Serrier Hassan, Sultan-Taieb Hélène, Luce Danièle, Bejean Sophie
Laboratoire d'Économie et Gestion, Pôle Économie Gestion, Université de Bourgogne, 2 boulevard Gabriel, BP 26611, 21066, Dijon Cedex, France,
Eur J Health Econ. 2014 Jul;15(6):661-73. doi: 10.1007/s10198-013-0528-6. Epub 2013 Aug 24.
The objective of this article was to estimate the social cost of respiratory cancer cases attributable to occupational risk factors in France in 2010.
According to the attributable fraction method and based on available epidemiological data from the literature, we estimated the number of respiratory cancer cases due to each identified risk factor. We used the cost-of-illness method with a prevalence-based approach. We took into account the direct and indirect costs. We estimated the cost of production losses due to morbidity (absenteeism and presenteeism) and mortality costs (years of production losses) in the market and nonmarket spheres.
The social cost of lung, larynx, sinonasal and mesothelioma cancer caused by exposure to asbestos, chromium, diesel engine exhaust, paint, crystalline silica, wood and leather dust in France in 2010 were estimated at between 917 and 2,181 million euros. Between 795 and 2,011 million euros (87-92%) of total costs were due to lung cancer alone. Asbestos was by far the risk factor representing the greatest cost to French society in 2010 at between 531 and 1,538 million euros (58-71%), ahead of diesel engine exhaust, representing an estimated social cost of between 233 and 336 million euros, and crystalline silica (119-229 million euros). Indirect costs represented about 66% of total costs.
Our assessment shows the magnitude of the economic impact of occupational respiratory cancers. It allows comparisons between countries and provides valuable information for policy-makers responsible for defining public health priorities.
本文旨在估算2010年法国因职业风险因素导致的呼吸道癌症病例的社会成本。
根据归因分数法并基于文献中现有的流行病学数据，我们估算了每种已识别风险因素导致的呼吸道癌症病例数。我们采用基于患病率的疾病成本法。我们考虑了直接和间接成本。我们估算了市场和非市场领域因发病（旷工和出勤但生产力下降）导致的生产损失成本以及死亡成本（生产损失年数）。
2010年法国因接触石棉、铬、柴油机尾气、油漆、结晶硅石、木材和皮革粉尘导致的肺癌、喉癌、鼻窦癌和间皮瘤的社会成本估计在9.17亿至21.81亿欧元之间。总成本中的7.95亿至20.11亿欧元（87 - 92%）仅归因于肺癌。2010年，石棉是对法国社会成本最高的风险因素，在5.31亿至15.38亿欧元之间（58 - 71%），领先于柴油机尾气，其估计社会成本在2.33亿至3.36亿欧元之间，以及结晶硅石（1.19亿至2.29亿欧元）。间接成本约占总成本的66%。
我们的评估显示了职业性呼吸道癌症经济影响的规模。它有助于进行国家间比较，并为负责确定公共卫生优先事项的政策制定者提供有价值的信息。
