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Your Environment. Your Health.

Assessing the health benefits of air pollution reduction for children

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost-benefit analysis (CBA)
Wong EY, Gohlke J, Griffith WC, Farrow S, and Faustman EM
Environmental Health Perspectives
This study estimated that the inclusion of child-specific data on hospitalizations, emergency department visits, school absences and low birth weight would add $1-2 billion to the predicted cost estimates of decreased morbidity and mortality derived from the US Clean Air Act (CAA). The results highlighted the need for environmental health policy analyses to include improved information for children's health effects.
Children and adolescents (≤ 18 years)

Health Outcomes

  • Mortality (post-neonatal mortality)
  • respiratory outcomes (asthma, upper respiratory symptoms, lower respiratory symptoms, shortness of breath, chest tightness, wheeze, acute bronchitis)
  • birth outcomes (low birth weight, birth defects (ventricular septal defect))

Environmental Agents

List of Environmental Agents:

  • Air Pollutants (ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter (PM10 and PM2.5))

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source


  • Cost-benefit analysis (CBA)

Cost Measured:

  • Hospital admissions and emergency department visits

Potential Cost Measures:

  • Pain and suffering
  • lost leisure time

Benefits Measures:

  • Reduced cases of post-neonatal mortality
  • reduced number of asthma hospitalizations, emergency department visits
  • avoided school absences
  • reduced number of low birth weight infants

Potential Benefits:

  • Benefits of reduced birth defects (e.g., cardiac defects)

Location: (Not available)

Models Used:

  • Fast Environmental Regulatory Evaluation Tool (FERET)

Methods Used:

  • The authors utilized a meta-analysis approach to assess child-specific health impacts derived from the US Clean Air Act (CAA). The authors — 1) surveyed the peer-reviewed air pollution literature for studies focused exclusively on children or presenting results for children ≤ 18 years of age in the US; 2) included 23 original studies examining the association between a considered health effect and an air pollutant; 3) used estimated expected average changes in annual air pollutant concentrations for the entire US on a national level through 2010 based on a previous analysis of the US EPA 1990 - 2010 study (Farrow et al. 2001) to allow comparability with previous studies; 4) estimated a projected 2010 US population ≤ 18 years old; and 5) analyzed health impacts using regression coefficients from different studies of the same health outcome that were combined to form a regression coefficient specific to each end point and pollutant.

Sources Used:

  • International Classification of Diseases (US DHHS 1991); US Census Bureau (2002); additional sources cited in publication

Economic Evaluation / Methods and Source


  • Wong EY, Gohlke J, Griffith WC, Farrow S, and Faustman EM. 2004. Assessing the health benefits of air pollution reduction for children. Environmental Health Perspectives.
  • Pubmed
  • DOI

NIEHS Funding:

  • 1P01ES09601

Other Funding: (Not available)

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