Environmental and economic impact of using increased fresh gas flow to reduce carbon dioxide absorbent consumption in the absence of inhalational anaesthetics.

BACKGROUND: Increasing fresh gas flow (FGF) to a circle breathing system reduces carbon dioxide (CO2) absorbent consumption. We assessed the environmental and economic impacts of this trade-off between gas flow and absorbent consumption when no inhalational anaesthetic agent is used. METHODS: A test lung with fixed CO2 inflow was ventilated via a circle breathing system of an anaesthetic machine (Dräger Primus or GE Aisys CS2) using an FGF of 1, 2, 4, or 6 L min-1. We recorded the time to exhaustion of the CO2 absorbent canister, defined as when inspired partial pressure of CO2 exceeded 0.3 kPa. For each FGF, we calculated the economic costs and the environmental impact associated with the manufacture of the CO2 absorbent canister and the supply of medical air and oxygen. Environmental impact was measured in 100 yr global-warming potential, analysed using a life cycle assessment 'cradle to grave' approach. RESULTS: Increasing FGF from 1 to 6 L min-1 was associated with up to 93% reduction in the combined running cost with minimal net change to the 100 yr global-warming potential. Most of the reduction in cost occurred between 4 and 6 L min-1. Removing the CO2 absorbent from the circle system, and further increasing FGF to control CO2 rebreathing, afforded minimal further economic benefit, but more than doubled the global-warming potential. CONCLUSIONS: In the absence of inhalational anaesthetic agents, increasing FGF to 6 L min-1 reduces running cost compared with lower FGFs, with minimal impact to the environment.

The Relative Effects of Economic Growth, Environmental Pollution and Non-Communicable Diseases on Health Expenditures in European Union Countries.

National and global health policies are increasingly recognizing the key role of the environment in human health development, which is related to its economic and social determinants, such as income level, technical progress, education, quality of jobs, inequality, education or lifestyle. Research has shown that the increase of GDP (Gross Domestic Product) per capita can provide additional funds for health but also for environmental protection. However, often, economic growth is associated with the accelerated degradation of the environment, and this in turn will result in an exponential increase in harmful emissions and will implicitly determine the increasing occurrence of non-communicable diseases (NCDs), mainly cardiovascular diseases, cancers and respiratory diseases. In this paper, we investigate the role and effects of economic growth, environmental pollution and non-communicable diseases on health expenditures, for the case of EU (European Union) countries during 2000-2014. In order to investigate the long-term and the short-term relationship between them, we have employed the Panel Autoregressive Distributed Lag (ARDL) method. Using the Pedroni-Johansen cointegration methods, we found that the variables are cointegrated. The findings of this study show that economic growth is one of the most important factors influencing the health expenditures both in the long- and short-run in all the 28 EU countries. With regards to the influence of CO2 emissions on health expenditure, we have found a negative impact in the short-run and a positive impact on the long-run. We have also introduced an interaction between NCDs and environmental expenditure as independent variable, a product variable. Finally, we have found that in all the three estimated models, the variation in environmental expenditure produces changes in NCDs' effect on health expenditure.

Inequality of female health and its relation with urbanization level in China: geographic variation perspective.

Urbanization development plays a vital role in the health of modern residents; however, there have been very limited researches to specifically and comprehensively explore the relationship between urbanization level evaluating indicators (ULEIs) and female health outcomes. The mortality rate of breast cancer (BC), cervical cancer (CC), and ovarian cancer (OC) and classified urbanization factor are collected at provincial level. Stepwise regression model (SRM) and geographically weighted regression model (GWRM) are conducted to obtain spatial relationship between the mortality rate of those cancer and ULEI. Our results show that there is remarkable difference of mortality rate of BC, CC, and OC in different provinces as well as higher BC, CC, and OC distributed in northern regions. The increase of value added of primary industry (VAPI), taxi, and coal consumption has detrimental effect on BC and CC. Fuel oil consumption (FOC) ultimately results in increase of mortality rate of BC and OC, and urban fixed asset investment (UFAI) poses a risk to increase the mortality rate of OC. Contrarily, natural gas consumption (NGC) appear to mitigate mortality rate of BC. In particular, our findings demonstrate that there exist spatial differences for VAPI, FOC, NGC, taxi, and coal consumption influencing BC, CC, and OC. It is suggested that policy makers should take account of regional discrepancy and implement a sustainable urbanization development considering female health.

Decoupling emissions of greenhouse gas, urbanization, energy and income: analysis from the economy of China.

The adoption and ratification of relevant policies, particularly the household enrolment system metamorphosis in China, led to rising urbanization growth. As the leading developing economy, China has experienced a drastic and rapid increase in the rate of urbanization, energy use, economic growth and greenhouse gas (GHG) pollution for the past 30 years. The knowledge of the dynamic interrelationships among these trends has a plethora of implications ranging from demographic, energy, and environmental and sustainable development policies. This study analyzes the role of urbanization in decoupling GHG emissions, energy, and income in China while considering the critical contribution of energy use. As a contribution to the extant body of literature, the present research introduces a new phenomenon called "the environmental urbanization Kuznets curve" (EUKC), which shows that at the early stage of urbanization, the environment degrades however, after a threshold point the technique effects surface and environmental degradation reduces with rise in urbanization. Applying the autoregressive distributed lag model and the vector error correction model, the paper finds the presence of inverted U-shaped curve between urbanization and GHG emission of CO2, while the same hypothesis cannot be found between income and GHG emission of CO2. Energy use in all the models contributes to GHG emission of CO2. In decoupling greenhouse gas emissions, urbanization, energy, and income, articulated and well-implemented energy and urbanization policies should be considered.

