Air pollution and hospital admissions for asthma and heart disease: An economic damage function

• Main Author: Schreder, Douglas
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2004
• Subjects: Air pollution; Asthma; Cardiovascular disease; Economics; Environmental science; Epidemiology; Mortality; Outdoor air quality; Patient admissions; Public health; Studies; Willingness to pay
• ISBN: 9780496737598; 0496737597

Numerous epidemiological studies have indicated positive associations for air pollution on respiratory and cardiovascular-related hospital admissions. Relatively few studies have examined cumulative and threshold effects of pollution on admissions or have included estimated economic effects of increased admissions. In subject thesis time series regression analysis was utilized to estimate effects of air pollution on daily hospital admissions for asthma and ischemic heart disease (IHD) in Cook County for years 1995–1998. Regression analysis included multivariate one and two-pollutant ordinary least squares (OLS) models with control for day-of-week and seasonal effects and testing for lagged and cumulative lagged effects of pollution on admissions. Threshold effects of exposure were studied using multiple adaptive regression splines (MARS) methodology. Economic effects were estimated utilizing hospital-related cost information associated with admissions data. OLS results indicated statistically significant positive effects (95% confidence level) on asthma admissions for ozone, carbon monoxide, and nitrous oxide on ages less than 35 and for fine particle matter, nitrous oxide, and nitrogen dioxide on ages 35 and older. For IHD admissions, significant positive effects were indicated for ozone, fine particle matter, nitrous oxide, and nitrogen dioxide for ages 35–54; and ozone, fine particle matter, carbon monoxide, nitrogen dioxide, and sulfur dioxide for ages 55 and older. The magnitude of effects when considering cumulative lags was generally less than that for individual lags on asthma and IHD admissions. MARS results indicated threshold effects on asthma admissions for ozone and carbon monoxide for ages less than 35; and on IHD admissions for fine particle matter for ages 35 and older and nitrogen dioxide on ages 35–54. Economic results indicated substantial costs in Cook County resulting from air pollution. A 10% increase in mean ozone, for example, results in estimated 88 additional annual asthma admissions with total annual estimated additional costs of $1.7 million. Results are sensitive to methodological approaches, particularly in control for seasonal effects and interactions with other pollutants. The complex nature of physiological effects of pollutants on humans and measurement of human exposure to outdoor air pollution further complicates analysis, suggesting need for continuing research in this area.