K.J. Somaiya Institute of Management Studies and Research, Vidyavihar (East), Mumbai 400077, India.
Public Health. 2011 Mar;125(3):157-64. doi: 10.1016/j.puhe.2010.11.009. Epub 2011 Feb 18.
Mumbai, a mega city with a population of more than 12 million, is experiencing acute air pollution due to commercial activity, a boom in construction and vehicular traffic. This study was undertaken to investigate the link between air pollution and health impacts for Mumbai, and estimate the monetary burden of these impacts.
Cross-sectional data were subjected to logistic regression to analyse the link between air pollution and health impacts, and the cost of illness approach was used to measure the monetary burden of these impacts.
Data collected by the Environmental Pollution Research Centre at King Edward Memorial Hospital in Mumbai were analysed using logistic regression to investigate the link between air pollution and morbidity impacts. The monetary burden of morbidity was estimated through the cost of illness approach. For this purpose, information on treatment costs and foregone earnings due to illness was obtained through the household survey and interviews with medical practitioners.
Particulate matter (PM(10)) and nitrogen dioxide (NO(2)) emerged as the critical pollutants for a range of health impacts, including symptoms such as cough, breathlessness, wheezing and cold, and illnesses such as allergic rhinitis and chronic obstructive pulmonary disease (COPD). This study developed the concentration-response coefficients for these health impacts. The total monetary burden of these impacts, including personal burden, government expenditure and societal cost, is estimated at 4522.96 million Indian Rupees (INR) or US$ 113.08 million for a 50-μg/m(3) increase in PM(10), and INR 8723.59 million or US$ 218.10 million for a similar increase in NO(2).
The estimated monetary burden of health impacts associated with air pollution in Mumbai mainly comprises out-of-pocket expenses of city residents. These expenses form a sizable proportion of the annual income of individuals, particularly those belonging to poor households. These findings have implications for public health policy, particularly accessibility and affordability of health care for poor households in Mumbai. The study provides a rationale for strengthening the public health services in the city to make them more accessible to poor households, especially those living in the slums of Mumbai.
孟买是一个拥有超过 1200 万人口的特大城市，由于商业活动、建筑和交通车辆的蓬勃发展，孟买正面临着严重的空气污染问题。本研究旨在调查孟买的空气污染与健康影响之间的关系，并估算这些影响的货币负担。
采用横断面数据进行逻辑回归分析，以探讨空气污染与健康影响之间的关系，并采用疾病成本法来衡量这些影响的货币负担。
采用逻辑回归分析孟买市环境污染研究中心收集的数据，以探讨空气污染与发病影响之间的关系。采用疾病成本法估算发病的货币负担。为此，通过家庭调查和与医务人员的访谈，获得了有关治疗费用和因疾病而丧失的收入信息。
细颗粒物（PM(10)）和二氧化氮（NO(2)）是一系列健康影响的关键污染物，包括咳嗽、呼吸困难、喘息和感冒等症状，以及过敏性鼻炎和慢性阻塞性肺疾病（COPD）等疾病。本研究制定了这些健康影响的浓度-反应系数。这些影响的总货币负担，包括个人负担、政府支出和社会成本，估计为 4522.96 亿印度卢比（INR）或 50μg/m(3)PM(10)增加 1 微克/立方米的 113.08 百万美元，或类似的 NO(2)增加 8723.59 亿卢比或 218.10 百万美元。
孟买市空气污染相关健康影响的估计货币负担主要由城市居民的自付费用构成。这些费用占个人年收入的相当大一部分，特别是来自贫困家庭的个人。这些发现对公共卫生政策具有重要意义，特别是对孟买市贫困家庭获得医疗保健的可及性和可负担性。本研究为加强该市的公共卫生服务提供了依据，以使它们更容易为贫困家庭，特别是孟买贫民窟的家庭所接受。
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