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Particulate matter exposure and preterm birth: estimates of U.S. attributable burden and economic costs

Environmental Health Economic Analysis Annotated Bibliography

Details

Research article Cost analysis (CA)
Authors
Trasande L, Malecha P, and Attina TM
Journal
Environ Health Perspect
Summary
This meta-analysis estimated the economic costs of preterm birth attributable to PM2.5 exposure in the United States. The authors determined, across 48 states, that 3.32 percent of all preterm births in 2010 were attributable to PM2.5 exposure, and reported a combined estimate of $5.09 billion for preterm-birth related costs for medical care and lost economic productivity. They also determined that the PM2.5 attributable fraction of preterm birth was highest in urban counties. These results suggest that PM2.5 exposure may contribute substantially to the burden and costs of preterm birth in the United States, and considerable health and economic benefits may be achieved through environmental regulatory interventions that reduce PM2.5 exposure in pregnancy.
Population
Pregnant women and their children

Health Outcomes

  • Birth outcomes (preterm birth)

Environmental Agents

List of Environmental Agents:

  • Air pollutants (particulate matter (PM 2.5/fine))

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source

Type:

  • Cost analysis (CA)

Cost Measured:

  • Medical care costs for treatment of preterm birth-associated medical conditions in the first 5 years of life
  • medical care costs for treatment of preterm-birth associated with medical conditions after the first 5 years of life due to preterm birth-associated developmental disability
  • lost economic productivity (due to reduced cognitive potential)
  • preterm birth-associated IQ deficits or loss

Potential Cost Measures:

  • Direct and indirect costs related to maternal health, stillbirths, and birth defects that may be associated with PM2.5 exposure

Benefits Measures: (Not available)

Potential Benefits: (Not available)

Location:

  • United States

Models Used:

  • Environmentally Attributable Fraction (EAF) model

Methods Used:

  • Authors performed a meta-analysis to estimate the burden of preterm birth in the United States, and the economic costs attributable to PM2.5 exposure (as a proxy for outdoor air pollution) in 2010. The authors — 1) obtained daily averages of PM2.5 in 2008 for all ZIP codes in the United States as modeled by EPA; 2) estimated deciles of PM2.5 exposure for each county in 2008; 3) used data from different studies to contribute to estimates for preterm birth associated with prenatal PM2.5 exposure; 4) obtained county-level preterm birth rates for 2010 from the CDC WONDER database; 5) calculated the corresponding odds ratios for each decile of exposure above the lowest decile; 6) computed the attributable fraction of preterm birth for outdoor air pollution for each decile; and 7) estimated PM2.5-attributable direct (medical treatment costs) and indirect costs (lost economic productivity) associated with preterm birth.

Sources Used:

  • Data on daily averages of PM2.5 in 2008 for ZIP codes in the U.S. (U.S. EPA, 2014); CDC WONDER database for county-level preterm birth rates for 2010 in the U.S. (CDC, 2014a); U.S. Census data (U.S. Census Bureau, 2010); Medical Care Consumer Price Index (U.S. Department of Labor, Bureau of Labor Statistics, 2014); additional sources cited in publication

Economic Evaluation / Methods and Source

Citation:

  • Trasande L, Malecha P, and Attina TM. 2016. Particulate matter exposure and preterm birth: estimates of U.S. attributable burden and economic costs. Environ Health Perspect.

Pubmed:

DOI:

NIEHS Funding: (Not available)

Other Funding: (Not available)