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Sri Ramachandra Medical College & Research Institute Chennai

Economic valuation of health concerns in North Chennai using a Comparative risk assessment framework. Sri Ramachandra Medical College & Research Institute Chennai. Overall Aim.

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Sri Ramachandra Medical College & Research Institute Chennai

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  1. Economic valuation of health concerns in North Chennai using a Comparative risk assessment framework Sri Ramachandra Medical College & Research Institute Chennai

  2. Overall Aim To use the comparative risk assessment framework to quantify and rank environmental health risks faced by an industrial municipal zone in North Chennai.

  3. Specific Objectives vTo quantify population exposures to select air and water pollutants. vTo estimate health risks using dose – response information established specifically for developing countries. vTo collect primary data on the prevalence of respiratory, gastro-intestinal and vector-borne diseases within the resident population of the study zone. vTo assess economic costs of the health damage through collection of local information on costs of hospital visits, treatment and work-loss days specifically attributable to environmental exposures.

  4. Specific Objectives vTo compare the health and economic risks associated with each environmental problem and rank them accordingly. vTo strengthen institutional capacity for CRA analyses through administration of training. vTo provide the framework for the design of an environmental management plan for the zone based on the heath risk assessment, the economic costs and community perceptions.

  5. List of Environmental Concerns • Air • Particulates (Total / Respirable) • Indoor air pollutants (From use of biomass fuels) • SOX • NOX • Lead • Ozone

  6. List of Environmental Concerns • Water • Microbial contamination • Heavy metals • Solid waste • Access to sanitation • Proximity to solid waste dump sites

  7. Methodology Sources Control Technologies Emissions/Discharges Fate & Transport Ambient Concentrations Locations & patterns of activity Doses of pollutants Dose-Response relationships Health Effects

  8. Methodology • Predictive • Use dose- response information established in previous studies • Value using local economic information • Observational • Use Cross- sectional Epidemiological (recorded/reported) information to establish point prevalence • Value using locally recorded/reported costs

  9. PMD=0.00112*(PM10-41)*Population*0.0076 RHD=1.2*(PM10-41)*Population/100000 ERV=23.54*(PM10-41)*Population/100000 RAD*1000=0.0575*(PM10-41)*Population/1000 RSD*1000=0.183*(PM10-41)*Population/1000 COPD=6.12*(PM10-41)*Population/100000 LRI in children=0.00169*0.4*(PM10-41)*Population Asthma=0.0326*0.07*(PM10-41)*Population Dose response functions

  10. Health End point Impact on study population(211100) Pre mature deaths 202.45 Respiratory hospital admissions 285.41 ERV 5598.8 RAD/1000 1367.59 RSD/1000 4352.51 COPD 1455.59 LRI in Children 16,078.13 Asthma 54275.58

  11. Health End point Unit costs(Rs) Total costs(in lakhs of rupees) Pre mature deaths 393,879 797.41 Respiratory hospital admisssions 1713.5 4.89 ERV 228.3 12.78 RAD 41.2 563.45 RSD 20 870.50 COPD 69997 1018.87 LRI in Children 346 55.63 Asthma 200 108.55 Rs. 3432.08 Lakhs

  12. Study zone(NAAQ Data) Rs.865/person Study zone (Using both NAAQ and primary sampling data) Rs.1626/person Chennai (NAAQ Data-W. Bank estimates) Rs275/person Bombay Average (NAAQ Data-W. Bank estimates) Rs.734/person Bombay(URBAIR, W. Bank) Rs.1840/person Comparison of economic estimates

  13. Risks from gases released during biofuel combustion Percent of homes exceeding WHO Short – term guide lines wile cooking CO SO2 NO2 Wood 67% 21% 19% Wood + Kerosene 54% 16% 17%

