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QALY as evaluation tool in a health surveillance program

Environmental Health Economic Analysis Annotated Bibliography

Details

Research article Cost analysis (CA)
Authors
Esser A, Gube M, Schettgen T, Kraus T, and Lang J
Journal
Int J Hyg Environ Health
Summary
This study assessed whether PCB exposure can be associated with the quality adjusted life years (QALYs) of participants in an occupational exposure surveillance program. The authors found a significant effect of PCB exposure on QALY where PCB exposure reduced health-related quality of life (HRQL) in the remaining lifetime of surveillance program participants. The results supported the use of QALYs to monitor HRQL effects in surveillance programs and suggested that exposure to hazardous substances has an influence on QALYs.
Population
Participants in the Health Effects in High-Level Exposure to PCB (HELPcB) medical surveillance program

Health Outcomes

  • Not available

Environmental Agents

List of Environmental Agents:

  • Chlorinated compounds (polychlorinated biphenyls (PCBs))

Source of Environmental Agents:

  • Occupational exposure via a capacitor and transformer recycling company

Economic Evaluation / Methods and Source

Type:

  • Cost analysis (CA)

Cost Measured:

  • Quality adjusted life years (QALYs)
  • health-related quality of life (HRQL)

Potential Cost Measures: (Not available)

Benefits Measures: (Not available)

Potential Benefits: (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)
  • Complex Number Model as alternate method to calculate QALYs
  • Hierarchical linear regression models with control variables to test whether PCB exposure is associated with HRQL and QALYs

Methods Used:

  • The authors assessed whether PCB exposure can be associated with the quality adjusted life years (QALYs) of participants in an occupational exposure surveillance program. The authors — 1) determined internal PCB load of program participants using gas chromatography with mass spectrometry in plasma; 2) used a questionnaire to assess health related quality of life (HRQL) and generated an HRQL index value; 3) used a linear model that combined HRQL index value with remaining life expectancy of an individual to calculate QALY; 4) used a Complex Number Model as alternate method to calculate QALYs; and 5) used a hierarchical linear regression model with control variables to assess whether PCB exposure was associated with individual HRQL and QALYs.

Sources Used:

  • Remaining life expectancy values via the mortality table 2010 for Germany (Federal Statistical Office, 2012); Biomonitoring data (PCB levels in plasmas) from surveillance program participants (Schettgen et al., 2011); HRQL data from surveillance program participants using EQ-5D-3L self-report tool (Rabin et al., 2013); additional sources cited in publication

Economic Evaluation / Methods and Source

Citation:

  • Esser A, Gube M, Schettgen T, Kraus T, and Lang J. 2014. QALY as evaluation tool in a health surveillance program. Int J Hyg Environ Health.

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 (unrestricted grant to the UK Hospital Aachen, RWTH Aachen University, grant number360328)