Institute of Occupational and Environmental Medicine, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Thorax. 2011 Feb;66(2):128-33. doi: 10.1136/thx.2010.136762. Epub 2010 Nov 21.
To estimate the social costs of occupational asthma in the UK.
A desk-top approach using cost-of-illness methodology was employed, defining direct and indirect lifetime costs for six scenarios: a male and a female worker each exposed to isocyanates, latex and biocides (eg, glutaraldehyde) or flour. The numbers of new cases annually in each industry were estimated from Survey of Work-related and Occupational Respiratory Disease (SWORD) data. The main outcome measure was the current value total working lifetime costs of new cases annually for each scenario.
Assuming 209 new cases of occupational asthma in the six scenarios in the year 2003, the present value total lifetime costs were estimated to be £25.3-27.3 million (2004 prices). Grossing up for all estimated cases of occupational asthma in the UK in 2003, this came to £70-100 million. About 49% of these costs were borne by the individual, 48% by the state and 3% by the employer.
The cost to society of occupational asthma in the UK is high. Given that the number of newly diagnosed cases is likely to be underestimated by at least one-third, these costs may be as large as £95-135 million. Each year a new stream of lifetime costs will be added as a newly diagnosed cohort is identified. Approaches to reduce the burden of occupational asthma have a strong economic justification. However, the economic burden falls on the state and the individual, not on the employer. The incentive for employers to act is thus weak.
评估英国职业性哮喘的社会成本。
采用疾病成本法，定义了 6 种情况下男性和女性工人接触异氰酸酯、乳胶和杀生物剂（如戊二醛）或面粉的直接和间接终生成本。根据工作相关和职业性呼吸道疾病调查（SWORD）数据，估算了每年每个行业的新病例数。主要观察指标为每年每种情况下新病例的总工作寿命成本的现值。
假设 2003 年 6 种情况下有 209 例职业性哮喘新病例，估计终生总成本现值为 2530-2730 万英镑（2004 年价格）。根据英国 2003 年所有职业性哮喘估计病例进行外推，这一数字达到 7000-1 亿英镑。这些成本中约 49%由个人承担，48%由国家承担，3%由雇主承担。
英国职业性哮喘给社会造成的成本很高。由于新诊断病例数至少低估了三分之一，这些成本可能高达 9500-1.35 亿英镑。随着新确诊病例队列的确定，每年都会增加新的终生成本流。减少职业性哮喘负担具有很强的经济合理性。然而，经济负担落在国家和个人身上，而不是雇主身上。因此，雇主采取行动的动力不足。