  14. Blood lead levels in children under 12

  15. Blood lead levels in adults

  16. Risks from lead Loss of IQ points 2 points/child Reduction in infant mortality 4.5deaths/year Reduction in Blood pressure Men 2.6 - 3.2 mm Hg Women 1.6 - 1.8 mm Hg Cardiovascular illness Heart Attacks 114/year Strokes 14/year Premature deaths 110/year

  17. Economic valuation for risks from lead Loss of IQ points Rs. 373 lakhs (Using a cost $1248/child for an IQ loss of 2 points and a Per capita GNP ratio of .0133) Premature deaths Rs.433.26 lakhs (VSL Rs.393,879/-)

  18. Comparison of risks between air/water/solid waste(%prevalence of symptoms) Respiratory Gastrointestinal Vector-borne Thangal 11.4 16.06 8.31 Ernavoor 12.7 16.59 7.46 Sathangadu 8.6 9.49 5.47 Kuppam 19.8 19.07 5.00 Thiruvottiyur 14.2 14.6 7.8

  19. Direct Per capita Health Expenditure(Rs) Income loss (WLD)(Rs.) Per capita costs borne by the Municipality(Rs.) Total Per capita Costs(Rs.) Total costs Thangal 441.48 194.10 6.17 641.75 28878709 Ernavoor 365.64 555.89 6.17 927.70 46385040 Sathangadu 122.88 442.39 6.17 571.44 28571950 Kuppam 467.16 706.86 6.17 1180.19 46027410 Thiruvottiyur 266.52 295.02 6.17 567.71 15384951 Rs.1652.48Lakhs PMD  Rs. 797.41 Lakhs TOTAL  Rs.2449.89 Lakhs Assessment of costs from Household Data(Air related)

  20. Direct Per capita Health Expenditure(Rs) Income loss (WLD)(Rs.) Per capita costs borne by the Municipality(Rs.) Total Per capita Costs(Rs.) Total costs Thangal 482.64 459.84 12.18 954.65 42959128 Ernavoor 1138.56 835.30 12.18 1986.03 99301540 Sathangadu 318.6 492.58 12.18 823.35 41167450 Kuppam 122.04 376.3 12.18 510.51 19909851 Thiruvottiyur 546.48 345.34 12.18 903.99 24498110 Rs.2278.36Lakhs Defensive Expenditure Rs. 85.42 Lakhs TOTAL  Rs.2363.42 Lakhs Assessment of costs from Household Data(Water Related)

  21. Direct Per capita Health Expenditure(Rs) Income loss (WLD)(Rs.) Per capita costs borne by the Municipality(Rs.) Total Per capita Costs(Rs.) Total costs Thangal 120 183.69 54.6 358.29 16123050 Ernavoor 174.6 955.89 54.6 1185.09 59254500 Sathangadu 30.72 301.14 54.6 386.46 19323000 Kuppam 102.00 856.55 54.6 1033.19 39512772 Thiruvottiyur 100.08 482.51 54.6 637.19 17267849 Rs.1514.81Lakhs Defensive Expenditure Rs. 243.13 Lakhs TOTAL  Rs.1757.94 Lakhs Assessment of costs from Household Data(Solid waste Related)

  22. Comparison of costs (other than PMD) from risks related to air, water and solid waste (Lakhs of Rupees) Treatment Wage loss Defensive Total Air 710 942.00 1652 Water 1167 1111 85.42 2363 Solid waste 1175 338 243 1757

  23. Conclusions • The study has been able to document population exposures to particulate matter(PM10) including indoor sources. • Risks from PM10 are the greatest followed by lead. • Risks from CO are likely to be high in homes using biofuels. • Risks from air concerns are however outweighed by water concerns.

  24. Conclusions ( continued) • Data collected thus far would allow the generation of an emissions inventory and thereby the assessment of source attribution. • The study has been done with significant stakeholder participation and therefore has great potential to be used in the design of an EMP for the zone. • The study has allowed identification of areas where the largest data gaps in exposure assessment are likely to be and therefore future studies in the city could perhaps be executed with less uncertainties.!!

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