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

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.

An integrated framework for multipollutant air quality management and its application in Georgia.

Air protection agencies in the United States increasingly confront non-attainment of air quality standards for multiple pollutants sharing interrelated emission origins. Traditional approaches to attainment planning face important limitations that are magnified in the multipollutant context. Recognizing those limitations, the Georgia Environmental Protection Division has adopted an integrated framework to address ozone, fine particulate matter, and regional haze in the state. Rather than applying atmospheric modeling merely as a final check of an overall strategy, photochemical sensitivity analysis is conducted upfront to compare the effectiveness of controlling various precursor emission species and source regions. Emerging software enables the modeling of health benefits and associated economic valuations resulting from air pollution control. Photochemical sensitivity and health benefits analyses, applied together with traditional cost and feasibility assessments, provide a more comprehensive characterization of the implications of various control options. The fuller characterization both informs the selection of control options and facilitates the communication of impacts to affected stakeholders and the public. Although the integrated framework represents a clear improvement over previous attainment-planning efforts, key remaining shortcomings are also discussed.

The health benefits of reduced tropospheric ozone in California.

Californians are exposed daily to concentrations of ozone (O3) that are among the highest in the United States. Recently, the state adopted a new 8-hr ambient standard of 0.070 ppm, more stringent than the current federal standard. The new standard is based on controlled human studies and on dozens of epidemiologic studies reporting associations between O3 at current ambient levels and a wide range of adverse health outcomes. Clearly, the new O3 standards will require further reductions in the precursor pollutants and additional expenditures for pollution control. Therefore, it is important to quantify the incremental health benefits of moving from current conditions to the new California standard. In this paper, a standard methodology is applied to quantify the health benefits associated with O3 concentration reductions in California. O3 concentration reductions are estimated using ambient monitoring data and a proportional rollback approach in which changes are specific to each air basin, and control strategies may impact concentrations both below and above the standard. Health impacts are based on published epidemiologic studies, including O3-related mortality and morbidity, and economic values are assigned to these outcomes based on willingness-to-pay and cost-of-illness studies. Central estimates of this research indicate that attaining the California 8-hr standard, relative to current concentrations, would result in annual reductions of 630 cases of premature mortality, 4200 respiratory hospital admissions, 660 pediatric emergency room visits for asthma, 4.7 million days of school loss, and 3.1 million minor restricted activity days, with a median estimated economic value of dollar 4.5 billion. Sensitivity analyses indicate that these findings are robust with respect to exposure assessment methods but are influenced by assumptions about the slope of the concentration-response function in threshold models and the magnitude of the O3-mortality relationship. Although uncertainties exist for several components of the methodology, these results indicate that the benefits of reducing O3 to the California standard may be substantial and that further research on the shape of the O3-mortality concentration-response function and economic value of O3-related mortality would best reduce these uncertainties.

An ex post cost-benefit analysis of the nitrogen dioxide air pollution control program in Tokyo.

The benefits and costs of past nitrogen dioxide (NO2) control policies were calculated for Tokyo, Japan, using environmental, economic, political, demographic, and medical data from 1973 to 1994. The benefits of NO2 control were estimated as medical expenses and lost work time due to hypothetical no-control air concentrations of NO2. Direct costs were calculated as annualized capital expenditures and 1 year's operating costs for regulated industries plus governmental agency expenses. The major findings were as follows: (1) Using Tokyo's average medical cost of pollution-related illness, the best net estimate of the avoided medical costs due to incidence of phlegm and sputum in adults was 730 billion yen ($6.08 billion; 1 U.S. dollar = 120 yen). (2) The best net estimate of the avoided medical costs due to incidence of lower respiratory illness in children was 93 billion yen ($775 million). (3) Using Tokyo's average duration of pollution-related illness and average wages, the best net estimate of the avoided costs of lost wages in workers was 760 billion yen ($6.33 billion). (4) The best net estimate of the avoided costs of lost wages in mothers caring for their sick children was 100 billion yen ($833 million). (5) Using Tokyo-specific data, the best net costs were estimated as 280 billion yen ($2.33 billion). (6) Using human health and productivity benefits, and annualized capital cost and operating cost estimates, the best net benefits-to-costs ratio was 6:1 (upper limit 44:1; lower limit 0.3:1). Benefit calculations were sensitive to assumptions of mobile source emissions and certain health impacts that were not included. Cost calculations were highly dependent on assumptions of flue gas volume and fuel use. For comparative purposes, we identified other studies for air pollution-related illness. Assumptions that formed the basis for most of the inputs in the present study, such as duration of illness, medical treatment costs, per person illness in children, and lost wages for working mothers, were similar to those recommended in the literature. Lost wages in sick workers and per capita illness incidence in adults were higher than numbers reported elsewhere. Further advances in cost-benefit analysis (CBA) procedures to evaluate the economic effectiveness of NO2 controls in Tokyo are recommended to estimate impacts and values for additional human health benefits, ecosystem health and productivity effects, and nonliving system effects, as well as benefits of ancillary reductions in other pollutants. The present study suggests that Tokyo's past NO2 control policies in total were economically quite effective.