Health Outcomes

• Mortality, Cardiovascular outcomes, Respiratory outcomes

Health Outcome List:

• Mortality/morbidity
• cardiorespiratory disease/illness
• respiratory outcomes (asthma, chronic obstructive pulmonary disease, respiratory infections, non-specific respiratory symptoms)
• cardiovascular outcomes (congestive heart failure, cardiac dysrhythmias, myocardial infarction/angina)

Environmental Agents

List of Environmental Agents:

• Air pollutants (sulfates)

Source of Environmental Agents:

• Not available

Economic Evaluation / Methods and Source

Type:

• Cost-benefit analysis (CBA)

Cost Measures:

• Respiratory and cardiac hospital admissions
• hospital utilization costs
• costs of physician visits, medication use, equipment and out-of-pocket expenses
• emergency department visits
• restricted activity days
• asthma symptom days
• acute respiratory symptom days
• cost of productivity losses (e.g., time lost by parents and caregivers)

Potential Cost Measures:

• Reduced work capacity

Benefits Measures:

• Benefits of reduced acute cardiorespiratory morbidity related to air pollution — reduced morbidity
• reduced pain/suffering
• reduced expenditures on mitigation of illness
• reduced risk of lost productivity
• reduced emergency department visits and hospital admissions for cardiorespiratory disease

Potential Benefits Measures:

• Not available

Location:

• Saint John and Toronto, Canada

Models Used:

• Cost of treatment model

Models References:

• Not available

Methods Used:

• The authors estimated the benefits of avoiding a variety of acute cardiorespiratory morbidity outcomes related to air pollution. The authors — 1) used empirical data on the duration and severity of cardiorespiratory disease as inputs to complementary models of cost of treatment, lost productivity, and willingness to pay (WTP) to avoid acute cardiorespiratory morbidity outcomes linked to air pollution in epidemiological studies; 2) used a Monte Carlo estimation procedure to propagate uncertainty in key inputs and model parameters; and 3) illustrated application of their approach by examining the benefits associated with reduced cardiorespiratory emergency department visits and hospital admissions attributable to the decline in particulate sulfate concentrations observed in Toronto, Canada from the mid-1980s to the late 1990s.

Sources Used:

• Report of sulphur in gasoline and diesel fuels (Health and Environmental Impact Assessment Panel, 1997); Health and selected socioeconomic characteristics of the family: United States (Collins and LeClere, 1996); Sample design of the National Population Health Survey (Tambay and Catlin, 1995); Associations between ambient particulate sulfate and admissions to Ontario hospitals for cardiac and respiratory diseases (Burnett et al., 1995); additional sources cited in publication

Economic Citation / Fundings

Citation:

• Stieb DM, De Civita P, Johnson FR, Manary MP, Anis AH, Beveridge RC, and Judek S. Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution. Environmental Health. 2002. 1; 1.
• Pubmed
• DOI

NIEHS Funding:

• Not available

Other Funding: Not available