Degrees and dollars - Health costs associated with suboptimal ambient temperature exposure.
Degrees and dollars - Health costs associated with suboptimal ambient temperature exposure.
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度和美元 - 与次优环境温度暴露相关的健康成本。
DOI：
10.1016/j.scitotenv.2019.04.398
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Convertino,Matteo
中科院分区：
文献类型：
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作者：
Liu,Yang;Saha,Shubhayu;Hoppe,BrendalynnO;Convertino,Matteo
暴露在次优环境温度下会严重影响公众健康。之前的研究主要集中在风险评估上，很少从经济角度来考察健康结果。为了为环境健康政策提供信息，我们估计了明尼阿波利斯/圣路易斯地区与次优温度相关的健康结果的经济成本。圣保罗双城都会区。我们使用分布式滞后非线性模型来估计各种次优温度水平下死亡率、急诊科就诊和紧急住院治疗的归因分数/病例。分析按年龄组（即青年（0-19 岁）、成人（20-64 岁）和老年人（65 岁以上））进行分层。我们在经济成本评估中考虑了直接医疗成本和生产力损失。结果显示，年轻人有大量与温度相关的急诊就诊，而老年人则有大量与温度相关的死亡和紧急住院治疗。暴露在极低温和高温下每年会造成 27 亿美元的经济损失 [95% 经验置信区间 (eCI)：19.1 亿美元、34.8 亿美元]（成本均基于 2016 年美元价值）。中度、极低温和高温导致 94 亿美元[eCI：60.5 亿美元、125.7 亿美元]经济成本。大部分经济成本始终归因于寒冷（> 75％），而不是高温暴露，以及死亡率（> 95％），而不是发病率。我们的研究结果支持优先考虑与温度相关的健康干预措施，旨在通过针对老年人来最大限度地降低经济成本，并通过针对青少年来减少可归因的病例。
Suboptimal ambient temperature exposure significantly affects public health. Previous studies have primarily focused on risk assessment, with few examining the health outcomes from an economic perspective. To inform environmental health policies, we estimated the economic costs of health outcomes associated with suboptimal temperature in the Minneapolis/St. Paul Twin Cities Metropolitan Area.We used a distributed lag nonlinear model to estimate attributable fractions/cases for mortality, emergency department visits, and emergency hospitalizations at various suboptimal temperature levels. The analyses were stratified by age group (i.e., youth (0–19 years), adult (20–64 years), and senior (65+ years)). We considered both direct medical costs and loss of productivity during economic cost assessment.Results show that youth have a large number of temperature-related emergency department visits, while seniors have large numbers of temperature-related mortality and emergency hospitalizations. Exposures to extremely low and high temperatures lead to $2.70 billion [95% empirical confidence interval (eCI): $1.91 billion, $3.48 billion] (costs are all based on 2016 USD value) economic costs annually. Moderately and extremely low and high temperature leads to $9.40 billion [eCI: $6.05 billion, $12.57 billion] economic costs. The majority of the economic costs are consistently attributed to cold (>75%), rather than heat exposures and to mortality (>95%), rather than morbidity. Our findings support prioritizing temperature-related health interventions designed to minimize the economic costs by targeting seniors and to reduce attributable cases by targeting youth.