A risk assessment case study in the suburbs of Paris: balancing health effects of Cryptosporidium parvum and bromate

2002 ◽  
Vol 2 (3) ◽  
pp. 205-211
Author(s):  
V. Dilé-Mary ◽  
C. Galey ◽  
D. Gatel ◽  
J. Cavard ◽  
A. Havelaar
Keyword(s):  
Risk Assessment ◽  
Cryptosporidium Parvum ◽  
Disease Burden ◽  
Cell Cancer ◽  
Sharp Decrease ◽  
Risk Of Infection ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years

To meet newly proposed bromate standards, ozone doses should be decreased, thus also decreasing the risk of renal cell cancer, but the risk of infection with Cryptosporidium parvum will increase at the same time. The present study was designed to evaluate and balance these two risks, using a probabilistic risk assessment, which involves calculating the disease burden, expressed in the number of disability adjusted life-years (DALY) as developed by Havelaar et al. In the case of Neuilly-sur-Marne ozone contactors, four ozone doses were studied at 5°C and at 22°C. Results showed a sharp decrease of the disease burden with the application of ozone, and then a slight increase as the ozone dose was increased. Minimal DALYs were obtained with ozone doses of 1.5 mg/L at 22°C and 2.5 mg/L at 5°C. Nevertheless, these two ozone doses do not comply with the 10 μg/L bromate standard, as an average of 12 at 5°C and 11 at 22°C are produced.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

scholarly journals Risk of acute respiratory infection from crop burning in India: estimating disease burden and economic welfare from satellite and national health survey data for 250 000 persons

2019 ◽  
Vol 48 (4) ◽  
pp. 1113-1124 ◽  
Author(s):  
Suman Chakrabarti ◽  
Mohammed Tajuddin Khan ◽  
Avinash Kishore ◽  
Devesh Roy ◽  
Samuel P Scott
Keyword(s):  
Risk Factors ◽  
Respiratory Infection ◽  
Health Survey ◽  
Acute Respiratory Infection ◽  
Disease Burden ◽  
Crop Residue ◽  
Agricultural Crop ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years

Abstract Background Respiratory infections are among the leading causes of death and disability globally. Respirable aerosol particles released by agricultural crop-residue burning (ACRB), practised by farmers in all global regions, are potentially harmful to human health. Our objective was to estimate the health and economic costs of ACRB in northern India. Methods The primary outcome was acute respiratory infection (ARI) from India’s fourth District Level Health Survey (DLHS-4). DLHS-4 data were merged with Moderate-Resolution Imaging Spectroradiometer satellite data on fire occurrence. Mutually adjusted generalized linear models were used to generate risk ratios for risk factors of ARI. Overall disease burden due to ACRB was estimated in terms of disability-adjusted life years. Results Seeking medical treatment for ARI in the previous 2 weeks was reported by 5050 (2%) of 252 539 persons. Living in a district with intense ACRB—the top quintile of fires per day—was associated with a 3-fold higher risk of ARI (mutually adjusted risk ratio 2.99, 95% confidence interval 2.77 to 3.23) after adjustment for socio-demographic and household factors. Children under 5 years of age were particularly susceptible (3.65, 3.06 to 4.34 in this subgroup). Additional ARI risk factors included motor-vehicle congestion (1.96, 1.72 to 2.23), open drainage (1.91, 1.73 to 2.11), cooking with biomass (1.73, 1.58 to 1.90) and living in urban areas (1.35, 1.26 to 1.44). Eliminating ACRB would avert 14.9 million disability-adjusted life years lost per year, valued at US$152.9 billion over 5 years. Conclusions Investments to stop crop burning and offer farmers alternative crop-residue disposal solutions are likely to improve population-level respiratory health and yield major economic returns.

scholarly journals The estimated disease burden of norovirus in The Netherlands

2012 ◽  
Vol 141 (3) ◽  
pp. 496-506 ◽  
Author(s):  
L. VERHOEF ◽  
M. KOOPMANS ◽  
W. VAN PELT ◽  
E. DUIZER ◽  
J. HAAGSMA ◽  
...  
Keyword(s):  
General Practitioner ◽  
The Netherlands ◽  
Disease Burden ◽  
Age Distribution ◽  
Case Fatality ◽  
Disability Adjusted Life Years ◽  
The Past ◽  
Disease Outcomes ◽  
Disability Adjusted Life ◽  
Life Years

SUMMARYNoroviruses are an important cause of acute gastroenteritis in humans. We incorporated new insights gained over the past decade in an updated estimate of the disease burden of (foodborne) norovirus illness in The Netherlands in 2009. The disease outcomes – non-consulting cases, visiting a general practitioner, hospitalization and mortality – and the foodborne proportion were derived from cohort studies, surveillance data and literature. Age-specific incidence estimates were applied to the population age distribution in The Netherlands in 2009. The general population incidence was 3800/100 000 (95% CI 2670–5460), including 0·4 fatal cases/100 000, resulting in 1622/100 000 (95% CI 966–2650) disability-adjusted life-years in a population of 16·5 million. The updated burden of norovirus is over twofold higher than previously estimated, due in particular to the new insights in case-fatality ratios. Results suggest that the burden of norovirus institutional outbreaks is relatively small compared to the burden of community-acquired norovirus infections.

