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Costs of attributable burden disease to PM2.5 ambient air pollution exposure in Medellín, Colombia, 2010–2016
F1000Research
Abstract
Introduction : The impact of PM2.5 ambient air pollution exposure on morbimortality has been documented; however, for Latin American cities, there are no calculations of the economic burden. The objective of the study was to estimate the costs of attributable burden disease to PM2.5 ambient air pollution exposure in Medellín, Colombia.
Methods : The costs were assessed using the cost-of-illness approach and the human capital approach, which include direct medical costs and indirect costs due to loss of productivity. To estimate the value of the lost years of production the salaries established in the Great Integrated Household Survey carried out in September 2016 by the National Administrative Department of Statistics of Colombia were used. The PYWL were calculated taking as a reference the 57 years to age of death for female and 62 years for male. For both, an alternative scenario was proposed to account for the cost of working years by changing the reference age to 80 years.
Results : A total of 5540 potential years of working life lost due to premature deaths attributed to exposure to PM2.5 was calculated. The costs of attributable morbimortality to PM2.5 exposure in Medellín totaled 86,0 million dollars in baseline scenario and 281,2 million dollars in alternative scenario. Which represented 0.091% of the gross domestic product of Colombia and 0.627% of that from the Department of Antioquia. The highest percentage of the costs associated with the loss of productivity originated in the premature death of the population over 50 years of age, both due to chronic and acute events.
Discussion : The costs of mortality represented 80% of the total. PM2.5 ambient air pollution exposure generates significant costs associated with the loss of years of working life, due to acute infections and chronic diseases of respiratory tract and ischemic heart diseases
... Their work has established a correlation between population exposure to atmospheric pollutants such as PM10, PM2.5, and ozone, and an increased risk of morbidity and mortality. Specifically, they found that when PM2.5 levels were high, there was an increase in acute and chronic infections of the lower respiratory tract and cerebrovascular disease (Piñeros-Jiménez et al., 2018;Piñeros-Jiménez et al., 2019;Grisales-Romero et al., 2021;Nieto-López et al., 2022;Piñeros-Jiménez et al., 2022). They also characterized the pollutants' chemical composition-including nitrous oxide, sulfur, and black carbon-and found that these pollutants increase with environmental changes, particularly during the transition from dry to wet seasons. ...
... Residents' respiratory issues may be explained by exposure to pollutants (PM2.5) (Kampa and Castanas, 2008;Pope et al., 2016), especially given regional patterns (Grisales-Romero et al., 2021;Nieto-López et al., 2022) ...
Background: There has been a growing interest in the economic burden of mortality; however, a majority of evidence is concerned with particular diseases. Less is known on the overall cost of all-cause early deaths, principally in international context. Therefore, this study aims to estimate production losses of premature mortality across 28 European Union (EU-28) countries in 2015.
Methods: The human capital method was applied to estimate the production losses (indirect costs) of all-cause deaths occurring at working age. The sex- and age-specific data on the number of deaths were taken from Eurostat’s database and a set of labour market measures was used to determine time of work during whole lifespan in particular countries.
Results: The total production losses of all-cause premature mortality in EU-28 in 2015 were €174.6 billion, adjusted for purchasing power parity. The per capita production losses associated with early deaths were €342.39 for the whole EU-28 population on average; Lithuania experienced the highest per capita burden (€643.68), while the average costs were lowest in Greece (€188.69). These figures translated to an economic burden of 1.179% of gross domestic product in EU-28 and this share ranged from 0.679% in Luxembourg to 3.176% in Latvia. Most of the losses were due to men’s deaths and the proportion of losses associated with male mortality ranged from 64.7% in the Netherlands to 81.2% in Poland.
Conclusions: Premature mortality is a considerable economic burden for European societies; however, the production losses associated with early deaths vary notably in particular countries.
Background:
Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels.
Methods:
We estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM2·5) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements. Using integrated exposure-response functions for each cause of death, we estimated the relative risk of mortality from ischaemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infections from epidemiological studies using non-linear exposure-response functions spanning the global range of exposure.