Valoración económica en salud y medio ambiente del control de contaminantes orgánicos persistentes en Colombia / Economic assessment in health and environment from control of persistent organic pollutants in Colombia

Objetivo Estimar los beneficios económicos en salud y ambientales relacionados con la implementación del Convenio de Estocolmo para el control de Compuestos Orgánicos Persistentes (COP) en el país. Método La estimación se realizó teniendo en cuenta dos escenarios: cumplimiento del convenio y no cumplimiento del Convenio y el beneficio bruto se derivó de la diferencia en valor presente entre los costos en salud y ambientales que se asumen en cada escenario. Resultados Los beneficios brutos por la disminución de gastos en salud derivados de la implementación del Convenio se estiman entre USD $511 y USD $501 millones. Al introducir variables como los costos de gestión del convenio y los posibles beneficios por acceso a mercados internacionales, los beneficios para el país se estiman entre USD $1631 y USD $3118 millones. Discusión A pesar de los beneficios económicos generados por menores gastos en salud con la aplicación del Convenio, los costos asociados a la reducción de estos contaminantes, generan un balance negativo, que solo es compensado al cruzar estas cifras con la expectativa de mayores ingresos por acceso a mercados internacionales. Se considera que esta valoración económica como un primer ejercicio es un aporte importante, pero que debe ser actualizado a la luz de metodologías de valoración que involucren otras variables de rentabilidad social y diferentes escenarios por tecnologías emergentes, nuevo conocimiento sobre estos contaminantes, cambios en la legislación y/o cambios en las condiciones de tratados internacionales, entre otros.(AU)

Objective To estimate the economic benefits related to environment and health in the context of the implementation of the Stockholm Convention for the control of Persistent Organic Pollutants in the country. Method: The estimation was conducted based on two scenarios: non-compliance with the agreement and compliance with the Convention. Gross profit was derived from the difference in present value between the health and environmental costs that are assumed in each scenario. Results Gross profit by decreasing health costs arising from the implementation of the Convention was estimated at USD $ 511 and USD $ 501 million. By introducing variables such as management costs and agreement on potential benefits for access to international markets, the benefits to the country were estimated at between USD $1631 and USD $ 3118 million. Discussion Despite the economic benefits generated by lower expenditure on health for the Convention implementation, the costs associated with reducing pollutant emissions generated a negative balance, compensated only by the expectation of higher revenues for international market access. We consider this initial economic assessment an important contribution, but it should be reviewed to include valuation methodologies involving other social profitability variables and different scenarios for emerging technologies, new scientific knowledge about these pollutants, changes in legislation and / or changes in trade agreement conditions, among others.(AU)

An evaluation of the social and private efficiency of adoption: anaerobic digesters and greenhouse gas mitigation.

Climate science has begun to recognize the important role of non-carbon dioxide greenhouse gas emissions, including methane. Given the important contribution of methane, anaerobic digesters (ADs) on dairy farms in the U.S. present an opportunity to reduce greenhouse gas (GHG) emissions. We quantify the social and private costs and benefits of ADs that have been adopted in California and find that, despite high initial costs, large reductions in GHG emissions bring significant social benefits and represent good social investments given a $36 per-ton social cost of carbon. Subsidies that lower the initial private investment cost can help align socially and privately optimal adoption decisions.

Can China diminish its burden of non-communicable diseases and injuries by promoting health in its policies, practices, and incentives?

China has rapidly progressed through epidemiological and demographic transitions and is now confronting an increasing burden from non-communicable diseases and injuries. China could take advantage of what has been learnt about prevention and control of non-communicable diseases and injuries, which is well summarised in the WHO best buys (a set of affordable, feasible, and cost-effective intervention strategies in any resource setting), to improve individual and population health. Implementation of these strategies could allow China to exceed the incremental gains in decreasing non-communicable diseases and injury burdens of high-income countries, and greatly shorten the interval needed to achieve decreased morbidity and mortality in its population. With the lessons learnt from other countries and its own programmes and policies, China could provide a health model for the world.

The value of reducing cancer risks at contaminated sites: are more knowledgeable people willing to pay more?

We use conjoint choice questions to investigate people's tastes for cancer risk reductions and income in the context of public programs that would provide for remediation at abandoned industrial contaminated sites. Our survey was self-administered using the computer by persons living in the vicinity of an important contaminated site on the Italian National Priority List. The value of a prevented case of cancer is €2.6 million, but this figure does vary with income, perceived exposure to contaminants, and respondent opinions about priorities that should be pursued by cleanup programs.

Economic incentives and regulatory framework for shale gas well site reclamation in Pennsylvania.

