Cost of near-roadway and regional air pollution-attributable childhood asthma in Los Angeles County.

Abstract

BACKGROUND:

Emerging evidence suggests that near-roadway air pollution (NRP) exposure causes childhood asthma. The associated costs are not well documented.

OBJECTIVE:

We estimated the cost of childhood asthma attributable to residential NRP exposure and regional ozone (O3) and nitrogen dioxide (NO2) levels in Los Angeles County. We developed a novel approach to apportion the costs between these exposures under different pollution scenarios.

METHODS:

We integrated results from a study of willingness to pay to reduce the burden of asthma with results from studies of health care use and charges to estimate the costs of an asthma case and exacerbation. We applied those costs to the number of asthma cases and exacerbations caused by regional pollution in 2007 and to hypothetical scenarios of a 20% reduction in regional pollution in combination with a 20% reduction or increase in the proportion of the total population living within 75 m of a major roadway.

RESULTS:

Cost of air pollution-related asthma in Los Angeles County in 2007 was $441 million for O3 and $202 million for NO2 in 2010 dollars. Cost of routine care (care in absence of exacerbation) accounted for 18% of the combined NRP and O3 cost and 39% of the combined NRP and NO2 cost; these costs were not recognized in previous analyses. NRP-attributable asthma accounted for 43% (O3) to 51% (NO2) of the total annual cost of exacerbations and routine care associated with pollution. Hypothetical scenarios showed that costs from increased NRP exposure might offset savings from reduced regional pollution.

CONCLUSIONS:

Our model disaggregates the costs of regional pollution and NRP exposure and illustrates how they might vary under alternative exposure scenarios. The cost of air pollution is a substantial burden on families and an economic loss for society.

• Authors: Sylvia Brandt, Laura Perez, Nino Künzli, Fred Lurmann, John Wilson, Manuel Pastor, Rob McConnell
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 134 Issue 5 Pg. 1028-35 (Nov 2014) ISSN: 1097-6825 [Electronic] United States
• PMID: 25439228 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Air Pollutants
• Oxidants, Photochemical
• Vehicle Emissions
• Ozone
• Nitrogen Dioxide

Topics

• Adolescent
• Air Pollutants (adverse effects)
• Asthma (chemically induced, economics, epidemiology)
• California (epidemiology)
• Child
• Child, Preschool
• Costs and Cost Analysis
• Female
• Humans
• Male
• Nitrogen Dioxide (adverse effects, economics)
• Oxidants, Photochemical (adverse effects, economics)
• Ozone (adverse effects, economics)
• Vehicle Emissions (toxicity)