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

Stieb DM, De Civita P, Johnson FR, Manary MP, Anis AH, Beveridge RC, Judek S - Environ Health (2002)

Bottom Line: 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.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.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada. dave_stieb@hc-sc.gc.ca

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.

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Related in: MedlinePlus

Comparison of valuation estimates for acute respiratory symptom days with earlier studies. Legend: Labels denote reference number. Open symbols denote estimates from the present study. See Table 6 (additional file 1) for additional details on individual estimates.
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Figure 3: Comparison of valuation estimates for acute respiratory symptom days with earlier studies. Legend: Labels denote reference number. Open symbols denote estimates from the present study. See Table 6 (additional file 1) for additional details on individual estimates.

Mentions: We present a comparison of our estimates with those from earlier studies [1-7,43,44] in figures 1,2,3 and Table 6 (see additional file 1). We have categorized estimates from earlier studies based on the authors' description of the health state, and the primary sources cited. It is difficult to make precise comparisons, however, because many other studies do not specify the level of activity limitation associated with the condition being valued, and our estimates pertaining to emergency department visits differ from earlier estimates in that they also capture costs for those patients who were ultimately admitted.


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

Stieb DM, De Civita P, Johnson FR, Manary MP, Anis AH, Beveridge RC, Judek S - Environ Health (2002)

Comparison of valuation estimates for acute respiratory symptom days with earlier studies. Legend: Labels denote reference number. Open symbols denote estimates from the present study. See Table 6 (additional file 1) for additional details on individual estimates.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC149396&req=5

Figure 3: Comparison of valuation estimates for acute respiratory symptom days with earlier studies. Legend: Labels denote reference number. Open symbols denote estimates from the present study. See Table 6 (additional file 1) for additional details on individual estimates.
Mentions: We present a comparison of our estimates with those from earlier studies [1-7,43,44] in figures 1,2,3 and Table 6 (see additional file 1). We have categorized estimates from earlier studies based on the authors' description of the health state, and the primary sources cited. It is difficult to make precise comparisons, however, because many other studies do not specify the level of activity limitation associated with the condition being valued, and our estimates pertaining to emergency department visits differ from earlier estimates in that they also capture costs for those patients who were ultimately admitted.

Bottom Line: 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.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.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada. dave_stieb@hc-sc.gc.ca

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.

Show MeSH
Related in: MedlinePlus