Findings:
Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000-422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015.
Interpretation:
Ambient air pollution contributed substantially to the global burden of disease in 2015, which increased over the past 25 years, due to population ageing, changes in non-communicable disease rates, and increasing air pollution in low-income and middle-income countries. Modest reductions in burden will occur in the most polluted countries unless PM2·5 values are decreased substantially, but there is potential for substantial health benefits from exposure reduction.
Funding:
Bill & Melinda Gates Foundation and Health Effects Institute.
El objetivo de este manual metodológico es definir el caso de referencia para el desarrollo de
evaluaciones económicas de tecnologías en salud en Colombia. La adopción de las pautas aquí
contenidas por los centros de investigación, grupos desarrolladores y demás actores que elaboren
evaluaciones de tecnologías en salud en Colombia, posibilitará el desarrollo sistemático de
evaluaciones económicas y disminuirá la variabilidad de los métodos, de las fuentes de información y
de la estructura paramétrica de los modelos de decisión, facilitando la reproducibilidad, transparencia
y la incorporación de los resultados de la evaluación económica como uno de los criterios para la
formulación de políticas públicas en salud. Este manual se revisará anualmente y, en caso de ser
necesario, se realizarán los ajustes pertinentes
This study investigates the economic valuation of air-pollution-related health risks in China by applying the contingent valuation method. An individual interview survey is conducted to elicit resident's willingness-to-pay (WTP) for health risk reductions of asthma and mortality. Binary choice WTP question is used in the in-person interview. Using binary probit model, the estimated value of a statistical case of asthma is about US24,000. The issues of private and public provision mechanisms of health risk reduction, and the scale effect of the WTP to the magnitude of risk are also discussed.
Cost-of-illness (COI) studies often include the 'indirect' cost of lost production resulting from disease, disability, and premature death, which is an important component of the economic burden of chronic conditions assessed from the societal perspective. In most COI studies, productivity costs are estimated primarily as the economic value of production forgone associated with loss of paid employment (foregone gross earnings); some studies include the imputed value of lost unpaid work as well. This approach is commonly but imprecisely referred to as the human capital approach (HCA). However, there is a lack of consensus among health economists as to how to quantify loss of economic productivity. Some experts argue that the HCA overstates productivity losses and propose use of the friction cost approach (FCA) that estimates societal productivity loss as the short-term costs incurred by employers in replacing a lost worker. This review sought to identify COI studies published during 1995-2017 that used the FCA, with or without comparison to the HCA, and to compare FCA and HCA estimates from those studies that used both approaches. We identified 80 full COI studies (of which 75% focused on chronic conditions), roughly 5-8% of all COI studies. The majority of those studies came from three countries, Canada, Germany, and the Netherlands, that have officially endorsed use of the FCA. The FCA results in smaller productivity loss estimates than the HCA, although the differential varied widely across studies. Lack of standardization of HCA and FCA methods makes productivity cost estimates difficult to compare across studies.
