[Health cost reductions through improved water and sanitation in Buenos AiresRedução dos custos em saúde por obra de água e esgoto em Buenos Aires]. / Reducción de costos en salud por obras de agua y alcantarillado en Buenos Aires.

OBJECTIVE: To estimate the benefits that would be obtained by reducing the number of diarrhea cases through improved water, sanitation, and hygiene conditions in the study population (25 districts in Buenos Aires). METHODS: The benefits were estimated by calculating the number of disability-adjusted life years saved, which were given a monetary value. On this basis, a probabilistic sensitivity analysis was carried out, considering the uncertainty in 15 variables. We also considered potential underestimation of the health data. RESULTS: The health benefits of improved access to water and sanitation in the area covered amounted to 3.262 billion Argentine pesos (ARS), equivalent to 203.9 million US dollars (USD), with a range between USD 67.5 and 559.5 million, based on the sensitivity analysis. CONCLUSIONS: The calculated benefits (savings in diarrhea-related health costs), adjusted for underestimation in the health data, would cover 35.3% of the investment costs, with around 95% coverage for water and 85% for sanitation. Since this research is limited in scope, the calculated benefits represent a minimum level. Further research could consider cost reductions for other diseases, time savings, and environmental impact.

OBJETIVO: Estimar o benefício que traria a redução no número de casos de diarreia decorrente de melhoria nas condições de água, saneamento e higiene da população estudada em 25 subdivisões administrativas em Buenos Aires. MÉTODOS: A estimativa é feita em termos de poupar anos de vida ajustados por incapacidade, aos quais se atribui uma cifra monetária. Uma análise probabilística é feita sobre esta base considerando a incerteza de 15 variáveis. Também é considerada a possível subestimação dos dados de saúde. RESULTADOS: Os benefícios em saúde com o acesso ideal à água e saneamento na área estudada chegam a 3 milhões e 262 mil pesos argentinos, um valor equivalente a 203,9 milhões de dólares dos Estados Unidos. Estes valores variam entre 67,5 e 559,5 milhões de dólares após ser realizada a análise de sensibilidade. CONCLUSÕES: Os benefícios estimados (economia de custos em saúde por diarreia), ajustados para a subestimação de dados de saúde, cobririam 35,3% dos custos de investimento, considerando uma cobertura próxima a 95% em água e 85% em saneamento. Dado o alcance limitado deste estudo, os benefícios estimados representam um limite inferior. Outros possíveis estudos derivados poderiam considerar a redução de custos por outras doenças, economia de tempo e impacto ao meio ambiente.

Future fire-smoke PM2.5 health burden under climate change in Paraguay.

Recent years have seen a rise in wildfire and extreme weather activity across the globe, which is projected to keep increasing with climate-induced conditions. Air pollution, especially fine particulate matter (PM2.5) concentration, is heavily affected by PM2.5 emissions from wildfire activity. Paraguay has been historically suffering from fires, with an average of 2.3 million hectares burnt per year during the 2003-2021 period. Annual PM2.5 concentration in Paraguay is 13.2 µg/m3, more than double the recommended by the WHO. We estimate that, historically, almost 40 % of fine air particulates can be attributed to fires. Using a random forest algorithm, we estimate future fire activity and fire related PM2.5 under different climate change scenarios. With global warming, we calculate that fire activity could increase by up to 120 % by 2100. Annual fire smoke PM2.5 from fires is expected to increase by 7.7 µg/m3 by 2100. Under these conditions, Paraguay is expected to suffer an increase in 3500 deaths per year attributable to fire smoke PM2.5 by 2100. We estimate the economic cost of fire smoke-related mortality by 2100 at US $ 5600 million, equivalent to 2.6 % of Paraguay's GDP, excluding other health- and productivity-related impacts on society.

Valuing mortality attributable to present and future temperature extremes in Argentina.

This study analyzes the weather-related health damage of present and future extreme temperatures in Argentina. Focusing on mortality, short-term impacts of temperature are obtained by regressing monthly mortality rates on inter-annual monthly weather variability. For this purpose, a countrywide panel dataset at the municipal level was constructed from the universe of deaths between 2010 and 2019, and daily meteorological records from the ERA5 weather dataset. Then, NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP) are used to project future mortality by 2085 under two climate scenarios. Finally, present and future mortality-related economic damages are assessed using the Value of a Statistical Life. The results show that one additional day of extreme temperatures increase all-cause mortality rates relative to mild weather and that the impact of hotter-than-average temperatures is greater in magnitude than that of colder ones. Substantial heterogeneity exists between causes of death and age groups, with older people facing greater risks, while the results for gender are inconclusive. All days of extreme cold in a year generate damage equivalent to 0.64% of GDP, while heat damage is 0.11% of GDP. The total damage by extreme temperatures adds up to 0.75% of the 2019 GDP. When future temperatures are valued, the total damage increases by an additional 1.45% under scenario RCP8.5 because the lower mortality occurring on cold days only partially offsets the increase in the number of hot days. On the contrary, if temperature changes were to be mild (i.e., under scenario RCP4.5), overall mortality would be lower at the national level and the corresponding damages would decrease by 0.02%.