with the mortality rates of 2.86 per 100, 000 and 2.48 per 100, 000, and DALYs rates of 44.90 per 100, 000 and 30.75 per 100, 000, respectively. The burden of LRIs increased significantly in children under 5 years old and elderly individuals aged 75 and above. From 1990 to 2021, the standardized mortality rate and the standardized DALYs rate of LRIs attributed to non-optimal temperature factors in China showed a declining trend average annual percentage change (AAPC): -5.04% and-7.33%, respectively.

CONCLUSIONS The overall burden of LRIs attributable to non-optimal temperature in China has generally declined from 1990 to 2021. with higher burden in males than that in females, and higher burden in individuals under 5 years old and those aged 75 and above. In China, low temperature risk plays an important role in the non-optimal temperature effect. To reduce the burden of LRIs disease, early intervention measures should be implemented for males, the middle-aged and elderly people and children, and early protection for susceptible populations should be provided based on changes in external environmental temperature, which are of significant public health importance for reducing disease burden.