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Details

Research article
Authors

Esser A, Gaum PM, Schettgen T, Kraus T, Gube M, and Lang J

Journal

J Toxicol Environ Health A

Summary
This cost analysis examined the longitudinal impact of occupational PCB exposure on health-related quality of life (HRQL) and quality-adjusted life years (QALY) for participants enrolled in the Health Effects in High-Level Exposure to PCB (HELPcB) medical surveillance program. Findings revealed that PCB exerts an influence on QALY, where individuals with a higher PCB exposure show a decline in QALY over time, especially for higher chlorinated PCBs. These results suggest that further investigations are needed to analyze the impact of lower chlorinated PCB congeners on the development of HRQL and QALY to explain the lack of longitudinal findings for these chemicals in the present study.
Population

Participants in the Health Effects in High-Level Exposure to PCB (HELPcB) medical surveillance program

Health Outcomes

Health Outcome List:

  • Not available

Environmental Agents

List of Environmental Agents:

  • Chlorinated compounds (polychlorinated biphenyl compounds (PCBs))

Source of Environmental Agents:

  • Occupational exposure via a capacitor and transformer recycling company

Economic Evaluation / Methods and Source

Type:

  • Cost analysis (CA)

Cost Measures:

  • Health-related quality of life (HRQL)
  • quality-associated life years (QALYs)

Potential Cost Measures:

  • Not available

Benefits Measures:

  • Not available

Potential Benefits Measures:

  • Not available

Location:

  • Germany

Models Used:

  • Linear calculation model to calculate Quality-Adjusted Life Year (QALY) using Health-Related Quality of Life (HRQL) and Remaining Life Expectancy (RLE)

Models References:

  • Greiner et al., 2005; Esser et al., 2012; Esser et al., 2014

Methods Used:

  • Authors examined the longitudinal impact of PCBs on health-related quality of life (HRQL) and quality-adjusted life years (QALYs) for participants enrolled in the Health Effects in High-Level Exposure to Polychlorinated Biphenyls (HELPcB) medical surveillance program. The authors — 1) included 118 participants for whom a complete data set in three cross-sections at three consecutive years was available; 2) used results from the EQ-5D-3L self-report instrument/questionnaire to determine the HRQL for participants; 3) calculated QALYs for participants using a linear calculation model; and 4) performed statistical analysis (repeated-measurement analysis of covariance) for each PCB congener and each PCB sum variable including potential confounders.

Sources Used:

  • Health Effects in High-Level Exposure to PCB (HELPcB) medical surveillance program (Schettgen et al., 2011); EQ-5D-3L self-report instrument via the EuroQol Group (Rabin et al., 2013); Algorithm derived from time trade off (TTO) study (Greiner et al., 2005); Remaining life expectancy values via the mortality table 2010 for Germany (Federal Statistical Office, 2012); additional sources cited in publication

Economic Citation / Fundings

Citation:

  • Esser A, Gaum PM, Schettgen T, Kraus T, Gube M, and Lang J. Effect of occupational polychlorinated biphenyls exposure on quality-adjusted life years over time at the HELPcB surveillance program. J Toxicol Environ Health A. 2015. 78; 2.
  • Pubmed
  • DOI

NIEHS Funding:

  • Not available

Other Funding:

  • Institution for Statutory Accident Insurance and Prevention in the Energy, Textile, Electrical, and Media Industry (BGETEM), Cologne, Germany — Grant number 360328