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Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution

Environmental Health Economic Analysis Annotated Bibliography

Details

Research article Cost-benefit analysis (CBA)
Authors
Stieb DM, De Civita P, Johnson FR, Manary MP, Anis AH, Beveridge RC, and Judek S
Journal
Environmental Health
Summary
This paper evaluated epidemiological studies estimating the costs and benefits of reducing acute cardiorespiratory morbidity associated with air pollution. The authors determined that decreases in particulate sulfate concentrations in Toronto between 1984 and 1999 resulted in annual benefits of $1.4 million in relation to reduced emergency department visits and hospital admissions for cardiorespiratory disease. The authors described an approach to estimating the value of avoiding morbidity effects of air pollution that addressed a number of the limitations of the current literature and is applicable to future assessments of the benefits of improving air quality.
Population
Not available

Health Outcomes

  • 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 Measured:

  • 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: (Not available)

Location:

  • Saint John and Toronto, Canada

Models Used:

  • Cost of treatment model

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 Evaluation / Methods and Source

Citation:

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

Pubmed:

DOI: (Not available)

NIEHS Funding: (Not available)

Other Funding: (Not available)