Department of Health Information Technology, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran; Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
Ecotoxicol Environ Saf. 2024 Nov 1;286:117158. doi: 10.1016/j.ecoenv.2024.117158. Epub 2024 Oct 15.
Air pollution is one of the main causes of global disease burden, especially in low-income and middle-income countries. Estimation of the current situation and prediction of the future health effects of death and incidence of stroke and coronary heart disease (CHD) attributed to PM were done using BenMAP-CE software. Estimating and forecasting the economic burden of these diseases were done in 4 scenarios: Stability of the current PM concentration, annual 10 % reduction of PM concentration, reduction to 5 µg/m3, and reduction to 12 µg/m3, with three approaches for calculating the economic burden in mortality costs, including the human capital(HC), years of life lost(YLL) and value of statistical life(VSL) was performed. With the stability of the PM concentration, the economic burden of stroke attributed to PM with the approach of calculating the cost of death with the HC, the YLL, and VSL will reach from 64, 82 and 172 million USD in 2020-849, 1120 and 2703 million USD in 2030 and these costs for CHD in the mentioned approaches of calculating the cost of death will reach respectively from 499, 568 and 898 million USD in 2020-7096, 8088, and 13,621 million USD in 2030. We find that the morbidity economic burden (including direct, indirect, and intangible costs) of stroke compared to the cost of death with the HC, and YLL approaches are 67.58 times, 3.15 times respectively, and in the VSL approach is 47.32 % of stroke death cost. Also, the costs of CHD morbidity economic burden compared to the cost of death in the method of calculating the cost of death with the HC, YLL, and VSL approaches are 42.09, 7.25, and 1.16 times, respectively. This study provides comprehensive baseline information for health policymakers to understand the benefits of air pollution control policies globally, especially in LMICs.
空气污染是全球疾病负担的主要原因之一，尤其是在低收入和中等收入国家。本研究使用 BenMAP-CE 软件估算了当前情况，并预测了因 PM 导致的死亡和中风及冠心病（CHD）发病的未来健康影响。在 4 种情景下对这些疾病的经济负担进行了估计和预测：当前 PM 浓度稳定、PM 浓度每年降低 10%、降低至 5μg/m3 以及降低至 12μg/m3，并采用 3 种方法计算了死亡率的经济负担成本，包括人力资本（HC）、生命损失年数（YLL）和生命统计学价值（VSL）。在 PM 浓度稳定的情况下，采用 HC 方法计算死亡成本、YLL 和 VSL 方法计算中风归因于 PM 的经济负担，2020-2030 年将分别达到 6.4 亿-84.9 亿、11.2 亿-27.03 亿美元，在上述计算死亡成本的方法中，CHD 的经济负担将分别达到 4.99 亿-7.096 亿、5.68 亿-8.088 亿和 8.98 亿-1362.1 亿美元。结果发现，与 HC 和 YLL 方法相比，中风的发病经济负担（包括直接、间接和无形成本）分别是死亡成本的 67.58 倍和 3.15 倍，而在 VSL 方法中是死亡成本的 47.32%。同样，与 HC、YLL 和 VSL 方法计算的死亡成本相比，CHD 的发病经济负担分别是死亡成本的 42.09 倍、7.25 倍和 1.16 倍。本研究为卫生政策制定者提供了全面的基准信息，以了解全球空气污染控制政策的效益，特别是在中低收入国家。
