Serrier Hassan, Sultan-Taïeb Hélène, Luce Danièle, Béjean Sophie
Sante Publique. 2017 Oct 2;29(4):509-524. doi: 10.3917/spub.174.0509.
To estimate the social cost of respiratory cancers attributable to occupational risk factors in France in 2010.
We estimated the number of cases of respiratory cancers attributable to each identified occupational risk factor according to the attributable fractions method. We also estimated direct (costs of hospital stays, drugs, outpatient care) and indirect costs (production losses) related to morbidity (absenteeism and presenteeism) and mortality (years of lost production). Production losses for paid work and unpaid domestic activities were taken into account.
The social cost of respiratory cancers (lung, larynx, sinonasal, pleural mesothelioma) attributable to exposure to asbestos, chromium, diesel engine exhaust, polycyclic aromatic hydrocarbons, painting occupations (unidentified carcinogen), crystalline silica, wood and leather dust in France in 2010 was estimated to be between €960 and 1,866 million. The cost of lung cancer represents between €804 and 1,617 million. The three risk factors with the greatest impact are asbestos (€530 to 890 million), diesel engine exhaust (€227 to 394 million), and crystalline silica (€116 to 268 million).
These results provide a conservative estimate of the public health and economic burden of respiratory cancers attributable to occupational risk factors from a societal perspective.
估算2010年法国职业风险因素所致呼吸道癌症的社会成本。
我们根据归因分数法估算了每种已确定职业风险因素所致呼吸道癌症病例数。我们还估算了与发病（旷工和出勤主义）和死亡（生产损失年数）相关的直接成本（住院、药品、门诊护理费用）和间接成本（生产损失）。考虑了有偿工作和无偿家务活动的生产损失。
2010年法国因接触石棉、铬、柴油机尾气、多环芳烃、油漆行业（未识别致癌物）、结晶硅石、木材和皮革粉尘所致呼吸道癌症（肺癌、喉癌、鼻窦癌、胸膜间皮瘤）的社会成本估计在9.60亿欧元至18.66亿欧元之间。肺癌成本在8.04亿欧元至16.17亿欧元之间。影响最大的三个风险因素是石棉（5.30亿欧元至8.90亿欧元）、柴油机尾气（2.27亿欧元至3.94亿欧元）和结晶硅石（1.16亿欧元至2.68亿欧元）。
从社会角度来看，这些结果对职业风险因素所致呼吸道癌症的公共卫生和经济负担提供了保守估计。
