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Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution.

ABSTRACT: BACKGROUND:Few assessments of the costs and benefits of reducing acute cardiorespiratory morbidity related to air pollution have employed a comprehensive, explicit approach to capturing the full societal value of reduced morbidity. METHODS:We used empirical data on the duration and severity of episodes of cardiorespiratory disease as inputs to complementary models of cost of treatment, lost productivity, and willingness to pay to avoid acute cardiorespiratory morbidity outcomes linked to air pollution in epidemiological studies. A Monte Carlo estimation procedure was utilized to propagate uncertainty in key inputs and model parameters. RESULTS:Valuation estimates ranged from 13 dollars (1997, Canadian) (95% confidence interval, 0-28 dollars) for avoidance of an acute respiratory symptom day to 5,200 dollars (4,000 dollars-6,400 dollars) for avoidance of a cardiac hospital admission. Cost of treatment accounted for the majority of the overall value of cardiac and respiratory hospital admissions as well as cardiac emergency department visits, while lost productivity generally represented a small proportion of overall value. Valuation estimates for days of restricted activity, asthma symptoms and acute respiratory symptoms were sensitive to alternative assumptions about level of activity restriction. As an example of the application of these values, we estimated that the observed decrease in particulate sulfate concentrations in Toronto between 1984 and 1999 resulted in annual benefits of 1.4 million dollars (95% confidence interval 0.91-1.8 million dollars) in relation to reduced emergency department visits and hospital admissions for cardiorespiratory disease. CONCLUSION:Our approach to estimating the value of avoiding a range of acute morbidity effects of air pollution addresses a number of limitations of the current literature, and is applicable to future assessments of the benefits of improving air quality.

SUBMITTER: Stieb DM

PROVIDER: S-EPMC149396 | biostudies-literature | 2002 Dec

REPOSITORIES: biostudies-literature

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Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution.

Stieb David M DM De Civita Paul P Johnson F Reed FR Manary Matthew P MP Anis Aslam H AH Beveridge Robert C RC Judek Stan S

Environmental health : a global access science source 20021218 1

<h4>Background</h4>Few assessments of the costs and benefits of reducing acute cardiorespiratory morbidity related to air pollution have employed a comprehensive, explicit approach to capturing the full societal value of reduced morbidity.<h4>Methods</h4>We used empirical data on the duration and severity of episodes of cardiorespiratory disease as inputs to complementary models of cost of treatment, lost productivity, and willingness to pay to avoid acute cardiorespiratory morbidity outcomes li ...[more]

PMID: 12537591

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Project description:BackgroundImpacts on children's health are under-represented in benefits assessments of policies related to ambient air quality and climate change. To complement our previous compilation of concentration-response (C-R) functions for a number of children's health outcomes associated with air pollution, we provide per-case monetary estimates of the same health outcomes.ObjectivesOur goal was to establish per-case monetary estimates for a suite of prevalent children's health outcomes (preterm birth, low birth weight, asthma, autism spectrum disorder, attention-deficit/hyperactivity disorder, and IQ reduction) that can be incorporated into benefits assessments of air pollution regulations and climate change mitigation policies.MethodsWe conducted a systematic review of the literature published between January 1, 2000 and June 30, 2018 to identify relevant economic costs for these six adverse health outcomes in children. We restricted our literature search to studies published in the U.S., with a supplemental consideration of studies from the U.K. and prioritized literature reviews with summary cost estimates and papers that provided lifetime cost of illness estimates.ResultsOur literature search and evaluation process reviewed 1065 papers and identified 12 most relevant papers on per-case monetary estimates for preterm birth, low birth weight, asthma, autism spectrum disorder, and attention-deficit/hyperactivity disorder. Details are presented in full. We separately identified estimates of the lost lifetime earnings associated with the loss of a single IQ point. The final per-case cost estimates for each outcome were selected based on the most robust evidence. These estimates range from $23,573 for childhood asthma not persisting into adulthood to $3,109,096 for a case of autism with a concurrent intellectual disability.ConclusionTo our knowledge, this is the first time that the child-specific health outcomes of preterm birth, low birth weight, asthma, autism spectrum disorder, attention-deficit/hyperactivity disorder, and IQ reduction have been systematically valued and presented in one place. This is an important addition to the body of health-related valuation literature as these outcomes have substantial economic costs that are not considered in most assessments of the benefits of air pollution and climate mitigation policies. In general, however, the available per-case estimates presented here did not incorporate the broad societal and long-term costs and are likely underestimates. Although our context has been air pollution and climate policies, the per-case monetary estimates presented here can be applied to other environmental exposures. Fuller assessments of health benefits to children and their corresponding economic gains will improve decision-making on environmental policy.

Project description:Risk-related information regarding air pollution can help people understand the risk involved and take preventive measures to reduce health loss. However, the health benefits through these protective behaviors and the health threat of information inequality have not been systematically measured. This article reports the health gains and losses caused by the interaction of "air pollution-air pollution information-human", and studies the heterogeneity and impact of this interaction. Based on field investigations and transfer learning algorism, this study compiled the first nationwide city-level risk-related information (ERI) response parameter set in China. Then, we developed a Information-Behavioral Equivalent PM2.5 Exposure Model (I-BEPEM) model to project the health benefits caused by the impact of environmental risk-related information on residents' protective behaviors under different scenarios. The protective behavior led by air pollution risk information reduces 5.7% PM2.5-related premature deaths per year. With a 1% increase in regional ERI reception, PM2.5-related premature mortality decreases by 0.1% on average; If the level of information perception and behavioral protection in all cities is the same as that in Beijing, PM2.5-related premature deaths will decrease by 6.9% annually in China. Further, changing the air quality standard issued by China to the American standard can reduce the overall PM2.5-related premature deaths by 9.9%. Meanwhile, compared with men, other age groups and rural residents, women, older persons, and urban residents are more likely to conceive risk information and adopt protective behaviors to reduce the risk of premature death from air pollution. Air pollution risk information can significantly reduce people's health loss. Changing the real-time air quality monitoring information indicator standard to a more stringent level can quickly and effectively enhance this effect. However, the uneven distribution of this information in regions and populations has resulted in the inequality of health gains and losses.

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Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution.

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Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution.

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