scholarly journals Equity and economic evaluation of system-level health interventions: A case study of Brazil's Family Health Program

2020 ◽  
Author(s):  
James Love-Koh ◽  
Andrew Mirelman ◽  
Marc Suhrcke
Keyword(s):  
Economic Evaluation ◽  
Social Welfare ◽  
Population Health ◽  
Health Interventions ◽  
System Level ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Average Health

Abstract Distributional economic evaluation estimates the value for money of health interventions in terms of population health and health equity impacts. When applied to interventions delivered at the population and health system-level interventions (PSIs) instead of clinical interventions, additional practical and methodological challenges arise. Using the example of the Programme Saúde da Familia (PSF) in Brazil, a community-level primary care system intervention, we seek to illustrate these challenges and provide potential solutions. We use a distributional cost-effectiveness analysis (DCEA) approach to evaluate the impact of the PSF on population health and between-state health inequalities in Brazil. Data on baseline health status, disease prevalence and PSF effectiveness are extracted from the literature and incorporated into a Markov model to estimate the long-term impacts in terms of disability-adjusted life years. The inequality and average health impacts are analysed simultaneously using health-related social welfare functions. Uncertainty is computed using Monte Carlo simulation. The DCEA encountered several challenges in the context of PSIs. Non-randomized, quasi-experimental methods may not be powered to identify treatment effect heterogeneity estimates to inform a decision model. PSIs are more likely to be funded from multiple public sector budgets, complicating the calculation of health opportunity costs. We estimate a cost-per-disability-adjusted life years of funding the PSF of $2640. Net benefits were positive across the likely range of intervention cost. Social welfare analysis indicates that, compared to gains in average health, changes in health inequalities accounted for a small proportion of the total welfare improvement, even at high levels of social inequality aversion. Evidence on the population health and health equity impacts of PSIs can be incorporated into economic evaluation methods, although with additional complexity and assumptions. The case study results indicate that the PSF is likely to be cost-effective but that the inequality impacts are small and highly uncertain.

scholarly journals Mapping the Trends in Esophageal Cancer Disease Burden in the United States: Results from the Global Burden of Disease Study 2017

2021 ◽  
Author(s):  
Di Lu ◽  
jianxue Zhai ◽  
Jintao Zhan ◽  
Xiguang Liu ◽  
Xiaoying Dong ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Burden Of Disease ◽  
Disease Burden ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Cancer Disease ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Disease Study ◽  
High Bmi

Abstract Background: Esophageal cancer is the 10th leading cancer in US but given limited research attention. This study aimed to investigate the esophageal cancer disease burden more comprehensively in US. Methods: Having retrieved states-categorized data on esophageal cancer incidence, mortality and disability-adjusted life years from the Global Burden of Disease study online resource, the current trends on esophageal cancer disease burden attributed to different risk factors and their relationship with economic status were analyzed using age-standardized rate and the estimated annual percentage change.Results: In US, the esophageal cancer age-standardized rate of incidence has been stable but age-standardized rates of mortality and disability-adjusted life years trended to decreased with estimated annual percentage changes of -0.237% and -0.471% from 1990 to 2017. Age-standardized rate of incidence was higher in males than in females, but both didn’t increase, so as age-standardized rates of mortality and disability-adjusted life years. The largest increase in age-standardized rates of incidence, mortality and disability-adjusted life years was observed in Oklahoma, whereas the largest decrease was seen in the District of Columbia. Age-standardized rates of mortality and disability-adjusted life years contributed to high BMI or diet low in fruits were growing. per capita disposable personal income trended to negatively correlated with estimated annual percentage changes of incidence, mortality and disability-adjusted life years.Conclusions: The esophageal cancer disease burden in US decreased from 1990 to 2017 but was heavier in males than in females, and increased in economically weaker states and populations with high BMI and low-fruit diet.

scholarly journals Economic valuation of increased malaria due to climate change: A South African case study

2002 ◽  
Vol 5 (2) ◽  
pp. 395-412 ◽  
Author(s):  
Randall Spalding-Fecher ◽  
Shomenthree Moodley
Keyword(s):  
Climate Change ◽  
South African ◽  
Economic Valuation ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Projected Changes ◽  
Complex Health Problems ◽  
Valuation Tools

Malaria is one of the world's most serious and complex health problems. It is also one of the diseases identified as most likely to be affected by climate change, because transmission is sensitive to temperature and rainfall. The objective of this paper is to provide an initial economic valuation of the increased incidence of malaria due to projected changes in climate in South Africa, excluding costs and benefits of prevention and adaptation. We use market based economic valuation tools for morbidity, including cost of treatment and lost short term productivity, and report lost disability adjusted life years from malaria mortality due to climate change. We also discuss how human capital and willingness to pay approaches could be used for mortality valuation. The results show that the opportunity cost of increased morbidity from malaria would be between R277 million and R466 million in 2010, while the lost disability adjusted life years from increased mortality would be from 11 800 to 18 300 years in that year.

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