economic valuation of health concerns in north chennai using a comparative risk assessment framework...
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Economic valuation of health concerns in North Chennai using a Comparative risk assessment
framework
Sri Ramachandra Medical College & Research Institute
Chennai
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.
Specific ObjectivesTo quantify population exposures to select air and water
pollutants.
To estimate health risks using dose – response information established specifically for developing countries.
To collect primary data on the prevalence of respiratory, gastro-intestinal and vector-borne diseases within the resident population of the study zone.
To 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.
Specific Objectives
To compare the health and economic risks associated with each environmental problem and rank them accordingly.
To strengthen institutional capacity for CRA analyses through administration of training.
To 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.
List of Environmental Concerns
Air Particulates (Total / Respirable)Indoor air pollutants (From use of biomass
fuels) SOXNOXLeadOzone
List of Environmental Concerns
Water Microbial contamination Heavy metals
Solid waste Access to sanitation Proximity to solid waste dump sites
MethodologySources
Emissions/Discharges
Ambient Concentrations
Doses of pollutants
Health Effects
Control Technologies
Fate & Transport
Locations & patterns of activity
Dose-Response relationships
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
Suspended Particulate Matter for Thiruvottiyur area during the
years 1991-1997
0.0050.00
100.00150.00200.00250.00300.00350.00400.00450.00500.00
Locations
Co
nce
ntr
atio
ns
Max Min Ave
NOx values for Thiruvottiyur area during the years 1991-1997
0.00
50.00
100.00
150.00
200.00
250.00
300.00
350.00
Location
Co
nce
ntr
atio
n
Max Min Ave
SO2 values for Thiruvottiyur area during the years 1991-1997
0.00
20.00
40.00
60.00
80.00
100.00
120.00
140.00
Thiruv
ottiy
ur
Ernav
oor
Satha
ngad
u
Burm
a Col
ony
CISF
Qrts
Saday
anku
ppam
Locations
Co
nc
en
tra
tio
n
Max Min Ave
Hydrocarbon values in Thiruvottiyur area during the years 1991-
1997
0
24
68
10
1214
1618
20
Thiruvottiyur Ernavoor
Locations
Co
nc
en
tra
tion
Max Min Ave
0
200
400
600
800
1000
1200
1400
Respirable Paticulates
(ug/m3)
Wood(38) LPG(12) Kerosene-pump
stove(24)
Kerosene-wickstove(12)
Type of fuel
IAQ Monitoring Results
While cooking
24 hours
Population Exposure Distribution for PM 10
05
101520253035404550
0-20 20-40 40-60 60-80 80-100
100-120
120-140
140-160
160-180
180-200
200-220
PM10 (ug/m3)
%P
op
ula
tio
n
Cumulative Population exposure distribution
0%
20%
40%
60%
80%
100%
120%
40-60 60-80 80-100 100-120
120-140
140-160
160-180
180-200
200-220
RSPM (ug/m3)
Cum
ulat
ive
(%)
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
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
Health End point Unit costs(Rs)Total costs(in
lakhs of rupees)
Pre mature deaths 393,879 797.41Respiratory 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
Comparison of economic estimates
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
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%
Blood lead levels in children under 12
<10 10-20 20-30 30-40 >40 0%
10%20%30%40%50%60%70%80%90%
100%%population
Concentration of lead (ug/dL)
Mean 20.1ug/dL
Blood lead levels in adults
<10 10-20 20-30 30-40 >40 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
%population
Concentration of lead (ug/dL)
Mean 16.5 ug/dL
Risks from lead
Loss of IQ points 2 points/child
Reduction in infant mortality 4.5deaths/year
Reduction in Blood pressureMen 2.6 - 3.2 mm HgWomen 1.6 - 1.8 mm HgCardiovascular illnessHeart Attacks 114/yearStrokes 14/yearPremature deaths 110/year
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/-)
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
Assessment of costs from Household Data(Air related)
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(Water Related)
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(Solid waste Related)
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
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
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.
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.!!