Groundwater Arsenic-Attributable Cardiovascular Disease (CVD) Mortality Risks in India

Cardiovascular diseases (CVDs) have been recognized as the most serious non-carcinogenic detrimental health outcome arising from chronic exposure to arsenic. Drinking arsenic contaminated groundwaters is a critical and common exposure pathway for arsenic, notably in India and other countries in the circum-Himalayan region. Notwithstanding this, there has hitherto been a dearth of data on the likely impacts of this exposure on CVD in India. In this study, CVD mortality risks arising from drinking groundwater with high arsenic (>10 μg/L) in India and its constituent states, territories, and districts were quantified using the population-attributable fraction (PAF) approach. Using a novel pseudo-contouring approach, we estimate that between 58 and 64 million people are exposed to arsenic exceeding 10 μg/L in groundwater-derived drinking water in India. On an all-India basis, we estimate that 0.3–0.6% of CVD mortality is attributable to exposure to high arsenic groundwaters, corresponding to annual avoidable premature CVD-related deaths attributable to chronic exposure to groundwater arsenic in India of between around 6500 and 13,000. Based on the reported reduction in life of 12 to 28 years per death due to heart disease, we calculate value of statistical life (VSL) based annual costs to India of arsenic-attributable CVD mortality of between USD 750 million and USD 3400 million.

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The Population-Attributable Fraction for Premature Mortality Due to Cardiovascular Disease Associated With Stage 1 and 2 Hypertension Among Japanese

American Journal of Hypertension ◽

10.1093/ajh/hpaa128 ◽

2020 ◽

Author(s):

Yu Hatano ◽

Yuichiro Yano ◽

Shouichi Fujimoto ◽

Yuji Sato ◽

Kunitoshi Iseki ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Population Attributable Fraction ◽

Heart Association ◽

Premature Mortality ◽

Attributable Fraction ◽

Hazard Ratios ◽

Increased Risk ◽

Stage 1 ◽

Cvd Mortality

Abstract BACKGROUND Our aim was to assess how the population-attributable fraction (PAF) for premature mortality due to cardiovascular disease (CVD) associated with hypertension changes if blood pressure (BP) thresholds for hypertension were lowered from systolic/diastolic BP ≥140/90 mm Hg to ≥130/80 mm Hg, as defined using the 2017 American College of Cardiology/American Heart Association blood pressure guideline. METHODS Analyses were conducted using a database of participants who underwent a national health checkup examination started in 2008 in Japan (n = 510,238; mean age, 59.6 ± 8.1 years; 42% men). Each participant was categorized as having normal or elevated BP, or stage 1 or 2 hypertension according to the guideline. Data on premature mortality due to CVD occurring before age 70 years were available through March 2015. RESULTS Over a median follow-up of 3.4 years, 739 deaths from CVD occurred. After multivariable adjustment, hazard ratios for premature CVD mortality for elevated BP, stage 1 hypertension, and stage 2 hypertension vs. normal BP were 1.02 (95% confidence interval, 0.72, 1.44), 1.33 (1.02, 1.75), and 2.41 (1.90, 3.05), respectively. The PAF associated with stage 1 and 2 hypertension was 4.4% and 39.4%, respectively. CONCLUSIONS In the current nationwide study of Japanese adults, stage 1 and 2 hypertension were associated with an increased risk for premature CVD mortality. The PAF for premature CVD mortality associated with hypertension increased by 4.4% if BP thresholds for hypertension were lowered from systolic/diastolic BP ≥140/90 to ≥130/80 mm Hg.

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Meta-analysis of Value of Statistical Life Estimates

IIM Kozhikode Society & Management Review ◽

10.1177/2277975216678546 ◽

2017 ◽

Vol 6 (1) ◽

pp. 110-120 ◽

Cited By ~ 1

Author(s):

Agamoni Majumder ◽

S. Madheswaran

Keyword(s):

Wage Differential ◽

Meta Analysis ◽

Policy Instrument ◽

Value Of Statistical Life ◽

Mortality Risks ◽

Statistical Life ◽

Compensating Wage Differential ◽

Health Related ◽

Emerging Issues ◽

Hedonic Wage

Value of Statistical Life (VSL) is one of the most debatable areas in economics. However, VSL is frequently used as a policy instrument for evaluating various safety, health and environmental regulations. Policymakers have to undertake the difficult task of assigning monetary value to the reduction of various health and mortality risks while analyzing safety policies. Compensating wage differential (CWD) for job risks acts as a reference point for valuing mortality risks while VSL serves as a basis to analyze these benefits of risk reduction policies. However, it has been observed in the recent past that VSL estimates vary substantially across various studies. Therefore, it has become necessary for researchers and policymakers to understand the source of this variation in order to aid policymaking. This paper attempts to bring together some of the emerging issues in VSL literature and presents a meta-analysis that is based on 34 observations from 30 hedonic wage-based VSL studies. The results of this meta-analysis show that certain emerging areas in VSL literature such as worker’s compensation benefits, age and long-term health-related job risk require more emphasis and further examination.

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