kosten kinderastma door autoverkeer veel hoger dan tot nu toe gedacht

Onderzoekers van de University of Massachusetts, uit Californië en Zwitserland hebben de kosten geschat van kinderastma veroorzaakt door luchtvervuiling, die op haar beurt veroorzaakt wordt door het autoverkeer. Ze stellen meteen vast dat de totale kosten van astma heel wat hoger zijn dan wat vroegere schattingen suggereerden, en dat de bewijzen tegen de auto als ernstige vervuiler zich opstapelen. Daarnaast zijn die kosten aanzienlijk hoger in regio’s met meer luchtvervuiling door autoverkeer.

Costs of childhood asthma due to traffic-related pollution in two california communities

Abstract

Recent research suggests the burden of childhood asthma attributable to air pollution has been underestimated in traditional risk assessments, and there are no estimates of these associated costs. We estimated the yearly childhood asthma-related costs attributable to air pollution for Riverside and Long Beach, California, including: 1) the indirect and direct costs of health care utilization due to asthma exacerbations linked to traffic-related pollution (TRP); and 2) the costs of health care for asthma cases attributable to local TRP exposure.

We estimated these costs using estimates from peer-reviewed literature and the authors' analysis of surveys (Medical Expenditure Panel Survey, California Health Interview Survey, National Household Travel Survey, and Health Care Utilization Project).

A lower-bound estimate of the asthma burden attributable to air pollution was $18 million yearly. Asthma cases attributable to TRP exposure accounted for almost half of this cost. The cost of bronchitic episodes was a major proportion of both the annual cost of asthma cases attributable to TRP and of pollution-linked exacerbations.

Traditional risk assessment methods underestimate both the burden of disease and cost of asthma associated with air pollution, and these costs are borne disproportionately by communities with higher than average TRP.

S.J. Brandt

European Respiratory jounal 24-01-2012
http://erj.ersjournals.com/content/early/2012/01/24/09031936.00157811.abstract?sid=f5f7875b-b731-41c7-aba2-7c69beee0021

zie ook http://171.66.122.149/content/early/2004/06/07/rccm.200403-281OC.full.pdf

Asthma from traffic pollution underestimated, finds study

A study released online this week shows the cost and rates of asthma from traffic pollution have been underestimated. Researchers for the study used new techniques to find the cost of the disease is $18 million per year.

According to the investigation, led by University of Massachusetts Amherst resource economist Sylvia Brandt, with colleagues in California and Switzerland, factoring in traffic pollution as a cause and trigger for asthma boosts estimates of cases and cost associated with the respiratory disease.

The authors say factoring in new asthma cases and exacerbation from pollution is important, given the growing body of evidence that fine particulate matter from traffic inflames the airways and contributes to new diagnoses and makes existing asthma worse.

Brandt and colleagues looked at asthma rates and cost in River Side and Long Beach, using the updated technique. They found the total annual cost of asthma was $3,819 in Long Beach and $4,063 in Riverside.

Image credit: Wikimedia commons
 

The authors say, “the largest share of the cost of an asthma case was the indirect cost of asthma-related school absences." School absences are important, they add, because "they often lead to parents or caregivers missing work."

Brandt says, "Traditional risk assessment methods for air pollution have underestimated both the overall burden of asthma and the cost of the disease associated with air pollution. Our findings suggest the cost has been substantially underestimated and steps must be taken to reduce the burden of traffic-related pollution."

Half of the $18 million annually is from new cases, according to the study authors.

The researchers found cost, new cases and exacerbation of asthma related to missed work, school absences, extra doctor visits, travel and prescriptions is higher for those living in areas polluted by traffic and has been underestimated.

European Respiratory Journal:doi: 10.1183/​09031936.00157811
"Costs of childhood asthma due to traffic-related pollution in two california communities"
S.J. Brandt et al.
January 20, 2012

http://www.emaxhealth.com/1020/asthma-costs-traffic-pollution-underestimated-finds-study

Asthma Rate and Costs from Traffic Pollution Higher: Much Higher Than Past Traditional Risk Assessments Have Indicated

ScienceDaily (Jan. 25, 2012) — A research team led by University of Massachusetts Amherst resource economist Sylvia Brandt, with colleagues in California and Switzerland, have revised the cost burden sharply upward for childhood asthma and for the first time include the number of cases attributable to air pollution, in a study released this week in the early online version of the European Respiratory Journal.

The total cost of asthma due to pollution is much higher than past traditional risk assessments have indicated and there is growing evidence that exposure to traffic-related air pollution is a cause of asthma and a trigger for attacks, so it should be included, say the authors. They conducted the study in Long Beach and Riverside, Calif., communities with high regional air pollution levels and large roads near residential neighborhoods.

Total additional asthma-specific costs there due to traffic-related pollution is about $18 million per year, almost half of which is due to new asthma cases caused by pollution, they report. Brandt worked with researchers at the University of Basel, Switzerland, Sonoma Technology, Inc. and the University of Southern California.

Using updated techniques that count asthma cases attributable to air pollution for the first time and including a broader range of health care costs such as parents’ missed work days, extra doctor visits and travel time along with prescriptions, the researchers found that a single episode of bronchitic symptoms cost an average $972 in Riverside and $915 in Long Beach. Bronchitic symptoms (daily cough, congestion or phlegm, or bronchitis for three months in a row) are a critical outcome for children with asthma.

Further, people who live in cities with high traffic-related air pollution bear a higher burden of these costs than those in less polluted areas, they say.

Brandt and colleagues say the total annual cost for a typical asthma case was $3,819 in Long Beach and $4,063 in Riverside, and “the largest share of the cost of an asthma case was the indirect cost of asthma-related school absences.” School absences are an important economic consequence, they add, because “they often lead to parents or caregivers missing work.”

Overall, Brandt points out that the results are relevant and applicable to many settings and “families with children who have asthma are bearing a high cost. The total annual estimate between $3,800 and $4,000 represents 7 percent of median household income in our study in these two communities. This is troublesome because that is higher than the 5 percent considered to be a bearable or sustainable level of health care costs for a family.”

Riverside and Long Beach account for about 7 percent of the total population of California, the authors say, which suggests that state-wide costs of asthma related to air pollution are “truly substantial.”

For this work, Brandt and colleagues analyzed several surveys on health care visits by children with asthma and their previous estimates of the number of asthma cases attributable to pollution to estimate the annual costs of childhood asthma. They also estimated the cost of asthma exacerbation due to regional air pollutants. They feel the new method does a better job of accounting for the full impact of traffic-related pollution and will be widely applicable in urban areas.

She points out, “Traditional risk assessment methods for air pollution have underestimated both the overall burden of asthma and the cost of the disease associated with air pollution. Our findings suggest the cost has been substantially underestimated and steps must be taken to reduce the burden of traffic-related pollution.”

This work was supported by California’s South Coast Air Quality Management District and its settlement funds from BP, as well as by the U.S. National Institute for Environmental Health Sciences, the U.S. Environmental Protection Agency and the Hastings Foundation.

Sciencedaily 25-01-2012
http://www.sciencedaily.com/releases/2012/01/120125202759.htm