The Economic Burden of Exposure to Secondhand Smoke for Child and Adult Never Smokers Residing in US Public Housing
The Economic Burden of Exposure to Secondhand Smoke for Child and Adult Never Smokers Residing in US Public Housing
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DOI：
10.1177/003335491513000310
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发表时间：
2015-05-01
影响因子：
3.3
通讯作者：
Brown, Mary Jean
中科院分区：
文献类型：
--
作者：
Mason, Jacquelyn;Wheeler, William;Brown, Mary Jean
目标。世界卫生组织(WHO)报告称，不吸烟的人在家中暴露于二手烟(SHS)会导致疾病和死亡。我们估计了美国公共住房中SHS暴露给社会带来的总超额负担和成本。我们使用(1)世卫组织推荐的健康结果和方法，(2)公开可用的和其他大型数据库，以及(3)公布的发病率和死亡率估计，量化了与美国公共住房中具有全国代表性的不吸烟居民的SHS暴露因果相关的结果的公共健康负担。我们使用已发表的对直接医疗和非医疗保健成本以及生产力损失价值的估计来估计与SHS相关的疾病和死亡的社会成本。我们估计了两种血清可替宁检测下限(LODS)对公众健康和经济造成的负担：每毫升0.05ng和0.015 ng/ml。2011年，估计有37,791名从不吸烟的儿童和成年美国公共住房居民因在家中暴露于SHS而患病和死亡，这是根据LOD=0.05 ng/mL计算的(50,967名居民在LOD=0.015 ng/mL时)。这些疾病和死亡每年造成的社会成本总计为1.83亿美元(LOD=0.05 ng/毫升)和2.67亿美元(LOD=0.015 ng/毫升)。在总成本中，当LOD0.05 ng/mL和0.015 ng/mL时，直接成本(医疗和非医疗成本)分别为1.28亿美元和1.76亿美元。医疗保健占直接成本的大部分--在LOD=0.05ng/mL时为1.1亿美元，在LOD值=0.015 ng/mL时为1.53亿美元。不良的呼吸系统健康后果约占总社会成本的一半(LOD=0.05时为56%，LOD=0.015 ng/mL时为52%)。在美国所有公共住房实施无烟政策可以挽救生命，降低不吸烟居民中与SHS相关的发病率和死亡率，在LOD=0.05ng/mL时，每年可节省1.83亿美元，在LOD值=0.015 ng/mL时，每年可节省2.67亿美元。
Objective. The World Health Organization (WHO) reports that nonsmokers experience disease and death due to secondhand smoke (SHS) exposure in the home. We estimated the total excess burden and costs to society due to SHS exposure in U.S. public housing.Methods. We quantified the public health burden for outcomes causally related to SHS exposure for nationally representative never-smoking residents in U.S. public housing using (1) WHO-recommended health outcomes and methodology, (2) publicly available and other large databases, and (3) published estimates of morbidity and mortality rates. We used published estimates of direct medical and nonmedical care costs and the value of productivity losses to estimate SHS-related societal costs for disease and death. We estimated the public health and economic burden for two serum cotinine limits of detection (LODs): 0.05 nanograms per milliliter (ng/mL) and 0.015 ng/mL.Results. In 2011, an estimated 37,791 never-smoking child and adult U.S. public housing residents experienced illness and death due to SHS exposure at home based on an LOD=0.05 ng/mL (50,967 residents at LOD=0.015 ng/mL). Costs incurred by society for these illnesses and deaths totaled $183 million (LOD=0.05 ng/mL) and $267 million (LOD=0.015 ng/mL) annually. Of the total costs, direct costs (medical and nonmedical) accounted for $128 million and $176 million for LOD=0.05 ng/mL and LOD=0.015 ng/mL, respectively. Medical care accounted for the majority of direct costs-$110 million at LOD=0.05 ng/mL and $153 million at LOD=0.015 ng/mL. Adverse respiratory health outcomes accounted for approximately one-half (56% at LOD=0.05 ng/mL and 52% at LOD=0.015 ng/mL) of total societal costs.Conclusion. Implementing smoke-free policies in all U.S. public housing could save lives and decrease SHS-related morbidity and mortality in never-smoking residents, resulting in annual societal savings of $183 million at LOD=0.05 ng/mL and $267 million at LOD=0.015 ng/mL.