Improperly abandoned gas wells threaten human health and safety as well as pollute the air and water. In the next 20 years, tens of thousands of new gas wells will be drilled into the Marcellus, Utica, and Upper Devonian shale formations of Pennsylvania. Pennsylvania currently requires production companies to post a bond to ensure environmental reclamation of abandoned well sites, but the size of the bond covers only a small fraction of the site reclamation costs. The economics of shale gas development favor transfer of assets from large entities to smaller ones. With the assets go the liabilities, and without a mechanism to prevent the new owners from assuming reclamation liabilities beyond their means, the economics favor default on well-plugging and site restoration obligations. Policy options and alternatives to bonding are discussed and evaluated.

LCA and economic evaluation of landfill leachate and gas technologies.

Landfills receiving a mix of waste, including organics, have developed dramatically over the last 3-4 decades; from open dumps to engineered facilities with extensive controls on leachate and gas. The conventional municipal landfill will in most climates produce a highly contaminated leachate and a significant amount of landfill gas. Leachate controls may include bottom liners and leachate collection systems as well as leachate treatment prior to discharge to surface water. Gas controls may include oxidizing top covers, gas collection systems with flares or gas utilization systems for production of electricity and heat. The importance of leachate and gas control measures in reducing the overall environmental impact from a conventional landfill was assessed by life-cycle-assessment (LCA). The direct cost for the measures were also estimated providing a basis for assessing which measures are the most cost-effective in reducing the impact from a conventional landfill. This was done by modeling landfills ranging from a simple open dump to highly engineered conventional landfills with energy recovery in form of heat or electricity. The modeling was done in the waste LCA model EASEWASTE. The results showed drastic improvements for most impact categories. Global warming went from an impact of 0.1 person equivalent (PE) for the dump to -0.05 PE for the best design. Similar improvements were found for photochemical ozone formation (0.02 PE to 0.002 PE) and stratospheric ozone formation (0.04 PE to 0.001 PE). For the toxic and spoiled groundwater impact categories the trend is not as clear. The reason for this was that the load to the environment shifted as more technologies were used. For the dump landfill the main impacts were impacts for spoiled groundwater due to lack of leachate collection, 2.3 PE down to 0.4 PE when leachate is collected. However, at the same time, leachate collection causes a slight increase in eco-toxicity and human toxicity via water (0.007 E to 0.013 PE and 0.002 to 0.003 PE respectively). The reason for this is that even if the leachate is treated, slight amounts of contaminants are released through emissions of treated wastewater to surface waters. The largest environmental improvement with regard to the direct cost of the landfill was the capping and leachate treatment system. The capping, though very cheap to establish, gave a huge benefit in lowered impacts, the leachate collection system though expensive gave large benefits as well. The other gas measures were found to give further improvements, for a minor increase in cost.

Market-based control mechanisms for patient safety.

A new model is proposed for enhancing patient safety using market-based control (MBC), inspired by successful approaches to environmental governance. Emissions trading, enshrined in the Kyoto protocol, set a carbon price and created a carbon market--is it possible to set a patient safety price and let the marketplace find ways of reducing clinically adverse events? To "cap and trade," a regulator would need to establish system-wide and organisation-specific targets, based on the cost of adverse events, create a safety market for trading safety credits and then police the market. Organisations are given a clear policy signal to reduce adverse event rates, are told by how much, but are free to find mechanisms best suited to their local needs. The market would inevitably generate novel ways of creating safety credits, and accountability becomes hard to evade when adverse events are explicitly measured and accounted for in an organisation's bottom line.

Cost-benefit analysis as a tool for decision making in environmental projects. Application to a reduction of dioxin emissions in Tarragona Province, Spain.

BACKGROUND, AIM AND SCOPE: The Damage-Function method is an efficient tool recently used in decision-making processes concerning environmental management. It is based on finding the relation between the origin of an environmental charge, and its impact on human health and the environment. The aim of the present investigation was to assess the positive impacts, also called benefits, of changes in environmental quality, and the economic viability of an industrial project on reduction of PCDD/F emissions. It has been developed with monetary criteria of two worldwide ambits: USA and European-Union countries. METHODS: The current study is a continuation of a previous investigation in which Substance Flow Analysis and Control Analysis Techniques were used to identify and to analyze all main flow values of PCDD/Fs inside the system of Tarragona Province (Spain). In the present study, Cost-Benefit Analysis (CBA) has been employed. The benefits derived from a minimization in the incidence of cancer due to a reduction in the emission of PCDD/Fs have been evaluated considering the value of a statistically saved life (VSL). Statistical analysis about uncertainty has also been incorporated. Here, the Monte Carlo simulation technique has been used. RESULTS: It is shown that CBS results depend firstly on the kind of VSL used. In fact, the differences between the decisions as a result of applying monetary criteria in USA and EU can be explained by differences between VSL values. CONCLUSION AND RECOMMENDATION: It is concluded that, for prices estimated in Euros, the emission cleaning project in the industrial plant is not feasible under any circumstance. However, although CBA seems to be a good analytical method, the final decision corresponds to the managers, who must weigh up not only the monetary criteria, but factors such as social questions.