Health Outcomes

Health Outcome List:

• Respiratory outcomes (asthma, asthma exacerbation-related outcomes such as bronchitis episodes, ear, and sinus infections)

Environmental Agents

List of Environmental Agents:

• Air pollutants (near-roadway air pollution, ozone (O3), nitrogen dioxide (NO2))

Source of Environmental Agents:

• Residential near-roadway air pollution, regional ozone (O3), and nitrogen dioxide (NO2)

Economic Evaluation / Methods and Source

Type:

• Cost analysis (CA)

Cost Measures:

• Costs of hospitalization
• inpatient hospital stays
• emergency room visits
• doctor visits
• asthma inhalers and drugs
• caregiver’s time spent traveling, waiting, and receiving care for office visits, ER visits, and hospitalizations
• medication use and treatment for asthma-related comorbidities (e.g., ear and sinus infections)
• school absences
• antibiotics prescriptions

Potential Cost Measures:

• Lower lifetime earnings for caregivers of children with asthma
• costs associated with adult asthma

Benefits Measures:

• Not available

Potential Benefits Measures:

• Not available

Location:

• Los Angeles County, California

Models Used:

• Yes

Models References:

• Authors developed a model to disaggregate the costs of regional pollution and near-roadway air pollution exposure

Methods Used:

• The authors estimated the cost of childhood asthma attributable to residential near-roadway air pollution, regional ozone, and nitrogen dioxide in Los Angeles County. The authors — 1) used concentration response functions (CRF) to estimate the prevalence of asthma attributable to near-roadway air pollution; 2) integrated results from a study of willingness to pay to reduce the burden of asthma with studies of health care utilization and charges to estimate the costs of an asthma case and exacerbation; and 3) applied those costs to the number of asthma cases and exacerbations due to regional pollution in 2007 and to hypothetical scenarios of a 20% reduction in regional pollution in combination with a 20% reduction or increase in the proportion of families living in proximity to a major roadway relative to 2007 levels.

Sources Used:

• Southern California Children's Health Study (2007); Final 2012 Air Quality Management Plan (South Coast Air Quality Management District, 2013); Healthcare Cost and Utilization Project (Agency for Healthcare Research and Quality, 2011); American Academy of Pediatricians Medicaid Reimbursement Survey 2007/2008; Agency for Healthcare Research and Quality (2004); Epocrates (2010); National Household Travel Survey (U.S. Department of Transportation/Federal Highway Administration, Bureau of Transportation Statistics, and National Highway Traffic Safety Administration, 2009); National Health Statistics Reports (2008) National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary; US Census Bureau (2012); California Health Interview Survey (2009); Health care utilization and cost in children with asthma and selected comorbidities (Grupp-Phelan et al., 2001); Medical Expenditure Panel Survey (2007); Contingent valuation scenarios for chronic illnesses: The case of childhood asthma (Brandt et al., 2012); additional sources cited in publication

Economic Citation / Fundings

Citation:

• Brandt S, Perez L, Kunzli N, Lurmann F, Wilson J, Pastor M, and Mcconnell R. Cost of near-roadway and regional air pollution-attributable childhood asthma in Los Angeles County. J Allergy Clin Immunol. 2014. 134; 5.
• Pubmed
• DOI

NIEHS Funding:

• R01ES016535, P01ES011627, P30ES007048, P01ES009581, 5R01ES014447

Other Funding:

• EPA grants: R826708, RD831861, R831845; South Coast Air Quality Management District; The Hastings Foundation