Journal Article

Estimating the costs of air pollution to the National Health Service and social care: An assessment and forecast up to 2035

Jaccard, Abbygail, Fecht, Daniela, de Preux, Laure, Gulliver, John, Ferguson, Brian, Pimpin, Laura, Belloni, Annalisa, Webber, Laura, Retat, Lise, Sassi, Franco, Corbould, Emily

2018

Overview

Air pollution damages health by promoting the onset of some non-communicable diseases (NCDs), putting additional strain on the National Health Service (NHS) and social care. This study quantifies the total health and related NHS and social care cost burden due to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) in England. Air pollutant concentration surfaces from land use regression models and cost data from hospital admissions data and a literature review were fed into a microsimulation model, that was run from 2015 to 2035. Different scenarios were modelled: (1) baseline 'no change' scenario; (2) individuals' pollutant exposure is reduced to natural (non-anthropogenic) levels to compute the disease cases attributable to PM2.5 and NO2; (3) PM2.5 and NO2 concentrations reduced by 1 μg/m3; and (4) NO2 annual European Union limit values reached (40 μg/m3). For the 18 years after baseline, the total cumulative cost to the NHS and social care is estimated at £5.37 billion for PM2.5 and NO2 combined, rising to £18.57 billion when costs for diseases for which there is less robust evidence are included. These costs are due to the cumulative incidence of air-pollution-related NCDs, such as 348,878 coronary heart disease cases estimated to be attributable to PM2.5 and 573,363 diabetes cases estimated to be attributable to NO2 by 2035. Findings from modelling studies are limited by the conceptual model, assumptions, and the availability and quality of input data. Approximately 2.5 million cases of NCDs attributable to air pollution are predicted by 2035 if PM2.5 and NO2 stay at current levels, making air pollution an important public health priority. In future work, the modelling framework should be updated to include multi-pollutant exposure-response functions, as well as to disaggregate results by socioeconomic status.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Air Pollutants - adverse effects / Air pollution / Air Pollution - adverse effects / Air Pollution - economics / Air Pollution - prevention & control / Analysis / Anthropogenic factors / Asthma / Birth weight / Cardiovascular disease / Cardiovascular diseases / Chronic illnesses / Chronic obstructive pulmonary disease / Climate change / Computer Simulation / Coronary artery disease / Costs / Dementia / Diabetes mellitus / Ecology and Environmental Sciences / Economic aspects / Engineering and Technology / England / Environmental Monitoring / Exposure / Food / Forecasting / Health care costs / Health Care Costs - trends / Health economics / Health services / Heart diseases / Humans / Incidence / Inhalation Exposure - adverse effects / Land pollution / Land use / Literature reviews / Lung cancer / Medicine and Health Sciences / Models, Economic / Mortality / Nitric Oxide - adverse effects / Nitrogen dioxide / Noncommunicable Diseases - economics / Noncommunicable Diseases - epidemiology / Noncommunicable Diseases - prevention & control / Noncommunicable Diseases - therapy / Outdoor air quality / Particulate matter / Particulate Matter - adverse effects / People and places / Physical Sciences / Pollutants / Pollution / Pollution control / Population / Public health / Regression analysis / Risk Assessment / Risk Factors / Social Sciences / Social Work - economics / Social Work - trends / Socialized medicine / Socioeconomics / Software / State Medicine - economics / State Medicine - trends / Supervision / Time Factors