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Scaling factors that relate human health costs to PM 2.5 exposures using available data

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Scaling factors that relate human health costs to PM 2.5 exposures using available data

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  1. Scaling factors that relate human health costs to PM 2.5 exposures using available data David R. Brown Sc.D. Environment and Human Health NESCAUM

  2. COST IN $ PROBABILITY OF A LOSS

  3. COST IN $ PROBABILITY OF A LOSS

  4. TOTALCOST IN $ A C B PROBABILITY OF A LOSS

  5. 2 COST IN $ Of ASTHMA hospitalization 1 PROBABILITY OF ASTHMA HOSPITALIZATION in CONNECTICUT

  6. Available scaling information • plausible link between the exposures and disease. • characterization of PM 2.5 exposures • the incidence and prevalence of the diseases related to PM 2.5 • Size of population at risk

  7. Results from the Harvard Six-cities study: All Cause Mortality Rates most exposed to least exposed City Fine Particles • All cause death 1.26 (1.08-1.47) • Lung Cancer 1.37 (0.81-2.31) • Cardio pulmonary 1.37 (1.11-1.68) • Other causes 1.01 (0.79-1.30) • Range of exposure 11-29.6 ug/m3 • Dockery, NEJM 1993; 329: 1753-1759

  8. Health actions from exposures of 2 hours or less. • Peters etal. pm 2.5 & myocardial infarction • 1.48 odds ratio 2 hr after 25ug/m3 increase • 1.69 odds ratio 1 day after 20ug/m3 increase • Gent etal. Severe asthma & O3, pm 2.5 • 35% increase wheeze 1 hr after 50ppb O3 inc. • 47% increase in chest tightness 1 hr after. • 1.24 odds ratio Chest tightness 12-18ug/m3 pm

  9. PM 2.5 New Haven, Hartford and Waterbury (ug/m3)

  10. This 3-month long series of hourly observations would be collapsed to a single value… 9.2 ug/m3… Totally obscuring any “structure” or other “content” within the data set (Carmine Dibattista, CT DEP).(22% of days each year exceed 30 ug/m3 for 6 hours)

  11. 8,264 heart attacks 9,835 Congestive heart failures 3,715 Asthma 8,352 Chronic obstructive pulmonary diseases $ 15,858 per heart attack $9,256 per Congestive heart failure admission $ 5,138 per asthma admission $ 6,876 per Chronic obstructive pulmonary disease Hospitalizations and costs for Connecticut 1998

  12. Adult diesel soot impacts Bridgeport, Stamford Norwalk • 69 premature deaths • 121 non fatal heart attacks • 1,503 Asthma attacks • 8,820 workdays lost • 46 cases of chronic bronchitis www.cat.us/projects/diersel

  13. O3 and PM2.5 Non-attainment Ozone and PM 2.5 non-attainment

  14. Draft NESCAUM material submitted to EHP/JAWMA

  15. Draft NESCAUM material submitted to EHP/JAWMA

  16. Draft NESCAUM material submitted to EHP/JAWMA

  17. Scale Y axis. $ 10’s MM TOTALCOST IN $ A C B PROBABILITY OF A LOSS Scale X axis; Number of 6 hour episodes that exceed 30 ug/m3

  18. Discussion outcome model $30 MM Scale Y axis. $ 10’s MM Savings TOTALCOST IN $ RISK 5% A C Program costs B 10% 20% 25% PROBABILITY OF A LOSS Scale X axis; Number of 6 hour episodes that exceed 30 ug/m3

  19. SummaryFour things needed are available, • characterization of PM 2.5 exposures, • the incidence and prevalence of the diseases related to PM 2.5, 3) plausible link between the exposures and disease and, 4) a systematic tool to evaluate practical policy decisions