569 fuera a costa de que su esperanza de vida disminuyera en, por ejem-plo, 6 meses. Hay, por tanto, di-versas combinaciones (Q,Y) que tienen el mismo valor para las personas. 4. La salud de una persona pue-de medirse como la suma de la calidad de vida durante los años que dura su vida. Por ejemplo, si una persona pasa 5 años en silla de ruedas, 10 años bien, 3 años con cáncer de próstata y al final muere, su salud puede ser re-presentada de la siguiente ma-nera: (Calidad de vida en silla de rue-das, 5 años) + (Calidad de vida en buena salud, 10 años) + (Calidad de vida con cáncer de próstata, 3 años) + Muerte. Otra persona (de la misma edad) puede estar 12 años en buena sa-lud seguidos de Alzheimer duran-te 2 años, al cabo de los cuales acontece la muerte. Por tanto, su salud es: (Calidad de vida en buena salud, 12 años) + (Calidad de vida Alz-heimer, 2 años) + Muerte. Lo que nosotros queremos es po-der comparar la salud de estas 2 personas de manera que sepamos cuál debemos elegir para producir el mayor beneficio sanitario po-sible. Para ello, llamemos a la calidad de vida asociada a un cierto pro-blema de salud U (Q), esto es, uti-lidad o bienestar asociada al esta-do de salud correspondiente. La ABC EN EVALUACIÓN ECONÓMICA
Gender emerges from a process of social construction that defines what is masculine and what is feminine on the basis of biological sexes to the extent of setting the positions of power between them. National political agendas and international bodies have addressed the unfavorable situation of women with respect to men caused by inequalities to which females have been subjected to throughout the history. In the Third Conference on Woman held in Nairobi in 1985, discrimination of females in the economic, political and social contexts was recognized, which is considered as a natural event. The Fourth Conference on Woman held in Beijing in 1995 discussed gender equity and woman empowerment, both accepted as a milestone for the planning of health policies and population programs. The UN General Assembly session held from June to July, 1999 in New York City called upon the scientific community to focus its efforts on the design and use of indicators capable of measuring the real health situation in general and the reproductive health in particular, paying special attention to gender approach. This article made a reflection on gender approach in the field of public health based on the theoretical sex-gender system.
El objetivo de este trabajo es analizar la evolución de la productividad en Colombia durante el período 1950-89 y establecer su relación con la tasa de cambio real. Se realizan cálculos aproximados sobre las tendencias de largo plazo de la productividad laboral y multifactorial. Posteriormente, se analiza su relación con los salarios reales y la tasa de cambio real (TCR) durante los años 1975-85. Se encontró que la productividad pasó de crecer al 1.9%, en los años 1950-80, a decrecer al 0,7% anual, en el período 1981-89. También se observó un desfase importante entre la evolución de los salarios reales y la productividad. Al involucrar dicho desfase en el cálculo de lo que podría llamarse una TCR-Salarial (Respecto el dólar), no se encuentran ganancias reales superiores al 2% entre 1989 y 1975. Sin embargo, si se realizan ajustes por productividad multifactorial al cálculo tradicional de la TCR-IPM, si se observan ganancias históricas hasta 18% entre 1989 y 1975.
The measurement of illness costs involves the distribution of direct expenditures by disease categories and the development of a systematic framework for use in estimating annual losses in output and the present value of lifetime earnings lost as a result of death. When the annual direct expenditures for medical care services and supplies are added to the losses to the economy caused by illness and to the present value of lost output for those who have died, the total economic costs of poor health in fiscal year 1967 are estimated to have amounted to at least $125 billion. The measurement of illness costs has been applied and used in the several cost-benefit analyses generated by the planning-programing-budgeting system within the Department of Health, Education, and Welfare. Alternative techniques to the use of various mortality and morbidity measures include the translation of benefits into dollar terms. The major issues that result in differences in analytical procedures arise from the difficulty of measuring intangible benefits and the varying values placed on different age groups. The translation of tangible savings into dollar benefits by cost-benefit analysis enables the decision-maker to consider them along with the unmeasurable and nonquantifiable social and political benefits.
Los intentos de cuantificación del valor estadístico de la vida (VEV) a través de los intercambios entre riesgo y salario se han desarrollado mayoritariamente a partir del Modelo de Salarios Hedónicos. Bajo este esquema conceptual, el presente trabajo realiza una estimación del VEV a partir de una amplia base de datos del mercado de trabajo español y de la construcción de índices de riesgo laboral que incorporan simultáneamente la ocupación y la rama de actividad para el período 1997-2000. Los principales resultados de la aplicación constatan una relación positiva entre el riesgo de accidentalidad y el salario percibido y sitúan el VEV en España en el rango de 2 a 2,7 millones de euros, a precios del 2000.
Local attributable burden disease to PM2.5 ambient air pollution in Medellín, Colombia, 2010-2016 [versión 1, peer review: 1 approved.
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